Mental health billing services, from the session to paid.

They cover the whole path from a session to the payment. That means verifying each patient's mental health benefits, checking every code before the claim goes and sending claims. It also means following each claim until the payer decides, posting payments from the EOB, working denials and appeals, filing authorizations and billing patients for what is left. The whole cycle is on our RCM services page.

Therapy billing starts with the patient's plan: active or not, in network or out, the copay or coinsurance, and any session limit or authorization rule. After the session, your clinician picks the code, which for psychotherapy depends on the minutes spent with the patient. The claim goes to the payer that covers mental health care. The payer decides and pays its share, and the patient owes the rest.

The main ones go by time with the patient: 90832 for 16 to 37 minutes, 90834 for 38 to 52 minutes and 90837 for 53 minutes or more. Medicare's guidance says not to bill a psychotherapy code for a session under 16 minutes. Diagnostic evaluations are 90791 and 90792, family therapy is 90846 and 90847, group therapy is 90853, and 90785 is an add-on for interactive complexity.

Yes. Our psychiatry billing services cover evaluations, E/M visits and therapy given in the same visit as an E/M service. Valian checks every code against the code books and the payer's rules, and that a diagnosis supports each line. Your psychiatrist picks every code, and Valian never changes one to get a claim paid.

It is when a health plan hands its mental health benefits to a separate company, often called a managed behavioral health organization, with its own network and rules. A claim sent to the plan on the medical card can come back with a note to send it to the correct payer. The separate company may also want its own authorization. Valian's check shows what the plan sends, and our team calls the payer when it is unclear who pays.

Often, yes, but each plan sets its own rules. Medicare covers mental health telehealth at home permanently. The claim carries place of service 10 when the patient was at home and 02 when they were somewhere else, plus the modifier the payer wants. From January 1, 2028, Medicare also wants an in-person visit within 6 months before a patient's first telehealth session at home. After that, it wants at least one every 12 months, with some exceptions.

Yes, since January 1, 2024. Marriage and family therapists and mental health counselors can enroll in Medicare and bill it directly, and addiction counselors who meet the counselor rules can enroll as mental health counselors. They must accept assignment, which means taking Medicare's approved amount as full payment. Once a clinician is enrolled, Valian sends their claims like any other clinician's.

Yes. When your practice is out of network with a patient's plan, the benefits check shows what the plan pays out of network, such as its deductible and coinsurance, before the first session. Valian can send the claim to the plan for the patient. Some practices give the patient a superbill instead, with the codes, the diagnosis and the provider's details, so the patient can ask the plan to pay them back.

Our team files them. When a plan wants an authorization for ongoing therapy, testing or another service, your staff asks for one from the patient's verification page. Our team files it with the notes, from your practice's own fax number, and follows up until the payer decides. The approval number is kept on the visits it covers, so it is on hand for every claim.

Yes, some plans cap sessions or ask for an authorization after a set number. Federal parity law bars individual plans and employer plans with more than 50 workers that cover mental health care from limiting it more strictly than they limit medical care. Valian's check shows any limit the plan sends, and our team calls the payer when a limit or an authorization is in question.

Often for reasons that are easy to miss. The note's minutes do not support the code. The claim went to the medical plan when a separate company pays for mental health care. An authorization is missing, or the sessions ran past the number approved. A telehealth line has the wrong place of service. Valian shows each denial's reason in plain words with its fix, sends a corrected claim when one is needed, and our team writes and files the appeals.

No. HIPAA gives extra protection to psychotherapy notes kept apart from the rest of the record. It also says session start and stop times, the diagnosis, the treatment plan and a summary of progress are not part of those notes. Claims are built from those billing details, not from the clinician's private notes. A Business Associate Agreement is signed before any patient data moves.

No. Valian does not do payer credentialing, the work of getting a clinician into a plan's network. Once your clinicians are in network, or billing out of network, we handle what comes after: benefits checks, claims, follow-up, posting, denials and appeals. We also file the claim sign-ups a payer needs before it accepts your electronic claims.

It varies. Many billing companies charge a share of what they collect, and others charge per claim or by the month. Valian sets your price with you after the discovery call, based on how many claims you send and which parts of billing you want our team to run. Nothing is charged until you agree to it.

Start with a discovery call. Then the Business Associate Agreement and the billing agreement are signed, your session codes and fees go in, and we file the claim sign-ups your payers need. You keep your practice software. New sessions go through Valian from the day you start, and claims your old biller already sent finish where they are, so nothing goes out twice.