Muhammad Abeer Saeed

Case Study: Mental Health Billing & RCM Prepared by Abeer Saeed | RCM Specialist Client Type: Outpatient Mental & Behavioral Health Clinic (Private Practice & Telehealth) Services Covered:  Therapy Sessions: 90832 - 90837  Psychiatric Evaluations: 90791, 90792  Medication Management: 90833 - 90838  Couples Therapy: 90846, 90847  Group Therapy: 90853  Psychological Testing & Reporting: 96130 - 96137 Challenges:  Delays in reimbursements from payers  High rate of denials due to incorrect modifiers, time filing limits (TFL), and missing referrals  Patient disputes related to telehealth billing confusion Solutions Implemented:  Verified eligibility, benefits, and referrals before scheduling  Used accurate CPT codes and correct modifiers (95, GT) based on payer guidelines  Analyzed and appealed denials using payer-specific documentation  Trained sta on accurate note-taking, coding, and payer requirements  Simplified patient statements and improved billing communication Results Delivered:  92% reduction in claim rejections  40% increase in monthly collections  Decrease in patient billing complaints  Faster reimbursements and cleaner claim submissions Software & Payer Portals Used:   EHR & Billing Systems: InSync, EDI Insight, EasyPay Payer Tools: Availity, Cigna, UHC, Kaiser, Aetna, and other commercial payer portals Outcome: The provider experienced more consistent cash flow, fewer denials, and a dramatic improvement in billing satisfaction. With solid systems in place, the practice could focus on patient care while maintaining confidence in their revenue process.