Choosing the right billing partner for your mental health practice can make or break your revenue cycle. With the increasing complexity of behavioral health billing—including unique CPT codes, payer rules, Medicaid H codes, and evolving telehealth guidelines—a billing company must be more than just competent. They need to be specialized, proactive, and transparent. Unfortunately, many providers end up with billing partners who do more harm than good.
The stakes are high. Inaccurate billing leads to delayed payments denied claims, and compliance risks that could trigger audits or clawbacks. Below are five critical red flags you must watch out for when evaluating mental health billing companies, along with detailed insights and real-world examples to help you make the best decision. Looking for the best mental health billing company in 2025? Discover what features and services to prioritize so you can make the right choice for your practice.
1. They Don’t Specialize in Mental Health or Behavioral Health Billing
If a billing company serves “all medical specialties,” be cautious. Mental health billing is vastly different from general medical billing. It involves time-based CPT codes such as:
- 90832, 90834, and 90837 for individual therapy sessions
- 90791, 90792 for diagnostic evaluations
- 90846, 90847 for family therapy
- 90863 for medication management with therapy
- 96130–96138 for psychological testing
- H0015, H0031, and H2019 for intensive outpatient services and Medicaid-specific treatments
General billing services often lack the deep understanding needed to manage these codes, especially when it comes to documentation, authorization requirements, and payer-specific nuances. A specialized billing partner, on the other hand, knows exactly what each code requires in terms of documentation and how to navigate varying policies across payers like Medicare, Medicaid, and commercial insurers.
Not sure if you need a specialized billing partner? Learn how working with a mental health-specific billing company can transform your revenue cycle and reduce stress.
Pro Tip: Ask how many behavioral health providers the billing company currently supports. Request client references and ask whether they offer onboarding that includes a chart audit for CPT compliance.
2. Lack of Transparency in Reporting and Claim Tracking
You should never be left in the dark about your own revenue cycle. If a billing company can’t provide real-time reports, clear denial metrics, or even a breakdown of submitted vs. paid claims, that’s a red flag. Transparency is critical—not only for trust but also for data-driven decision-making.
A qualified billing partner will:
- Provide weekly or bi-weekly claims summaries
- Show aging reports (A/R over 30/60/90 days)
- Flag problematic payer trends
- Offer portal access or live dashboards
Lack of transparency often signals poor internal systems, outdated software, or a lack of accountability. Worse, it can result in thousands of dollars of uncollected revenue that go unnoticed until it’s too late to appeal.
Pro Tip: Ask for sample reports during your discovery call. Ensure they can track and communicate key performance indicators (KPIs) like first-pass acceptance rates and average reimbursement timelines.
3. No Plan for Handling Claim Denials or Payer Communication
Claim denials are inevitable, but they don’t have to be permanent. A strong billing company knows how to respond quickly, accurately, and persistently. One of the biggest red flags is a company that treats denied claims passively—just resubmitting without addressing the root issue.
Instead, you want a partner who will:
- Analyze each denial reason
- Correct and resubmit with documentation
- Appeal with payer-specific forms and language
- Track denial rates over time to adjust strategies
For example, many mental health providers struggle with repeated denials of 90837 due to “lack of medical necessity.” A specialized billing company will know how to guide your team to document progress, medical need, and time spent effectively, drastically reducing denial rates.
Pro Tip: Ask how they manage denials and appeals. Do they track denial trends by CPT or payer? What’s their average resolution time for rejections?
See a real-world breakdown of the ROI of outsourcing your mental health billing versus managing it in-house, with data-driven insights for practice owners.
4. Outdated Knowledge of Payer Rules or Telehealth Policies
Payer rules are not static. CMS, state Medicaid programs, and private insurers frequently update their policies, especially in response to industry trends like telehealth expansion or Medicare Advantage audits. If your billing company doesn’t stay current, you’ll pay the price in denied claims and lost revenue.
In 2025, for example, CMS expanded audits across all Medicare Advantage plans—signaling heightened scrutiny for providers. A billing company that isn’t aware of such changes won’t advise you on necessary documentation for risk-adjusted diagnoses or time-based services, leaving you vulnerable.
Similarly, states have different policies for teletherapy billing. Some still require modifier 95, while others have removed telehealth restrictions altogether. Your billing company should be aware of these variations and adjust your submissions accordingly.
Pro Tip: Ask how the company stays updated on payer policy changes. Do they have a compliance officer? Do they participate in billing forums, CMS briefings, or mental health association updates?
Not all billers are created equal. This comparison explains the difference between mental health billing and general medical billing and why specialization matters more than you think.
5. They Promise Unrealistic Collection Rates or Instant Results
If a company promises a 100% acceptance rate or tells you they’ll fix all your revenue issues within the first week—run. Mental health billing is complex, and even the best teams require time to analyze, adjust, and optimize your processes.
The truth is, real results come from:
- Conducting a full initial billing audit
- Aligning workflows with your EHR
- Training your team on documentation best practices
- Streamlining authorization and eligibility checks
Reputable billing companies will offer realistic timelines and set clear, achievable benchmarks (e.g., reduce denials by 25% in 60 days). They won’t overpromise. Instead, they’ll focus on building long-term systems that improve your collections and cash flow consistently over time.
Pro Tip: During your sales conversation, ask for real-case outcomes, not just promises. Look for KPIs achieved over 90 days, not exaggerated short-term wins.
Final Thought
Choosing a mental health billing company isn’t just about convenience—it’s about protecting your practice’s revenue, compliance, and peace of mind. Avoiding these five red flags will steer you away from the wrong partners and toward companies that bring real, measurable value.
Remember: billing is not a back-office task—it’s the financial heartbeat of your practice. A poor billing partner could silently bleed your revenue or put you at risk with audits. A good one, like Global Tech Billing LLC, will feel like an extension of your team—transparent, accountable, and always advocating for your success.
Take your time. Ask the hard questions. And don’t settle for anything less than a billing company that truly understands behavioral health care.
FAQs:
1. Why is specialization in mental health billing important?
Mental health billing involves complex CPT codes, payer-specific policies, and frequent audits. A specialized billing company understands these nuances, reducing denials and improving collections.
2. How can I tell if a billing company is transparent?
Look for regular reporting, claim tracking access, and performance metrics like first-pass acceptance rates and denial breakdowns. Lack of transparency is a major red flag.
3. What’s the risk of using a generalist billing service for mental health?
Generalists may mishandle codes like 90837 or H0015, miss telehealth modifiers, and fail to comply with documentation requirements—leading to delays or audits.
4. Should my billing partner help with payer communication?
Yes. A strong billing partner should proactively follow up on denials, appeal claims, and communicate with insurers to resolve issues quickly.
5. Can a billing company guarantee fast results?
No reputable company should promise instant fixes. Improvement takes time, especially if you have legacy A/R or documentation gaps. Be wary of unrealistic claims.
