CLAIMWISE BILLING
BEHAVIORAL HEALTH BENEFITS VERIFICATION
Every insurance policy is different - we verify patients' behavioral health benefits so that you can focus on providing care.
When you hire us, we take care of everything - including speaking to patients' insurance carriers to verify their benefits. The ClaimWise team helps your patients attain maximum coverage for vital services like drug and alcohol addiction treatment. We streamline the eligibility and benefits verification process for rehab centers, therapists, and other behavioral health providers.
Eligibility and Benefits Verification Details
During a verification of benefits (VOB), ClaimWise gathers all of the necessary information on behalf of your client. The client’s employer, whether the policy is fully or self-funded, whether they price according to a percentage of medicare rates or they contract their pricing out to a third-party like Multiplan, and more information is all made available to the provider through a simple phone call.
While this information is made available by law, insurance carriers aren’t necessarily forthcoming with it. Therefore, ClaimWise knows it's necessary to dig deeper and ask the right questions. Effective billing requires a wealth of information that only comes with time and experience, and this starts with a healthy and thorough verification of benefits.
Does the patient have active behavioral health benefits?
So, your patient has an insurance plan. But is it active?
Before anything else, we've got to determine whether your patient's behavioral health insurance benefits are active and therefore able to be utilized. ClaimWise will call the patient's insurance company on your behalf. From here, we've still got some digging to do!
​
​
What do your patient's benefits cover?
We've determined that your client has an active policy with coverage for behavioral health services. Now we're ready to see what their insurance is obligated to pay for.
​
Medical billing for mental health and substance abuse services is often provided at treatment facilities. If this is the case, the client might have different benefits and financial obligations at different levels of care, like inpatient treatment or outpatient programming.
Start providing your valuable care!
Now that we've verified your patient's eligibility and coverage, it's time for you to start providing the care you so love to give!
​
We make it easy for you to focus on providing the services to insurance members that they need to recover from substance use disorders and other co-occurring mental health conditions. From here on out, we'll take care of everything insurance-related so that you can focus on treating your patients.
More on Behavioral Health Eligibility and Benefits
Behavioral health treatment refers to everything from long-term stays in drug and alcohol addiction treatment centers to more basic weekly individual therapy services with mental health providers. All we need to begin your treatment process is the information on the front and back of the patient's insurance ID card, their name, and their date-of-birth.
​
Once we determine that a client has an active policy with coverage for behavioral health services, then we determine the specifics of their insurance plan. Medical billing for mental health and substance abuse services is often provided at treatment facilities. If this is the case, the client might have different benefits and financial obligations at different levels of care, whether that is inpatient or outpatient.
Though the client might have a health insurance policy through one insurance carrier such as their local Blue Cross Blue Shield, that carrier might carve-out the plan’s behavioral health benefits to another carrier such as Beacon Health Options. These factors can affect what address or payer ID is used to bill claims, what vendor the payment comes from and in what form, and what phone number is necessary to follow up on outstanding claims.
​
