Running a mental or behavioral health practice in the USA means balancing excellent clinical care with a complex revenue cycle. This checklist is designed for psychiatrists, psychologists, therapists, counselors, and clinic managers who want fewer denials and more predictable cash flow.
Use it as a monthly audit tool or as a roadmap when you evaluate outsourcing partners.
1. Patient Intake & Insurance Setup
- ☐ Collect complete demographic and insurance information at intake
- ☐ Scan or store insurance cards (front and back)
- ☐ Capture secondary insurance when applicable
- ☐ Confirm preferred contact method for billing questions
- ☐ Obtain necessary consents for billing and assignment of benefits
2. Eligibility Verification
- ☐ Verify coverage before the first appointment
- ☐ Re-verify for ongoing patients at set intervals (e.g., monthly or quarterly)
- ☐ Confirm mental health benefits, session limits, and cost-sharing
- ☐ Document whether prior authorization is required
- ☐ Flag out-of-network or limited-benefit plans early
Strong eligibility verification prevents many avoidable denials.
3. Prior Authorization Tracking
- ☐ Identify services that require authorization by payer
- ☐ Request authorizations before care begins when required
- ☐ Track authorized units and expiration dates
- ☐ Set reminders before authorizations run out
- ☐ Document authorization numbers on claims
4. Clinical Documentation
- ☐ Ensure notes support medical necessity for each billed service
- ☐ Align diagnosis codes with the documented condition
- ☐ Record start/stop times for time-based psychotherapy codes
- ☐ Document telehealth modality and patient location when required
- ☐ Complete notes promptly so billing is not delayed
5. Coding Accuracy
- ☐ Use correct CPT codes for evaluation, psychotherapy, and testing
- ☐ Apply appropriate add-on codes and modifiers
- ☐ Select the most specific ICD-10 diagnosis available
- ☐ Match place of service (including telehealth rules)
- ☐ Review coding for high-denial service lines monthly
Specialty medical billing and coding support can close gaps that general billers miss.
6. Claim Submission & Scrubbing
- ☐ Scrub claims for missing data before submission
- ☐ Submit claims electronically whenever possible
- ☐ Meet timely filing deadlines by payer
- ☐ Batch and track claim submission dates
- ☐ Confirm clearinghouse acceptance reports
7. Denial Management
- ☐ Work denial reports weekly (not monthly)
- ☐ Categorize denials by reason code and payer
- ☐ Correct and resubmit when the issue is fixable
- ☐ File formal appeals with supporting documentation
- ☐ Update processes so the same denial does not repeat
See our approach to denial management for behavioral health.
8. Payment Posting & Patient Balances
- ☐ Post insurance payments accurately and promptly
- ☐ Reconcile ERA/EOB differences
- ☐ Generate clear patient statements for residual balances
- ☐ Offer payment options consistent with practice policy
- ☐ Review credit balances and refunds on a schedule
9. Reporting & Oversight
- ☐ Monitor clean claim rate
- ☐ Track denial rate by reason
- ☐ Review days in A/R (overall and by aging bucket)
- ☐ Measure net collection rate
- ☐ Hold a short monthly revenue cycle review
Full revenue cycle management ties these steps together into one accountable process.
10. Compliance Basics
- ☐ Maintain HIPAA-compliant access to billing systems
- ☐ Limit PHI access to staff who need it
- ☐ Keep payer contracts and fee schedules organized
- ☐ Train staff on documentation and coding updates annually
- ☐ Document billing policies for consistency
How to Use This Checklist
Solo providers: Work through one section per week until your process is stable.
Group practices: Assign owners to each section and review metrics monthly.
Practices considering outsourcing: Use this list to evaluate whether a specialty billing partner covers every critical step.
CareTrack Billing helps mental and behavioral health practices across the USA implement these workflows — or run them for you. Book a free consultation to identify the highest-impact gaps in your current process.