Behavioral health billing, run by people who have run treatment programs
Claims, authorizations, denials and payer follow up for outpatient clinics, private practices, IOP, PHP, MAT, residential and detox. Priced so you know your cost before you sign.
Benefits verified 2
Submitted 1
Denied, being fixed 1
Paid 1
Outpatient and residential lose money in different places
Outpatient billing is volume: hundreds of sessions, visit limits, telehealth modifiers and copays, where small misses repeat every week. Residential billing is authorization: per diem days inside a window that has to be re-justified every few days.
Your billing team watches both: the visit count on session 16 and the review on day seven.
Follow a claim from first contact to payment
Where the money is protected at each step, for both kinds of care.
Every level of care, billed on its own terms
Six outpatient services and four programs. Each one loses money somewhere different, so each one is billed differently.
Outpatient and practices
Programs and facilities
Outpatient mental health
Therapy and counseling services
What your billing team handles
- Eligibility and copays verified before the first visit
- Visit limits tracked with reauthorization before they run out
- Telehealth billed with the modifier and place of service each payer requires
Where it usually breaks
Small coding misses that repeat across hundreds of sessions a month.
Codes billed most
Psychiatry and medication management
Prescribers, evaluations and med checks
What your billing team handles
- Evaluations, med checks and therapy add ons billed at the level the note supports
- Incident to and supervising provider rules applied before the claim goes out
- Telehealth med management billed with the modifier and place of service each payer requires
Where it usually breaks
Visit levels chosen by habit instead of by the documentation, repeated across hundreds of short visits.
Codes billed most
Private practice therapy
Solo clinicians and group practices
What your billing team handles
- Insurance billing taken fully off the clinician
- Client balances and statements handled for you
- Payer follow up so claims never sit unpaid
Where it usually breaks
Claims left unworked because the clinician is also the billing department.
Codes billed most
Medical clinics
Outpatient medical practices and integrated care
What your billing team handles
- Office visits, in office procedures and injections coded from the note
- Depression and anxiety screening billed every time it is delivered
- Collaborative care and behavioral health integration billed by monthly time
Where it usually breaks
Behavioral health minutes delivered every month and never billed, because nobody tracks the time.
Codes billed most
Substance abuse outpatient
ASAM Level 1 counseling and case management
What your billing team handles
- Documentation checked against ASAM criteria before billing
- 42 CFR Part 2 consent handled in the workflow
- Individual and group services billed at the right units
Where it usually breaks
Notes that don't support medical necessity, caught later in payer review.
Codes billed most
MAT and OTP
Medication for opioid use disorder
What your billing team handles
- Weekly OTP bundles billed with the correct drug and service components
- Take home supplies and additional counseling billed as add ons when delivered
- Medicaid methadone administration billed separately where the state requires it
Where it usually breaks
Bundle codes that don't match what was actually delivered that week.
Codes billed most
Intensive outpatient
IOP for mental health and substance use
What your billing team handles
- Program days matched to attendance and required hours before the claim goes out
- Authorizations and visit counts tracked per client
- Commercial per diems and Medicare IOP both billed
Where it usually breaks
Billing for days the client didn't attend the required hours.
Codes billed most
Partial hospitalization
PHP day programs
What your billing team handles
- Per diem billing reconciled against hours in the record
- Review dates tracked and your clinical packet submitted on time
- Step down to IOP billed without a coverage gap
Where it usually breaks
Authorizations that lapse between the PHP and IOP step down.
Codes billed most
Residential treatment
Mental health and substance use residential
What your billing team handles
- Length of stay authorizations tracked to the day
- Review dates tracked and your clinical packet submitted on time
- Room and board billed separately from treatment where the payer requires it
Where it usually breaks
A missed review on day seven that turns the rest of the stay into write offs.
Codes billed most
Detox and withdrawal management
Clinically and medically monitored withdrawal
What your billing team handles
- Acuity based code selection for each day
- Short authorization windows checked every day
- Clean handoff to residential billing at step down
Where it usually breaks
Daily authorizations that expire faster than anyone checks them.
Codes billed most
Published pricing
A percentage of what we collect, never of what you bill. The rate drops as collections grow.
- Private practices and outpatient clinics
- $995 monthly minimum
- Dedicated billing lead you can call
- Monthly report and review call
- IOP, PHP and outpatient programs
- Authorization tracking and review deadlines
- Reporting by program and payer
- Detox, residential and multi site organizations
- Short authorization windows tracked daily
- Executive revenue reporting by payer and level of care
Every rate includes authorization tracking and the same access: a direct line to your billing lead and as many calls as you need. Full utilization review, where our staff makes the payer calls and writes the clinical justification, is quoted separately.
What the rate covers
No add on fees for the work that recovers money. Credentialing and full utilization review are priced separately.
