General medical billing follows a documented exam, test, or procedure. Mental health billing follows a timed clinical session. A therapy claim does not have an X-ray, lab result, or operative report behind it. The claim is paid when the note, the code, the modifier, the POS, the auth, and the credentialing record all line up against the payer's specific policy on that date of service.
Our rates start at 5% of collections with zero upfront fees. For solo practitioners, billing leaks through skipped benefit checks, late submissions, 90837 denials, telehealth POS errors, and unclear balances. We keep the workflow simple: claims reviewed, scrubbed, submitted, posted, followed up, without forcing you to be your own billing department after sessions.
Pediatric practices rely heavily on Medicaid and CHIP reimbursements. These plans often have stricter documentation, authorization, and timeOne provider's missing payer link can become hundreds of denied claims before anyone notices. We handle onboarding, paneling, claim submission by rendering provider, and provider-level denial reporting, so the new hire's first month doesn't become next quarter's A/R problem.ly filing rules.
We review: E&M level support, medical decision-making documentation, medication management notes, psychotherapy add-on support, time documentation, diagnosis linkage, telehealth billing, incident-to and supervisory billing concerns where applicable
This includes assessment-batch billing, handling technician-administered testing rules, and capturing your report-writing time. Unit tracking runs against documented time for evaluation, administration, scoring, interpretation, and report writing.
We verify patient state versus provider licensure on every single claim. We check telehealth claims for patient home versus non-home location, audio-video versus audio-only, provider state licensure, patient state at time of service, payer telehealth coverage rules, and documentation of modality.
IOP and PHP day billing runs against an authorization with an approved day count and a date range. We also manage your ASAM level-of-care documentation, census reconciles daily against the authorized days, individualized treatment plan, group and individual session notes, and physician oversight all sit on the chart.
We maintain strict 42 CFR Part 2 confidentiality compliance. We also process MAT coding for methadone, buprenorphine, and naltrexone workflows. IOP and PHP day billing with utilization review touchpoints. With consent management distinct from the HIPAA authorization.
Including: 97151, 97152, 97153, 97154, 97155, 97156, 97157, and 97158. We track authorization units, provider type, supervision rules, session notes, and payer policy so the claim does not fail. We control the complex rules for supervision versus direct service and manage concurrent billing under Medicaid waiver programs.
ANR behavioral health billing team manages clean enrollment, correct provider type, proper documentation, and careful telehealth handling. We help all types of practices for medicare provider enrollment, PECOS updates, revalidation tracking, MAC documentation standards, psychotherapy and psychiatric E&M billing, telehealth POS and modifier review, Medicare secondary payer issues, and denial and appeal follow-up.
OEach state may have its own Medicaid rules. ANR manages Medicaid and MCO billing for: State-specific claim rules, Medicaid provider enrollment, managed Medicaid credentialing, H-code billing, prior authorization, Level-of-care documentation. Also, plans like Centene, Molina, Anthem, Aetna Better Health, BCBS Medicaid plans, and other state-specific.
Commercial behavioral health billing often fails because the claim goes to the wrong payer. We check carve-out routing during eligibility. Common behavioral health administrators include: Optum Behavioral Health, Carelon Behavioral Health, formerly Beacon Health Options, Magellan Healthcare, MHN, Compsych, Lucet, formerly New Directions.
For OON providers, the billing process has to be clear from the first visit. If you are out of network, we still have you covered. We manage superbill generation, negotiate single-case agreements, and verify OON benefits. We also handle claim submissions directly to the patient or directly to the payer.
Payer won't reverse a COB denial without an explicit COB update request from the patient or the practice. ANR Medical Billing coordinates primary and secondary payers to make sure you get fully reimbursed. This includes handling Medicare and Medicaid dual eligibility, employer and spousal coordination, and tertiary commercial plans.
| KPI | Industry Benchmark | ANR Client Average | ANR Client Average |
|---|---|---|---|
| Net Collection Rate | 95%+ | 97.4% | Percentage of collectible revenue actually collected after adjustments |
| First-Pass Clean Claim Rate | 95%+ | 97.1% | Claims accepted on first submission with zero rework |
| Days in Accounts Receivable | Under 35 days | 28 Days | Speed from claim submission to payment |
| Denial Rate by Root Cause | Under 5% | 3.2% | Reveals whether denials are coding, authorization, or documentation driven |
| Appeal Overturn Rate | 85%+ | 89% | How well your biller fights denied claims |
| A/R Over 90 Days | Under 15% | 9% | Percentage of receivables aging past the collection-risk threshold |
We pull three months of claim history from your EHR and clearinghouse. We identify denied claims that were never resubmitted, claims approaching timely filing deadlines, payments posted at rates below contract, and credentialing-related denial patterns.
We prioritize high-dollar codes (90837, 99214 + 90833, 96130–96137, J1301, 90867) and target the highest-overturn denial categories like modifier errors, authorization gaps, and documentation deficiencies.
When a payer reimburses below the contracted rate, we file formal underpayment disputes with supporting documentation. Most payer system errors are resolved in a single challenge cycle.
Claims aged 60+ days receive aggressive payer follow-up. Claims aged 90+ days are escalated to supervisor-level payer contacts. Our goal is to reduce A/R over 90 days from your current percentage to below 15% within the first quarter.
Protected Health Information handling, encrypted data transfer, BAA management
Mental Health Parity and Addiction Equity Act compliance for non-quantitative treatment limitations
Substance use disorder confidentiality (stricter than HIPAA)
Good Faith Estimates for self-pay patients, balance billing protections
Information blocking and patient access compliance
For PHP, IOP, and inpatient psychiatric facilities
| Billing Area | ANR Billing | In-House Billing |
|---|---|---|
| Expertise Coverage | A dedicated team tracks payer policies, modifier updates, and Medicaid rules. | Single billers find it difficult to keep up with constant Medicare, Medicaid, and commercial changes. |
| Denial Management | Every denial enters a strict 24-hour appeal process using payer-specific templates. | Appeals get delayed while the biller gets confused managing submissions, eligibility, and posting. |
| Scalability | Grow your practice with zero extra billing staff. Your percentage fee stays the same. | Adding just one clinician creates massive new workloads for credentialing and authorizations. |
| Cost Structure | You only pay a percentage of collections. No salaries, software fees, or training costs. | You pay full salary, taxes, benefits, PTO, and software costs ($65K to $95K+ per biller). |
| Coverage | Your claims are processed 24/7. You never experience coverage gaps or billing delays. | Your cash flow stops completely during PTO, sick days, vacations, or staff turnover. |
| Reporting | Access real-time dashboards and detailed monthly reports by provider, payer, and denial type. | You rely on manual reports that take days to build and lack deep financial insights. |
| Compliance Risk | A full compliance team protects every single workflow with built-in audit defense. | One single person carries the massive risk of HIPAA, MHPAEA,42 CFR Part 2, and No Surprises Act compliance. |
| Average Overhead Reduction | Cut your total billing operations costs by an average of 35% to 45%. | You pay maximum baseline costs and absorb all unexpected operational expenses. |
Our most advanced medical billing solutions are offered to all medical specialties across the state and include famous cities like:
