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Behavioral Health Billing

Mental health and substance abuse aid encompass an entire subset of human services. Though these services are necessary, and expansion of these programs should be welcomed, they can often lead to a burden on the medical billing, finance, and compliance teams. Everchanging federal and state rules and regulations, particularly for behavioral health billing can lead to erroneously billed claims, which ultimately affects providers’ revenue. 

 

For nearly 40 years Millin has focused our time, resources and development on behavioral health billing. While most billing companies push out generic software that does just enough to submit a claim across most programs, Millin has carefully designed our MillinPro billing software to include the various behavioral health billing nuances laid out in the guidance set forth by payers at all levels.

As behavioral health billing in most states moves from a historically simple, single payor system to a multi-payor environment with the likes of Medicaid, Medicare, Managed Care Organizations (MCOs) and commercial payors at the forefront, it’s crucial that your RCM platform can adapt to the constantly changing rules and regulations across insurance companies to ensure your claims are clean and you are collecting at the highest rate possible for your billed services. 

Mental Health Billing and Substance Abuse Billing

While many billing companies are focused on hospital billing, physician practice billing, surgical billing, etc., few billing companies have given the necessary attention to mental health billing and substance use billing.

Millin recognized the need for billing experts to focus on these processes for behavioral health providers. Being that those services are generally reimbursed by Medicaid or MCOs, there are many complicated billing rules and regulations associated with this type of billing. Not only is it critical to get paid in full on all behavioral health claims but ensuring that all mental health billing and substance abuse billing rules and regulations were followed is just as important to avoid recoupment of payments and penalties upon audit. Most recoupments are not due to fraud but simply due to human error and lack of following certain regulatory requirements that could have been avoided with the right expertise and systems in place. The process of submitting claims with the right CPT codes, modifiers and patient information promptly can significantly reduce the amount of denied or unpaid claims.

Millin designs and configures its MillinPro software according to specifications laid out by your agency during the implementation process. Rather than providing you with a blank template or “sandbox mode” we make sure to actively build your database on your behalf (with your input), helping you set up your payors, locations, demographics, and integrations with your other software so that everything is guaranteed to be set up correctly and ready to bill on Day 1 when you submit your claims through Millin.

The following are some of the common programs Millin customers use our behavioral health billing software to bill for include, but are not limited to:

  • Home and Community Based Services
  • Assertive Community Treatment
  • Care Coordination
  • Mental Health Outpatient Clinic
  • Day Treatment
  • Residential Treatment Facility
  • Inpatient
  • Detox
  • Substance Abuse outpatient clinic
  • Personalized Recovery Oriented Services
Read More

The following are some of the common programs Millin customers use our behavioral health billing software to bill for include, but are not limited to:

  • Home and Community Based Services
  • Assertive Community Treatment
  • Care Coordination
  • Mental Health Outpatient Clinic
  • Day Treatment
  • Residential Treatment Facility
  • Inpatient
  • Detox
  • Substance Abuse outpatient clinic
  • Personalized Recovery Oriented Services
  • Opioid Treatment Program
  • MAT Program
Read Less
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womanComputerFinal

The following are some of the common programs Millin customers use our behavioral health billing software to bill for include, but are not limited to:

  • Home and Community Based Services
  • Assertive Community Treatment
  • Care Coordination
  • Mental Health Outpatient Clinic
  • Day Treatment
  • Residential Treatment Facility
  • Inpatient
  • Detox
  • Substance Abuse outpatient clinic
  • Personalized Recovery Oriented Services
Read More

The following are some of the common programs Millin customers use our behavioral health billing software to bill for include, but are not limited to:

  • Home and Community Based Services
  • Assertive Community Treatment
  • Care Coordination
  • Mental Health Outpatient Clinic
  • Day Treatment
  • Residential Treatment Facility
  • Inpatient
  • Detox
  • Substance Abuse outpatient clinic
  • Personalized Recovery Oriented Services
  • Opioid Treatment Program
  • MAT Program
Read Less

Providers who choose to implement Millin alongside their EHR (Electronic Health Record) software of choice recognize a collection rate up to 99.2% across all programs which is well above the industry average. This is because taking a best-of-breed approach means that you can reap the benefits of the best-in-class billing system with a vendor whose primary function is the clinical records. You no longer need to worry about the “one size fits all” approach many EHR vendors take, leaving each individual provider in the dark to figure out their own program-specific billing issues.

