In healthcare, revenue generation is a crucial aspect but many practices don’t pay attention to their billing and coding, thus resulting in revenue leakage. When talking specifically about mental health practices, behavioral coding is often overlooked which weakens financial stability.
However, using some software can enable you to perform RCM and coding efficiently. These resources are built to automate and fasten tasks so that you can get rid of rejected claims.
So why do medical coding on your own when you can utilize software for all the operations? Here we will show you some top-rated behavioral coding software that will make your work easier.
Stick to the end to know everything about coding and what role software plays in medical billing.
What is Behavioral Coding?
Before learning anything, you must first be aware of what exactly the term behavioral coding means.
Mental health or behavioral coding is basically the process of translating health treatments into universal codes, creating claim applications, and filing these claims to the insurance payers to get reimbursement.
From an insurance payer’s point of view, a claim is a document in which codes for behavioral services are mentioned. They then translate these codes into services and find out how much insurance is to be paid for each individual patient.
Overall, this is a crucial part of RCM as coding directly impacts whether the claim will be accepted or not. That’s why we push you to use coding software to maintain accuracy.
Common Medical Coding Challenges
Above all, why exactly do you need software? Well, this is a concerning question for many healthcare providers because you might think: are coding issues worth solving through software?
Let’s have a look at these problems and identify why it needs to be solved.
Time-consuming
Manual coding takes a lot of human time. Whether you are a big mental health facility or a small practice, there may be hundreds of claims a day. When a person conducts coding, it would take hours to create claims, add codes, review them, and submit them either manually or electronically.
You might be okay with this process. But if you look closely, having software would reduce the time your staff takes for claim preparation and coding. Since the software can translate code and file claims automatically, why use manual resources to extend duration?
Coding Data Management Issues
A lot of patients get behavioral health treatments within a day. Handling all their services coding, applications, and billing data is a headache.
Additionally, where basic healthcare systems are able to store data, they may compromise on productivity if systems don’t work as fast as they should.
Incorrect Coding
One alarming thing for every healthcare facility is that due to incorrect behavioral coding, insurance payers reject the claim and thus revenue is lost. Losing your deserving money is painful right?
Learning Insurance Billing is Another Crucial Thing for Your Facility
When working on extensive coding in a day, a mess happens and it results in a number of coding issues. Common mistakes include wrong code mentioned, duplicate coding, coding for the treatments patients didn’t receive, and coding for insurance non-covered services.
Training Requirements
Not all healthcare facilities have proficient staff that learn the ropes quickly. Many times due to new hiring they are unable to perform well and thus mistakes happen during coding. Even old staff isn’t able to catch up with the coding trends and updates. They accidentally use deleted codes which results in claim denial.
That’s why many practices conduct yearly training sessions for their staff to make them experts in handling coding. But let us tell you that these sessions may cost up to $5000 per year.
So would you like to spend this amount every year on just letting your staff learn coding or saving these costs by having only coding software?
Compliance Issues
Another very crucial aspect during billing is to comply with healthcare regulations like HIPAA. This states that patient data needs to be protected at all costs. But old-fashioned software is easily accessible by hackers.
This way you are at risk all the time just because any time data breaches may happen and HIPAA will get you to face legal consequences for losing sensitive patient data.
Behavioral Coding Software To Utilize In Your Facility
If you want a hurdle-free billing and coding process in your practice then hold on. We have listed the top healthcare behavioral coding software you can use in your facility. All these resources are top-rated and highly used by other practices.
Have a look at them and find out the most suitable for your needs:
EncoderPro by AAPC
Best for: Comprehensive coding, E/M coding, risk adjustment coding, educational resources
Overview: EncoderPro comes with built-in features for a variety of coding tasks, a searchable database of codes, and educational resources to keep up with the latest coding standards. It’s a flexible tool for various coding-related healthcare professionals.
CCI Edit by Optum
Best for: Ensuring coding compliance with Medicare Correct Coding Initiative edits
Overview: By comparing codes to the most recent Medicare CCI edits, CCI Edit assists in identifying possible behavioral coding errors, minimizing claim denials and revenue loss. It emphasizes precision and adherence to Medicare rules.
LCD Navigator by 3M
Best for: Staying informed about Medicare Local Coverage Determinations
Overview: In order to ensure accurate billing in accordance with Medicare guidelines, LCD Navigator offers a web-based tool for searching for LCDs and viewing the most recent information on coverage criteria. It assists users in staying informed about the services that Medicare covers.
As a Small Practice Consider These Billing Services
PCS by TruCode
Best for: Coding compliance, accurate coding, latest guidelines adherence
Overview: PCS was created to guarantee precise coding in accordance with the most recent standards. Like EncoderPro, it provides a searchable database of codes and features for different coding tasks, but it also prioritizes healthcare compliance.
Intergy by Waystar
Best for: Comprehensive revenue cycle management with coding automation
Overview: Intergy is a more comprehensive solution that covers coding as well as the whole revenue cycle. It expedites the submission of claims, increases behavioral coding accuracy, and automates coding procedures. For facilities looking for a single platform for revenue cycle management, this is perfect.
AvaTran by AvaTran
Best for: Automating coding using natural language processing (NLP)
Overview: AvaTran analyzes clinical documentation and physician notes using natural language processing (NLP) technology to automate billing and coding tasks. For those who are accustomed to using NLP-assisted coding, this can reduce coding time and increase accuracy.
CodeCorrect by MDP
Best for: Coding compliance with real-time feedback and audits
Overview: CodeCorrect is a coding compliance tool similar to CCI Edit, but it has more features. It provides features for different coding tasks, a searchable code database, and real-time coding audits with feedback to increase coding accuracy.
How To Choose A Coding Software According To Your Needs
At last, you will have to select the most suitable software for your facility. Since your revenue depends on this decision, you must ensure some considerations before buying a program.
Coding Requirements
Identify specific behavioral coding tasks you want assistance with. Whether you need to conduct coding for diagnosis or procedure or for both, and in CPT, HCPCS, or ICD-10-CM format.
Integration Capabilities
Make sure they are able to integrate with your facility’s existing software like EHRs. This will help in prompt data flow and productive data utilization.
User Interface
Before paying, use a free trial of the software to test their interface. It must be easy to use otherwise your staff would be confused all the time about how to perform specific coding tasks.
Besides, you must also provide some basic level training to your staff so that they can make the most out of this software.
Compliance and Security
Only buy software that prioritizes regulation compliance and data security over anything. They must follow HIPAA regulations as well as have strong data safety protocols. Look for features like audit trails and role-based access control to maximize controllability.
Cost Considerations
Last but not least, cost should also be considered even after having a transparent fee structure at hand. Ask for any upfront costs, ongoing licensing fees, and regular maintenance expenses.
We advise you to compare the cost of each software to find out which one seems fit to your budget and whether it would benefit your facility in the long run.
Elevate Your Mental Health Practice
In this era of modern RCM and coding applications, having outdated systems is a big red flag for your mental health facility. Where generating revenue has become a challenge, there are many software available to give you the deserving profits.
So from the above information and behavioral coding software list, do a favor to your facility and give it an upgrade by having this resource.
You will be amazed at how much revenue you are saving and getting in return after implementing coding software.