Insurance Billing
A deeper look into the service that defines our work—and your results.
Billing isn’t just paperwork. It’s the nervous system of your practice—quietly running in the background, supporting your care, your clients, and your revenue. Done well, it’s invisible. But when it’s off, everything gets harder. That’s why this isn’t just our job—it’s our craft. We bring structure, precision, and a sharp eye for detail to every part of the billing process.
There are many layers to what we do. This overview breaks down the core pieces so you can see what’s happening behind the scenes—and why it matters so much.
Front-End
The foundation: everything that happens before a claim is ever submitted.
This stage often looks simple, but it’s where many of the most costly billing errors are born. We take it seriously—because the more you solve upfront, the less you have to fix later.
Benefit Checks
What we do: For every new client, we verify their insurance coverage in detail. We use payer portals and other tools to gather all available data, so you have a clear, accurate picture.
Why it matters: Most clients don’t understand their benefits. Not fully. And the truth is, they shouldn’t have to. That’s our job.
They may not know that their mental health benefits are managed by a separate network like Carelon or Optum—even if they’re in-network with the main insurer. They often don’t realize what their deductible is, or how many sessions are covered.
A good benefit check prevents the “surprise billing” conversations that frustrate clients and burden your team. It gives you answers before questions even come up. It protects trust. And it gives you a chance to make informed decisions with clarity from day one.
Eligibility Verification
What we do: Before each session, we confirm that the client’s insurance is still active.
Why it matters: Insurance can drop off overnight. A missed payment, a job change, a shift in Medicaid eligibility—it doesn’t take much. And when coverage disappears without warning, denials follow.
This is one of the easiest problems to avoid, and one of the most common causes of lost revenue. By checking eligibility before every session, we keep your claims clean and your schedule efficient.
Claim Submission
What we do: We submit claims to both commercial and public payers, including secondary insurance. Every claim is tailored to the payer, with accurate coding, formatting, and insurance-specific rules.
Why it matters: A claim that goes out wrong wastes time. A claim that goes out right gets paid. This is where a lot of billing teams cut corners—but we don’t. Clean claims aren’t just good practice. They’re the baseline for everything that follows.
Back-End
Where the real work begins—after the claim has been judged.
This is the part of billing that’s harder to automate, harder to teach, and harder to do well. But it’s also where the value of skilled billing really shines.
Posting Payments
What we do: After an insurance company processes a claim, they send an Explanation of Benefits (EOB). We review it, post payments to the appropriate accounts, apply adjustments, calculate client responsibility, and send invoices. We also handle secondary billing and sort claims into the right workflows based on what the EOB tells us.
Why it matters: This is where everything comes together—or falls apart.
Good payment posting is like financial triage. It shows what got paid, what didn’t, what needs follow-up, and what the client owes. It makes sense of all the variables—copays, deductibles, denials, write-offs, clawbacks. And it turns that chaos into a clean, organized ledger.
When this step is rushed or neglected, things go wrong fast. Missed payments. Duplicate billing. Confused clients. We treat this phase with the care it deserves, because it’s the anchor of a healthy revenue cycle.
Resolving Claim Denials
What we do: Every denial is investigated and followed up. We call payers, submit appeals, work with provider relations teams, and escalate issues when needed to fight for the payment that’s due.
Why it matters: Denials are puzzles. And sometimes, the insurance company doesn’t even know what went wrong—they just know the claim didn’t pass their system.
This is where we dig deep. We look beyond the surface, ask better questions, and track down the real cause. Sometimes it’s simple. Sometimes it’s not. But either way, we don’t let it slide.
Most billing teams lose money here—not because they’re lazy, but because this work is slow, demanding, and often unclear. Our team has the experience and tenacity to chase these problems all the way through. That’s where revenue gets recovered—and where long-term financial stability is built.
Patient Billing
What we do: We send client statements and payment reminders. We also handle incoming questions—explaining bills, clarifying insurance, and helping resolve issues when they come up.
Why it matters: Clients are paying more out-of-pocket than ever. Deductibles are rising. Copays are growing. And patient billing now accounts for a major portion of your revenue.
But this is more than money—it’s about the relationship. Billing can be stressful and confusing for clients. Our approach is firm, clear, and kind. We explain what happened, why the charges exist, and what their options are.
Handled well, these conversations don’t just resolve balances. They build trust.
Reflection
Improving the system—one insight at a time.
What we do: We review our process regularly. We look at patterns in denials, payer trends, and internal workflows. We ask hard questions and act on the answers.
Why it matters: Billing doesn’t sit still. Regulations shift. Payers change their systems. Every year, the landscape looks different.
We don’t wait for problems to force change—we stay proactive. If a payer is denying the same code repeatedly, we dig in. If a new trend is emerging, we notice. We also share knowledge as a team so every biller gets better.
Little insights add up over time. And over months and years, they create a billing process that’s not just effective—but resilient.
Billing isn't just our craft—it's how we support your practice, protect your revenue, and help you provide exceptional care.
Let’s talk—contact us to find out how we can help.