Psychotherapy Claims Pre-Submission Review
Budget: $50 – $0 USD
I need an experienced behavioral-health biller to give each psychotherapy claim a final quality check before it leaves my desk. My practice regularly submits CPT 90791, 90837, 90834, and 90853 through the ClaimMD clearinghouse, and I want to reduce rejections by having a skilled reviewer verify every detail of the CMS-1500.
Here is what you’ll handle on every claim:
• Verify the CPT code and any required modifiers are appropriate for the documented session
• Ensure patient demographics, policy numbers, and diagnosis pointers are complete and correctly formatted
• Confirm supporting documentation is sufficient for the payer’s guidelines
• Perform a full line-by-line audit of the CMS-1500 and flag or correct anything that could trigger a denial
Familiarity with ERA/EDI transactions, clearinghouse workflows, and the nuances of behavioral-health billing is essential; experience with Kareo, TheraNest, or SimplePractice is helpful but ClaimMD proficiency will let you jump right in. Typical volume is 15-30 claims a week, with a 24-hour turnaround expected.
Deliverable: a clean, submission-ready CMS-1500 (or 837) and a short note summarizing any adjustments you made. If you can keep my acceptance rate high and my denials low, this will become an ongoing engagement.
Here is what you’ll handle on every claim:
• Verify the CPT code and any required modifiers are appropriate for the documented session
• Ensure patient demographics, policy numbers, and diagnosis pointers are complete and correctly formatted
• Confirm supporting documentation is sufficient for the payer’s guidelines
• Perform a full line-by-line audit of the CMS-1500 and flag or correct anything that could trigger a denial
Familiarity with ERA/EDI transactions, clearinghouse workflows, and the nuances of behavioral-health billing is essential; experience with Kareo, TheraNest, or SimplePractice is helpful but ClaimMD proficiency will let you jump right in. Typical volume is 15-30 claims a week, with a 24-hour turnaround expected.
Deliverable: a clean, submission-ready CMS-1500 (or 837) and a short note summarizing any adjustments you made. If you can keep my acceptance rate high and my denials low, this will become an ongoing engagement.