RCM Services
Credentialing, intake, billing, denials, A/R follow-up — handled by a team that has done it for behavioral health for a decade. You get the platform’s data and your billing team’s accountability, without the hiring headache.
Average clean claim rate across managed-services clients
Days in A/R for clients on full-service
Average BH operator tenure on the team
Recognized · Compliant · Trusted
SHORTLIST 2024
FRONT RUNNER
HIGH PERFORMER
COMPLIANT
CEDARWOOD NORTHPATH RIVERSTONE SAGEBROOK HARBORLINE KINDRED
People, not portals
When something blows up at 4 PM on a Friday — a payer rule changed, a clearinghouse threw a new rejection, a patient ran out of authorized sessions — you’ll talk to a person who has fixed it before. Not a ticket queue.
You'll know who handles your billing — not a pool.
Most billing questions resolved within hours.
SUD, IOP, MH plan limits — not generic medical.
The exact KPIs you'd want from an in-house team.
What we run
Pick the layer you need, or run the full stack. We staff to your volume and operate to your KPIs.
End-to-end credentialing: CAQH setup, payer applications, follow-up, re-credentialing calendar, and roster management.
The fastest way to leave money on the table is to bill out-of-network when you could be in-network — or to lapse on re-cred.
BH-specific payer playbooks (commercial + Medicaid), and a re-cred calendar your CFO can audit.
Real-time eligibility at intake plus re-verification at any treatment-plan escalation. Behavioral-health plan limits, session caps, and auth rules surfaced before they become denials.
Most denials trace back to eligibility or auth. Catching them upfront is the cheapest revenue you'll ever recover.
BH-specific eligibility checks — partial-hospitalization caps, IOP frequency limits, COB rules — not generic medical.
Charge capture and CPT/ICD-10 coding with BH-specific rule sets, including modifier and POS validation before submission.
Generic medical coding misses behavioral-health patterns — bundling rules, level-of-care logic, group vs individual. Mistakes here trigger downstream denials.
Coding QA built on a decade of behavioral-health denial data, with monthly accuracy review.
BH-aware scrubbing rules catch CPT/ICD-10 mismatches, modifier errors, and POS issues before claims hit the clearinghouse.
Each pre-submission catch is a denial you didn't have to work. Multiply that across volume.
Scrubbing rule library purpose-built from BH denial patterns — auto-updated as payer policy shifts.
Denial intake → playbook routing → appeal or correction → resubmit. Medicaid waterfalls, commercial appeals, and timely-filing edge cases all run through their own paths.
Most practices triage denials. We work them. The compounding difference shows up in aged A/R within one quarter.
Behavioral-health denial playbook library and a denials team that treats them as the primary KPI.
Aged-bucket triage with a recovery program that prioritizes the highest-value, most-collectible claims first.
Practices typically recover an additional 25–35% on aged A/R after we take it over — money that was already booked-but-uncollected.
Recovery economics math — we tell you which buckets are worth working and which aren't, before we touch them.
Patient statement, pay-online, payment plan setup, and respectful collection cadence handled by people trained on behavioral-health sensitivities.
Patient balances in BH are different — we treat them that way. Recovery without retraumatization.
BH-trained patient billing reps + payment-plan defaults that prioritize ongoing care.
Schedule a 30-minute working session. We’ll come prepared with what we’d do in your seat.