We work in your software
Whatever EHR, EMR or billing module you run, we log into yours. Nothing migrates, nothing is converted, and no copy of your data ends up somewhere you cannot reach. A BAA with 42 CFR Part 2 terms is signed before anyone logs in.
Commercial first. Medicare and Medicaid right behind.
Most programs depend on all three. Each one stalls claims in a different place.
| Payer | What we handle | Where claims stall |
|---|---|---|
| Commercial | In network and out of network claims, single case agreements, and authorization tracking through utilization management. | Underpayments measured against your contract. When a denial looks like a parity problem, the appeal is built around it. |
| Medicare and Medicare Advantage | Since January 1, 2024, licensed mental health counselors and marriage and family therapists can enroll and bill, and intensive outpatient is a covered benefit. | Medicare Advantage plans layer on their own prior authorization rules, separate from Original Medicare. |
| Medicaid | Rules change by state and, in Oregon, by CCO. Eligibility is rechecked at every level of care change. | A claim sent to the wrong plan does not deny. It simply stops. |
What your billing team does, and when
You get the work of a full billing department without hiring one. Here is the rhythm, plus the column that has no schedule. Nothing about reaching us is billed as an extra.
Every day
- Eligibility checks for new admissions
- Claims scrubbed and submitted
- Authorization end dates watched
- Payments posted
Every week
- Denials worked and appealed
- Stalled claims chased by phone and portal
- Review deadlines tracked and packets submitted
- Underpayments flagged
Every month
- Written billing report
- Review call with your leadership
- Aging by payer and level of care
- Recommendations for intake and documentation
Any time
- A direct line to your billing lead by phone, text or email
- Any call you need between the monthly reviews
- Same business day answers on claims, denials and admissions
- We will join payer calls, board meetings and staff training
A report you can read in five minutes
Every month: what came in, what your team did, and the few things that need you. Reviewed together on a call.
This month
What your billing team did
- Outpatient sessions billed612
- Residential and PHP days billed284
- Authorizations and reviews filed on time31 of 31
- Denials appealed with clinical records9
- Underpayments sent back to payers3
Needs your attention
- Four outpatient clients near their visit limitReauthorization requests go out this week.
- Two residential reviews due ThursdayUpdated progress notes needed from clinical by Wednesday.
- Commercial PPO paying 90837 below contractRecommend raising at your next payer meeting.
What changes with operators running billing
| Where it shows up | Typical billing company | Saint Health Group |
|---|---|---|
| Pricing | Quote after a sales call | Published |
| Who works your claims | Rotating, often unnamed | A dedicated billing lead you can reach |
| Software | Their platform, your data inside it | Your EHR, your login, your data stays yours |
| Behavioral health depth | One specialty among dozens | Leadership with behavioral health operating experience |
| Authorizations | Often left to your staff | Tracked and submitted for you |
| Reaching someone | Shared inbox, calls by tier | Direct line to your billing lead, calls whenever you need |
| Time to switch | 30 to 90 days of onboarding | Live in 7 to 14 days, with AR still worked |
| Contract | 12 to 24 months | 60 day cancellation |
Questions
Pricing, payers and Part 2.
How much does behavioral health billing cost?
Behavioral health billing companies typically charge 5 to 10 percent of collections, and most practices pay 6 to 8 percent. Saint Health Group charges 6 percent under $100,000 in monthly collections with a $995 minimum, 5 percent from $100,000 to $250,000, and 4 percent above $250,000, with no setup fee.
Do we have to switch EHRs to work with you?
No. We work inside whatever EHR, EMR or billing module you already run. You give our billing lead a user account in your system, and your claims, notes and remittance stay in your instance under your login. There is nothing to migrate when you start and nothing to unwind if you leave.
Which insurance do you bill?
Commercial insurance, Medicare and Medicare Advantage, and Medicaid, including in network claims, out of network claims and single case agreements.
Do you bill both outpatient and residential programs?
Yes. Outpatient mental health, private practice therapy, substance abuse outpatient and MAT, plus IOP, PHP, residential and detox. Many programs run more than one level of care, and the billing follows the client through each one.
Can you take over our existing AR?
Yes. The free audit shows what is still collectible before timely filing closes, and cleanup is quoted separately so your monthly rate stays clean.
Which EHRs do you work in?
The systems behavioral health programs already use, including Kipu, SimplePractice, RXNT and Ease Health.
How do you handle 42 CFR Part 2 records?
A business associate agreement with Part 2 terms, access limited to the staff working your account, and alignment with the updated Part 2 rule HHS began enforcing February 16, 2026.
Do you guarantee a revenue increase?
No. A fixed percentage promised before anyone has seen your data is a guess. The free audit shows what is recoverable in your own claims.
See what your billing is leaving uncollected
Send 90 days of claims data. You get a written review of denials, aging and missed authorizations, whether or not you hire us.