Killer 01
Parity violations
Behavioral parity violations are often denied without challenge. We appeal them with payer-specific templates.
Billing built for behavioral health,
not bolted onto it.
Time-based therapy codes, parity rules, telehealth modifiers, and panels that close without warning. We work these files every day.
Aetnapaneled
BCBSpaneled
UnitedHealthcarepaneled
Cignapaneled
Humanapaneled
Kaiser Permanentepaneled
Tricarepaneled
Anthempaneled
Centenepaneled
Molinapaneled
Medicarepaneled
ElevancepaneledAetnapaneledBCBSpaneledUnitedHealthcarepaneledCignapaneledHumanapaneledKaiser PermanentepaneledTricarepaneledAnthempaneledCentenepaneledMolinapaneledMedicarepaneledElevancepaneledQuiet killers
Where mental health revenue leaks. Three patterns we audit on every onboarding and fix first.
Killer 02
Telehealth modifier mismatches
POS 02 vs 10, modifier 95, and audio-only rules create silent denial drift.
Killer 03
Closed panels
Behavioral panels open and close quickly. We track and file as windows open.
How we work
Mental health operations, built right.
A specialty pod that lives inside your workflow, not a call-center model. These are the controls we run on every claim from day one.
Mental health pod · operating playbookActive
01
Specialty-trained behavioral billing pod
✓02
Prior auth tracking by visit count with renewal alerts
✓03
Interactive complexity and crisis code capture where documentation supports it
✓04
Group and family therapy differentiation by payer rules
✓Reviewed quarterly · last update May 2026v2.6
Codes & modifiers
The mental health code family.
What we actively scrub on every claim. Coders in this pod work these codes daily with payer edits and documentation patterns mapped into weekly QA.
CPT/HCPCS reviewed quarterly · payer LCD/NCD subscriptions · CCI updates · claim-level audit logs.
90791
Diagnostic eval
90792
90832
90834
90837
60-min therapy
90847
Family therapy
90853
90833
90836
90838
90785
Interactive complexity
Credentialing
Panels we already work for mental health. Enrollment, revalidation, and CAQH upkeep included.
✓LCSW
✓LPC
✓LMFT
✓Psychologists
✓Psychiatrists
✓PMHNPs
✓Medicare Part B and major behavioral carve-outs
FAQ
Frequently asked.
Practical questions we get during diligence. Ask anything we missed.
Do you work with SimplePractice, TherapyNotes, and TheraNest?+
Yes. We work in all three plus most major behavioral systems.
Can you handle prior auths for testing and extended sessions?+
Yes. Psych testing and high-duration session auth workflows are standard.
Do you support Medicare enrollment for therapists?+
Yes. Including therapist pathways eligible under current Medicare rules.
Typical behavioral denial rate benchmark?+
Industry often sits at 8 to 12 percent. Our target is below 5 percent.
30-day review
A quick conversation, not a long form.
Six short questions. We use them to route your request to the right specialist and return a focused recommendation summary.
HIPAA-safe by default
We don't ask for PHI. Practice-level data only.
~ 90 seconds
Press Enter to continue. No long intake form.
Based on what you've told us...
We route your request to the billing pod that can move fastest.