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You started your practice to provide clinical care. We provide dedicated billing operations so you never have to spend late nights chasing clearinghouse rejections or unposted remittances.
As you add clinicians and expand payer contracts, informal billing systems begin to fracture. Practice directors find themselves spending evenings tracking down unposted electronic remittances and navigating complex carve-out authorizations.
MD Revenue Group replaces fragmented administrative patchwork with an accountable revenue cycle. We handle the daily operational mechanics so your clinical team can focus entirely on patient care.
Our certified billing teams master the distinct coding rules, credential modifiers, and payer enrollment requirements across all outpatient mental health disciplines.
We manage individual, group, and family therapy billing using state-specific master’s modifiers (-HO) and managed Medicaid credentialing.
We verify your time-documentation and handle your commercial payer network enrollment.
We secure reimbursement for family and couples psychotherapy (90846, 90847) while navigating complex commercial carve-outs.
We ensure precise billing for diagnostic testing (96130, 96131, 96136) by separating your evaluation time from technical administration.
We synchronize your medication management visits (E/M 99213–99215) with psychotherapy add-ons (+90833, +90836) for compliant dual reimbursement.
We centralize billing operations for multi-clinician groups, unifying your workflows across multiple EHR schedules.
Commercial insurance cards display major payers like BCBS, Aetna, or UnitedHealthcare, but mental health benefits are quietly carved out to separate specialty networks. Here is why unguided billing breaks.
From pre-encounter carve-out verification to penny-perfect bank reconciliation, see how every claim moves through our audit-proof lifecycle.
Real-time 270/271 inquiry before patient encounters to verify behavioral health deductible status, active session copays, and hidden third-party carve-out payer ID routing.
Successful billing partnerships require transparent boundaries. Here is exactly what MDRG executes and what remains under your practice’s clinical control.
Therapy and behavioral practices often struggle between overburdened in-house staff and software-only auto-submission. See how a dedicated behavioral RCM pod changes the financial equation.
| Billing Capability & Standard | In-House Clinic Biller | Software Auto-Submit | MD Revenue GroupDedicated Behavioral Pod |
|---|---|---|---|
Specialized AAPC Behavioral Coders Certified experts who know psychotherapy timestamp rules, add-ons, and ASAM levels | Costly & Hard to Find ($65k+/yr) | None (No Human Review) | Included (Dedicated Behavioral Pod) |
Pre-Submission Timestamp Scrubbing Verifying notes match start/stop times before claims leave to stop 90837 downcoding | Inconsistent / Manual | Not Checked (Blind EDI) | 100% Pre-Claim Audit |
Automated Carve-Out Payer Rerouting Identifying Optum BH, Carelon, and Magellan before submitting to primary clearinghouse | High Error Rate | Routes to Primary (Rejection) | Automated Crosswalk Routing |
Aggressive Denial Appeals SLA Formal clinical narrative appeals for unworked denials within 48 business hours | Often Backlogged / Abandoned | Clinician Must Appeal | 48-Hour Systematic SLA |
Practice Pricing & Risk Alignment Compensation model aligned directly with actual collections and financial performance | Fixed Salary, Taxes & Overhead | Monthly Fee Regardless of Pay | Performance-Based (2.99%–8.5%) |
Long-Term Contract Commitment Flexibility to evaluate partnership value monthly without restrictive lock-ins | Severance & Re-hiring Friction | Annual Platform Lock-In | Month-to-Month (Earned Trust) |
We work directly inside your existing behavioral health EHR platform. Your clinicians and front desk document as usual without learning new tools.
Switching billing companies or transitioning from in-house billing requires careful coordination to prevent claim lag or unworked denial queues.
We configure billing credentials inside your EHR and establish EDI clearinghouse links.
We identify outstanding uncollected claims and map your top recurring denial patterns.
Our certified coders begin daily charge scrubbing and submission, ensuring zero downtime in your practice’s cash flow.
We transition your complete workflow with daily remittance posting and deliver your first monthly executive review.
Evaluating an outsourced billing partnership requires transparent answers about control, visibility, software access, and denial ownership.
No. All billing activity, claim submissions, and payment postings occur directly inside your practice’s existing EHR and clearinghouse accounts. You maintain complete, real-time administrative access to every patient ledger and remittance advice at all times. We provide monthly reconciliation summaries so you never have to guess what was collected.
