Behavioral Health 02
Multi-location behavioral health group lifts clean claims from 89% to 97%
A four-site behavioral health group needed a more reliable process for authorizations, claims, and payment posting across locations that had each drifted into their own habits.
- Practice type
- Behavioral health, four locations
- Location
- Midwest US
- Provider count
- 14 clinicians
- Engagement length
- 120-day implementation
| Period | Value | Phase |
|---|---|---|
| Month 1 | 11 | Before engagement |
| Month 2 | 10 | Before engagement |
| Month 3 | 7 | After engagement |
| Month 4 | 5 | After engagement |
| Month 5 | 4 | After engagement |
| Month 6 | 3 | After engagement |
The challenge
Authorizations were tracked in four different places, so units lapsed mid-treatment and completed sessions were written off. Payment posting ran a week behind, which meant nobody could tell which claims had actually been paid and which had quietly denied.
Our approach
Front-office handoffs were aligned to one shared billing workflow across all four sites, authorization units and expiry dates moved into a single tracked view, and outstanding claims became visible to site managers rather than only to billing.
How the engagement unfolded
- Week 1–3 Site-by-site audit Documented how each location actually handled intake, authorization and posting — which turned out to be four different ways.
- Week 4–8 One shared workflow Standardised the front-office handoff and moved authorization tracking into a single view with expiry alerts.
- Week 9–14 Posting and follow-up Brought payment posting current, then worked the backlog of unresolved claims each site had accumulated.
- Week 15–17 Handover and reporting Site managers took on weekly outstanding-claim review with reporting built for non-billing staff.
The authorization tracking alone changed how we work. We stopped writing off sessions our clinicians had already delivered.
Figures on this page are an illustrative example of a typical engagement, not measured results from a named client. Your own outcome depends on your payer mix, specialty and current workflow.
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