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Substance Abuse Rehab Billing Services

Swift Bizz’s Substance Abuse Medical Billing Services

Rehabilitation medical billing & coding, like that for any field of medicine is complicated and time-consuming, but it is vital to the success of any rehab or treatment facility. With insurers and government payers cutting down on their payments wherever they can and expenses rising, it is more important than ever to have efficient medical billing for rehab. Outsourcing rehabilitation medical billing services and claims management to professionals has proven to be the best solution for many treatment and rehab centers.

Rehab Centers Income Issues

The Affordable Care Act’s requirement for health insurance to cover mental health and substance abuse treatment (and not exclude pre-existing conditions) has given coverage to many people who need help, but it has also resulted in high deductibles, which are often a problem for addiction treatment center billing since most patients requiring treatment or rehab have lost their incomes.

Top Reasons to Outsource Substance Abuse Billing Company

High Ticket Losses

Substance abuse treatment takes a significant amount of time, which makes it costly. Since charges are generally bundled into codes that cover the entire program, or most of it, one unpaid claim can result in a loss of up to $30,000. This makes it imperative that rehab medical billing services be handled by professionals who have a system in place to ensure that no claims fall through the cracks.

Payments Sent To Patients

In many cases, when the rehab or treatment center is out of network for the payer, the payment ends up being sent to the patient instead of the service provider. The patient is, of course, responsible for paying the center’s bill, but this often doesn’t happen. This may even be used as leverage to get providers to join payers’ networks (and accept whatever fee they offer). The substance abuse billing system must ensure that an assignment of benefits is executed and attested to prior to accepting the patient.

Denial of Medical Necessity

Insurers have to cover treatment if it is medically necessary but may deny claims on the basis that medical necessity was not demonstrated if any of the necessary codings is not correctly included in the claim. This is another reason it is best to outsource drug rehabilitation centers insurance billing to a company that is dedicated only to rehab medical billing Revenue Cycle Management.

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