Millin Leadership

Reasons for our extremely high collection rate are due in part to some of the following features that come with the MillinPro software:

MillinPro System Benefits:

  • Millin incorporates many of the rules into its rules engine thus removing human error.
  • Pre-billing scrubbing features.
  • Proprietary issue tracker to easily document and track claims issues.
  • With the Clearinghouse and eMedNY (electronic...
Read More

Reasons for our extremely high collection rate are due in part to some of the following features that come with the MillinPro software:

MillinPro System Benefits:

  • Millin incorporates many of the rules into its rules engine thus removing human error.
  • Pre-billing scrubbing features.
  • Proprietary issue tracker to easily document and track claims issues.
  • With the Clearinghouse and eMedNY (electronic New York State Medicaid system) web-services integration, you no longer need to leave the system to submit claims or download remittances.
  • Customizable dashboard
  • Incorporated APG calculator for Article 16s, 28s, 31s, 32s (all non-APG payers are submitted at the contracted rate).
  • Batch Eligibility verification.
  • Comprehensive reporting system.
  • Secure HIPAA (Health Insurance Portability and Accountability) compliant web-based system back-ups on the West-Coast.
  • Ability to integrate with EMR (Electronic Medical Records) systems via HL7, API, or data upload.
  • Ability to integrate with your accounting system.
Read Less
Millin Leadership

Reasons for our extremely high collection rate are due in part to some of the following features that come with the MillinPro software:

MillinPro System Benefits:

  • Millin incorporates many of the rules into its rules engine thus removing human error.
  • Pre-billing scrubbing features.
  • Proprietary issue tracker to easily document and track claims issues.
  • With the Clearinghouse and eMedNY (electronic...
Read More

Reasons for our extremely high collection rate are due in part to some of the following features that come with the MillinPro software:

MillinPro System Benefits:

  • Millin incorporates many of the rules into its rules engine thus removing human error.
  • Pre-billing scrubbing features.
  • Proprietary issue tracker to easily document and track claims issues.
  • With the Clearinghouse and eMedNY (electronic New York State Medicaid system) web-services integration, you no longer need to leave the system to submit claims or download remittances.
  • Customizable dashboard
  • Incorporated APG calculator for Article 16s, 28s, 31s, 32s (all non-APG payers are submitted at the contracted rate).
  • Batch Eligibility verification.
  • Comprehensive reporting system.
  • Secure HIPAA (Health Insurance Portability and Accountability) compliant web-based system back-ups on the West-Coast.
  • Ability to integrate with EMR (Electronic Medical Records) systems via HL7, API, or data upload.
  • Ability to integrate with your accounting system.
Read Less

Because insurance companies seemingly love to make the billing process increasingly complicated, the day-to-day mental health billing and substance abuse billing workflow is getting much more labor intensive and confusing than it has ever been before. Billing accurately, timely, and submitting clean claims is the only way to ensure you are maximizing cashflow and decreasing denials. Our software ensures that all patient’s insurance information is always up to date, reducing the amount of rejected claims. Your agency exists to supply services to patients in need, and that’s where your time and effort should go. To help agencies continue to keep their focus on pursuing their mission, Millin offers full RCM services on top of our MillinPro software.

Contracting with Millin for billing management services relieves your agency of the burden that comes along with mental health billing, allowing your staff to work more effectively. This approach is proven time and time again to prevent money being lost due to billing and claim submission errors. To decrease claim denials and help get more revenue in the door, our behavioral health and mental health billers implement best practices.

We offer data-driven revenue cycle management solutions for behavioral and mental health organizations.

Additional Benefits When Outsourcing:

  • Millin’s billing staff specializes in the Clinic billing process.
  • Millin has business analysts on staff that review the continuous payer and regulatory changes and communicates with the plans and State when clarification is required, or contradictions are identified in order to ensure a compliant process.
  • Millin has an internal training program to ensure all billing staff is up to date with the latest changes and regulations.
  • Dedicated account managers.
  • Millin advises its client on upcoming billing and regulatory changes.
  • Millin can quickly find agency specific issues vs global issues and address those accordingly as we manage the billing process for many agencies.
  • You no longer need to worry about staff turnover.
  • You no longer need to worry about billing not being processed due to staff being out of the office.
  • And many more…

A healthy revenue cycle is essential to an organization's success. Millin’s expertly trained staff come from all different corners of the health care world and exist for the sole purpose of making MillinPro and the daily billing process for behavioral health agencies as efficient and effective as possible. Having a well-rounded team means a decrease in the time spent billing and more revenue in the door for your agency.