Yes. We work natively inside standard mental health platforms such as TherapyNotes, SimplePractice, Valant, AdvancedMD, and Kareo. Your clinicians do not need to learn new software or alter how they document patient charts.
Yes. Outpatient mental health practices frequently bill a complex mix of major commercial plans (Aetna, BCBS, Cigna, UnitedHealthcare), state Medicaid programs, and third-party carve-out managers (Optum Behavioral Health, Carelon). We apply payer-specific rules for every encounter.
Yes. During onboarding, we evaluate your practice’s legacy uncollected accounts receivable. We identify recoverable claims within timely filing and appeal windows, correct technical defects, and pursue outstanding balances to maximize capital recovery.
Onboarding is designed to minimize clinical disruption. We require EHR administrative access, your current fee schedule, active payer contract roster, and provider credentialing numbers (NPI, license, taxonomy). Setup typically takes 2 to 4 weeks with zero claim submission blackouts.
MDRG owns the entire denial lifecycle. Correctable technical rejections (e.g. modifier mismatch, eligibility date gap) are corrected and resubmitted within 48 hours. When medical necessity or parity denials occur, our team drafts structured clinical appeals supported by session documentation.
Here is how we evaluate whether our services match your practice model:
We do not hide behind anonymous offshore call centers or unverified software bots. MDRG provides direct access to credentialed revenue cycle managers and certified coding specialists.
Our coding and audit specialists maintain active credentials with the American Academy of Professional Coders (AAPC), ensuring precise CPT, ICD-10, and modifier application for behavioral healthcare encounters.
All data exchange, clearinghouse connections, and EHR interactions strictly adhere to HIPAA Omnibus standards, including 256-bit SSL encryption, restricted role-based access, and signed Business Associate Agreements (BAAs).
Founded by Faisal and Salwa in 2023 with over 13 years of combined revenue cycle leadership. Every practice has a named billing operations manager with direct phone and email escalation pathways.
Transparent month-end reporting on net collections, gross claims, denial categorization, and days in AR. We earn your partnership through monthly performance without restrictive multi-year lock-ins.
“Independent behavioral health clinicians should never have to sacrifice patient session time to battle commercial insurance clearinghouses. We treat your revenue cycle with the exact operational discipline you apply to patient care.”Faisal & Salwa — Founders, MD Revenue Group
Clear answers to common questions about outpatient mental health billing, timestamp documentation, and outsourcing transitions.
When an independent practice grows from 1 to 5+ therapists, the administrative burden of checking benefits, verifying modifiers, tracking denials, and posting payments multiplies exponentially. Outsourcing creates a dedicated billing department that scales automatically as you add clinicians, preventing billing delays and clinician burnout.
Our certified coding specialists scrub every claim against documented start and stop timestamps in your EHR. For extended 60-minute encounters (90837), we verify that the clinical narrative supports the medical intensity required to defend against automated downcoding to 45-minute codes (90834).
Our fees are structured as a performance-aligned percentage of net collections (typically ranging from 2.99% to 8.5%), depending on monthly volume, provider count, and payer complexity. We do not charge per-claim fees or lock practices into multi-year contracts. See our pricing overview for detailed tier information.
Yes. Through our credentialing services, we manage CAQH profile maintenance, payer applications, fee schedule reviews, and rendering NPI links for all incoming therapists, psychologists, and psychiatric nurse practitioners.
Once the primary insurer adjudicates an electronic remittance (835), patient responsibility is reconciled automatically. We generate clear, itemized patient statements through your EHR portal, minimizing patient confusion and accelerating copay collection velocity.
Our baseline review evaluates aggregate billing efficiency: denial rates by CPT code, average days in A/R, and fee schedule alignment. We use de-identified remittance data or view-only access to your billing ledger. Zero patient names, member IDs, or clinical therapy notes are ever required.
Once your clinicians sign and lock session notes in your EHR, our coders review and release claims to the clearinghouse within 24 to 48 hours, ensuring maximum cash flow velocity.
We specialize in integrated behavioral practices. Our coders manage evaluation and management (E/M) synchronization alongside psychotherapy add-ons (+90833, +90836) and Collaborative Care / BHI codes (99484, G0511). For specialized physician psychiatry, see our Psychiatry Medical Billing page.
Discover where uncaptured session time, downcoding, and payer rejections are eroding your collections. No patient-identifying data required.
Speak directly with an MDRG billing operations manager about your EHR setup, payer friction, credentialing timeline, or practice transition. No sales pitch, zero claim data needed.
