Billing Health Check
12 questions. 3 minutes. Get a letter grade for each area of your billing operation so you know exactly where you stand.
No email required to see your results.
The 6 areas of a healthy billing operation
A behavioral health practice is paid correctly and on time only when six parts of the revenue cycle work together. Use the sections below as an evergreen checklist for an outpatient mental health or therapy practice. Each area builds on the one before it, so a weak link early in the chain shows up as lost revenue at the end.
Eligibility and authorizations
Coverage problems caught before a claim is submitted cost nothing. The same problems caught after a session has happened cost everything. Verify insurance and scan the front and back of the card for every new patient, confirm benefits before care begins, and submit authorization requests with clinical input ahead of the first visit. Verification and authorization gaps generate more claim denials than almost any other single factor in behavioral health billing.
Claims cadence
Consistent submission keeps revenue moving, and delays compound quickly. Submit clean claims on a scheduled basis at least weekly, and identify and correct rejected claims within roughly 48 hours of receipt. A predictable cadence smooths cash flow and leaves plenty of room inside each payer timely filing deadline, while a once-a-month batch leaves almost none.
Payment posting
Accurate posting is how you know what you have actually collected and what you have not. Post and reconcile electronic remittances and manual explanations of benefits at least weekly. Until payments are reconciled against what was billed, your true collection rate is invisible and underpayments slip by unnoticed.
Denial management
Denials do not resolve themselves. They need dedicated, protected time and a person who owns them. Set aside regular time each week to work and appeal denials, and track denial reasons over time so you can address root causes instead of reworking the same claims. A denial that is not worked promptly often becomes permanently lost revenue.
Accounts receivable
Aging claims are silent revenue killers, and most practices do not find them until it is too late. Run a formal A/R audit at least once a month and keep a clear process for any claim that ages beyond 90 days. Monthly review surfaces aging claims before they cross timely filing limits, which is where thousands in recoverable revenue is quietly written off.
Patient balances
Uncollected patient balances add up quietly. Consistent policies and trained staff are the only reliable fix. Define clear rules for maximum patient balance, card on file, payment plans, and sliding scale fees, and apply them consistently across the clinic. Just as important, make sure clinical and non-clinical staff are trained on those policies and actually using them, because staff who are unsure will avoid the conversation and leave money on the table.
How the letter grades work
The Billing Health Check turns your answers into a letter grade for each area and one overall grade. Every question is answered yes, partially, or no, worth two points, one point, and zero points. Your points in an area are divided by the most you could have earned to give a percentage, and that percentage becomes the grade.
For an individual area, an A means a perfect score, a B is 75 percent or higher, a C is 50 percent or higher, a D is 25 percent or higher, and below that is an F. The overall grade is a little more forgiving because it blends all six areas together. An A overall is 90 percent or higher, a B is 75 percent or higher, a C is 55 percent or higher, a D is 35 percent or higher, and anything lower is an F.
The grades are a directional snapshot, not a financial audit. A high grade means your fundamentals are sound. A low grade points to where the next dollar of recovered revenue is most likely hiding.
What to do with a low grade in each area
Low on eligibility and authorizations
Build verification into intake so no new patient is seen without a benefits check, and scan both sides of the insurance card. Create a short pre-care checklist that ties authorization requests to clinical documentation so approvals are in hand before the first session.
Low on claims cadence
Move from monthly or ad hoc submission to a fixed weekly schedule, and assign someone to clear clearinghouse rejections within 48 hours. Even a few days of delay, repeated across months, is real cash flow you are giving up.
Low on payment posting
Set a recurring weekly block to post and reconcile every ERA and manual EOB. Reconciling against what you billed is what reveals underpayments and gives you a collection rate you can trust.
Low on denial management
Carve out protected, recurring time to work and appeal denials so the task stops losing to daily intake work. Start logging denial reasons so you can fix the upstream cause rather than reworking the same claims every month.
Low on accounts receivable
Put a monthly A/R audit on the calendar and define a clear path for anything aging past 90 days. The goal is to catch claims before they hit timely filing limits, when they are still recoverable.
Low on patient balances
Write down your balance policies, including maximum balance, card on file, payment plans, and sliding scale, then train every staff member to apply them the same way. Consistency and confidence at the front desk are what turn balances into collected revenue.
Frequently asked questions
How often should I submit claims?
Submit claims at least once a week, and daily if your volume supports it. A steady weekly cadence keeps cash flow predictable and gives you time to correct rejections well inside payer timely filing windows. Batching claims into a single monthly run is one of the most common and most costly habits in behavioral health practices.
What is a good days-in-A/R for a behavioral health practice?
A healthy behavioral health practice generally runs between 30 and 40 days in accounts receivable. Under 30 days is excellent. If you are consistently above 50 days, claims are aging faster than they are being paid, and a portion of that revenue is at risk of crossing timely filing limits and becoming unrecoverable.
How do I reduce denials in a therapy practice?
Stop most denials before they happen by verifying eligibility and benefits before the first session and securing authorizations with clinical input before care begins. For the denials that still occur, set aside dedicated, protected time each week to work and appeal them, and track denial reasons over time so you can fix the root cause instead of reworking the same claims.
How is the overall letter grade calculated?
Each of the six areas is scored from your answers, then combined into one percentage. An A is 90 percent or higher, a B is 75 percent or higher, a C is 55 percent or higher, a D is 35 percent or higher, and anything below that is an F. The grade is a directional snapshot of where your billing operation stands, not a clinical or financial audit.
How long does the Billing Health Check take?
About three minutes. It is a short set of yes, partially, and no questions across the six areas of a billing operation, and you see your results immediately. No email is required to view your grades.
Why do unposted payments matter so much?
Until ERAs and EOBs are posted and reconciled, you cannot see your true collection rate or spot underpayments. Unreconciled payments hide money you are owed and delay the discovery of payer errors. Posting and reconciling at least weekly is the baseline for knowing what you have actually collected.
When should patient balances be collected?
The most reliable point of collection is at or before the time of service, supported by a card on file, clear maximum balance policies, payment plans, and sliding scale rules that every staff member applies consistently. Balances that age without a consistent policy behind them are the hardest dollars in the practice to recover.
Is the Billing Health Check a substitute for a full audit?
No. It is a fast self-assessment designed to show you where to look first. A full review of your claims data, payer mix, and aging report gives a far more precise picture. If your grades point to real gaps, a free consultation with our team is the next step toward closing them.
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