 

Millin is made up of various departments with expertise in:

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IT R&D Department

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Billing & Technical Support

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Certified Coders & Billing Analysts

CustomerService

Accounts Receivable Specialists

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Developmental Disability Billing Experts

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Behavioral Health billing experts

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APG experts

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Executives

About Us

Millin Associates, a NY-based company, has assisted Health & Human Service agencies to navigate the revenue cycle maze since 1982. By increasing productivity and lowering operating costs, we enable our clients to realize immediate cash flow recovery and significant reductions in operating expenses.

The ability of our health care revenue cycle management professionals for Mental Health Services, I/DD, Substance Use Services, Health Home, and Foster Care services is unsurpassed. In Millin’s philosophy, the responsibility of your EMR should end after the clinical services are documented for the patients. Billing data and responsibilities should exist in a software system with a proven track record of focusing on the RCM process to avoid rejected or denied claims. Part of Millin’s model is to integrate our software with your agency’s EMR so we can receive the patient information seamlessly and bill accordingly.

Experience

Insurance regulations and rules are constantly evolving. Managed Care Organizations have been tasked with reimbursing Medicaid for its services as the government has decided to completely exit the reimbursement business.

MillinPro Billing & Reporting System

To increase efficiencies and implement best billing practices, we developed an innovative and cutting-edge web-based billing system. Our company is not like your typical tech company, as we design systems and use them simultaneously.

Providers of mental health services and substance use services in New York State are encouraged to use the system.

By developing a flexible system that can adapt to continuous changes in the regulatory and payer landscape, we have succeeded in adapting to significant changes. Below are a few of the features and benefits available through the system:

  • A continually updated rules engine that adapts to changing rules and payer mix
  • Verifying insurance eligibility in batches before submitting claims
  • Online claims submissions are no longer necessary - no logging into eMedNY or clearinghouses are necessary to submit claims and download remittances
  • User-friendly reporting system with comprehensive reporting capabilities
  • With our proprietary issue tracker functionality, you can monitor issues and track receivables in a more efficient manner
  • An easily customizable dashboard
  • Calculator for APG Grouper (for clinics)
  • A user-friendly scheduling system
  • The software alerts you to claims that require a prior authorization
  • MillinPro attaches the correct CPT codes, ICD code, and billing codes to each claim
  • A cloud-based, HIPAA-compliant system with real-time redundancies, backups, and enhanced security features - eliminating the need for costly IT infrastructure and maintenance
  • You always have the most recent version of the software because of automatic updates and upgrades
  • The ability to integrate with your preferred EMR and accounting software
 

Transparency With Your Mental Health Billing

A growing number of companies choose to outsource revenue cycle management to Millin Associates because of the increasingly complex billing process. Providing you with access to our innovative revenue cycle management system with customized dashboards and reporting capabilities is a key component of our service.

It is possible to keep track of everything we do at any given time as if we were at your office. We keep an open line of communication with our clients by arranging regularly scheduled phone calls to address questions, modifications in payer policies, and any upcoming regulatory changes. Should you have any questions, please feel free to contact us via email or telephone during business hours. 

From EMR to Billing: Best of Breed

Many of our clients use electronic medical records. A variety of EMR systems are sometimes used by agencies to track several types of services they provide. Having the ability to integrate MillinPro into your EMR system eliminates the need to worry about whether your EMR system (oftentimes a national vendor) can keep up with NY State billing changes while also providing you with a robust revenue cycle management solution.

Integration of the MillinPro billing system with your EMR can be achieved in the following ways:

  1.  A data feed can be created from your EMR for claims that are ready to be billed. A report is essentially a document that is then imported into MillinPro.
  2.  Integrating your EMR and MillinPro using an HL7 interface. Once billing approval occurs, your claims data is automatically transferred from your EMR into MillinPro. This includes notes, signatures, and any other information required by the EMR.
  3.  The MillinPro API should be embedded in the EMR. As soon as claims are approved for billing, MillinPro automatically transfers data from your EMR into MillinPro. Most commonly, this will be an ongoing process.

Taking advantage of our cutting-edge Revenue Cycle Management System specifically designed for NYC OPWDD services is what's great about this process. You have the option of working within the EMR of your choice while taking advantage of our ultramodern EMR.

Bottom line

As services across the country transition from a single payer environment to managed care, billing isn't going to be as straightforward as it used to be. Historically, billing agencies have been negatively affected due to a lack of expertise and sophisticated technology. A strong fiscal impact can be made on your agency by combining the ability of Millin Associates with innovative software and their 30+ years of experience in revenue cycle management services. 

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With over 40 years of Health & Human Services billing experience and expertise, we can help increase efficiencies and reduce or even eliminate denials. Experience Revenue Cycle Management Software & Services from the Company You Trust. 

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