Insurance Eligibility and Benefits Verification
Coverage, benefit, and authorization checks before the visit to help reduce avoidable front-end denials.
Who we serve
Behavioral & Mental Health Billing
Billing support for psychiatry, psychology, and counseling and therapy practices, where benefits, authorizations, and payer rules often differ from general medical billing.
Why billing in this specialty takes extra care
Behavioral health practices face billing rules that general medical billers don't always see. Mental health benefits may be managed by a separate company from the patient's medical plan, authorizations and visit limits are common, and payers have specific requirements for session-based services, telehealth, and different license types.
Prime Vision Revenue works inside your existing systems, follows your policies, and reports clearly on what we find, so your team can stay focused on patients.
How we help
- Benefits verification that confirms whether behavioral health is carved out, and to which administrator
- Tracking of authorizations, approved visit counts, and expiration dates, with alerts to your team
- Claim review for missing information and common payer edits before submission
- AR follow-up and denial work, including corrected claims and appeal preparation
- Reporting on denials by reason and payer so recurring issues can be fixed
Clinical documentation, session-time records, and coding decisions remain the responsibility of your clinicians. Psychotherapy notes, which HIPAA protects separately, are not needed for routine billing, and we do not ask for them.
Common challenges
Where revenue tends to slip
Separately managed behavioral benefits
Many health plans carve out behavioral health to a separate administrator, so claims sent to the medical payer can be denied as the wrong payer.
Authorizations and visit limits
Plans may require authorization after a set number of sessions, and services beyond an approved limit can be denied.
Session-based and time-based services
Psychotherapy and related services are often billed based on session time, which must be documented and reported consistently.
Telehealth and provider type rules
Payers set their own requirements for telehealth place-of-service codes and modifiers, and for which license types may bill which services.
Services most practices start with
Denial Management and Appeals Support
Root-cause review of denials, corrected claims, and appeal preparation, with trends shared back to your team.
Accounts Receivable (AR) Follow-Up
Structured follow-up on unpaid and underpaid claims, prioritized by age, balance, and timely-filing risk.
FAQ
Questions from behavioral & mental health practices
Do you work with solo therapists or only group practices?
Both. We work with solo clinicians as well as group practices, and we will tell you honestly whether outsourcing makes sense at your volume.
Can you track authorizations and session limits?
Yes. As part of verification and claims work, we track authorization numbers, approved visits, and expiration dates and alert your team before limits are reached.
Do you bill for telehealth sessions?
Yes. We follow each payer's current telehealth requirements for place-of-service codes and modifiers, and we confirm payer-specific rules during onboarding.
Talk to us about your practice
Start with a free consultation or a free billing and AR review. We'll listen first, then recommend a practical next step.