SimiTree Behavioral Health has the ability to meet all the business needs of your behavioral health practice.
The SimiTree Behavioral Health team offers a full range of practice management services. Credentialing, Verification of Benefits & Authorizations, Billing, and just about any other need you may have to make your business successful.
When working with Health Assets Management you will be assigned a dedicated credentialing specialist who will work directly with you on all your credentialing needs. This gives you the ease of having one point of contact.
Account Set-Up includes:
- Collection of required documents
- A review of your CAQH, NPPES profile, State license, PECOS (Medicare, if applicable) and participating in network contracts to confirm all information is correct and up to date
Our credentialing staff can:
- Complete new applications and re-credentialing applications
- Create your CAQH profile and maintain it
- File and document maintenance
- Complete demographic updates with your contracted payers
- EFT Enrollments for direct deposit payments
- Medicare and Medicaid Revalidations
- TIN Conversion, Changing to new TIN#
- Removal from contracted payers panels
- Obtain NPI
The executive and management staff at Health Assets offer consulting services to practices who are beginning, expanding or looking for ways to improve. Consultations are offered on an hourly basis to individual and group practices as well as clinics. Such topics as documentation, forming a group practice, working with NYS Office of the Professions, and other regulatory offices. The staff is available for Associations to speak to groups of mental health providers on topics relating to Outpatient Practice. Reach out to Health Assets to arrange for your individualized consultation.
Verification of Benefits & Authorization for Care
Our dedicated Verification of Benefits Team specializes in mental health and substance abuse coverage and has a comprehensive understanding of plans nationwide. Eligibility and benefits verifications are performed for routine services as well as psychological/ neuropsychological testing upon request. We will confirm the amount of co-payment, deductible, out of pocket limits, authorization requirements, visit limitations, number of available session and claims address for paper and/or electronic submission. Verification of Benefit services are also available for workers compensation plans, Employee Assistance Programs (EAP) and Health Savings/Health Reimbursement Accounts (HSA/HRA) as allowed by plan guidelines.
Verification of Benefits (VOB)/Eligibility Services includes:
Health Assets will contact the health plan/insurance company to confirm eligibility for outpatient mental health and behavioral health benefits.
Health Assets will return benefit detail to you on your personalized verification form. The form will list coverage, authorization requirements, and any pertinent plan limitations or guidelines.
Authorization Service includes:
Health Assets will contact the health plan/insurance company to obtain necessary authorization for care. Health Assets will obtain and provide your office with the OTR (Outpatient Treatment Report) form specific to the patient’s health plan. Once the clinician completes the information and signs the form, your office will fax, email or mail the OTR to Health Assets. Our staff will submit the request to the health plan/ insurance company. We will ensure the insurance company received the form and authorization is approved for care. Authorization information including approval numbers, visit limits, date ranges, CPT Code/modifier requirement for billing purposes will be confirmed and communicated back to your office.
Health Assets will track the authorizations and make every effort to inform you prior to expiration. Health Assets will maintain records of all services you provide under the authorization and assist with obtaining additional visits, in a timely fashion.
Billing & Claims Management
Health Assets Management will submit claims for all sessions electronically whenever possible. Some EAP, worker’s compensation, and others must be submitted by paper. We will send those for you, also.
Account set up includes:
- System setup for electronic billing and ERA’s with Medicare, Medicaid, and commercial insurance companies. Billing system license fees are included.
- Auditing the benefit information for your current patients, including information on copayment and deductible amounts, is available for an additional fee.
Billing Services includes:
- A simple, personalized transaction sheet to record sessions and send to us for claim submission.
- Emailing you copies of ERA’s on a weekly basis
- Following up on denials reported on the ERA’s, and advising you of any action that needs to be taken.
- We will follow up twice on unprocessed in-network claims that have aged out at least 30 days at no additional cost. Out of network claims can also be followed up on by request with a copy of the EOB.
- Health Assets has several reports that can be provided to you including claims reports to track what we have submitted on your behalf and payment reports to track payments. Additionally, annual reports can be supplied which can be used in conjunction with your 1099’s for tax purposes. You can speak directly with your account manager about which reporting options would be most beneficial to you!
Learn what we can do for your behavioral health business
March 23, 2023
February 4, 2022