Do you handle state Medicaid behavioral health carve-outs?

Yes. Carve-out rules differ sharply by state, from managed-care assignment to unit definitions, and we apply the rules for the state where the service is rendered rather than a national default.

Can you track authorizations for us?

Yes. We maintain the authorization calendar and alert your clinical team before the last approved units are consumed, which is where most behavioral health write-offs originate.

What about telehealth sessions?

Telehealth place-of-service and modifier requirements changed repeatedly and still vary by payer and state. We keep a per-payer matrix and bill to the rule in force on the date of service.

Do you support substance use programs billing multiple levels of care?

Yes. We track outpatient, intensive outpatient, and partial hospitalization separately, including the new authorization required at each transition.

Healthcare practice guide

Billing, Books, and Payroll for Behavioral Health and Substance Use Programs

Authorization tracking, level-of-care documentation, and Medicaid rules that change by state.

Behavioral health billing fails on authorizations and units, not on medicine. Sessions delivered past an expired authorization, group units billed against an individual code, and level-of-care changes that were never re-authorized all become write-offs. We track the authorization calendar as tightly as the claim queue.

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Your practice

Set once — every healthcare tool below pre-fills from it and it stays with you for this visit.

Facility typeStateRendering providersCounted as providers

Authorization compliance: 100% target
Denial rate benchmark: 8-12%
Days in A/R target: Under 40

Where the money leaks

Expired authorizations

Care delivered after the last approved unit is almost never paid retroactively. We alert before the final units are consumed.

Unit and modifier errors

Group, individual, and family sessions carry different codes and time thresholds. One wrong modifier denies the whole day.

Level-of-care transitions

Moving a client between outpatient, intensive outpatient, and partial hospitalization requires a new authorization before the first session at the new level.

How we run it

1
Authorization calendar
Every client's approved units and expiration date tracked in one view.
2
Session-to-claim reconciliation
Delivered sessions matched to billed units weekly, not monthly.
3
State Medicaid rules
Program-specific edits applied per state so claims match the plan actually in force.
4
Denial appeals with clinical documentation
Appeals packaged with the notes the payer requires, not a generic form letter.
5
Program-level reporting
Revenue and utilization by program so you can see which level of care carries the practice.