Denials you never see coming
Claims denied for hitting a visit limit, a missing telehealth modifier, or a payer rule nobody told you about.
Revenue cycle management (RCM) built for behavioral health practices
Faster reimbursements, fewer denials and far less administrative weight, so you can stay focused on patient care instead of insurance paperwork.
- No long-term contracts
- HIPAA-compliant processes
- Dedicated account manager
Sound familiar?
Behavioral health billing breaks generic RCM
Every specialty has its own codes, payers and rules. Here's what we hear most from practice owners.
Prior auth maze
Units, re-auths and reviews for psychological testing and ongoing therapy eat hours of your team's time every week.
Under-paid claims
Payers pay less than your contract says, secondary insurance never gets billed, or your charges are set below your contracted rates. Nobody compares what was paid to what should have been paid.
Billing staff turnover
When your one biller leaves, institutional knowledge and a full A/R queue walk out the door with them.
Telehealth compliance drift
POS 02 vs 10, modifier 95 vs GT, state-by-state rules. The goalposts move every plan year.
Wrong payer, wasted claim
The card says Blue Cross, but behavioral health is managed by a separate company. Bill the wrong one and the claim is dead on arrival.
Services
Your full revenue cycle, handled end to end
Every step, from verifying coverage to posting the final payment, handled by one team that knows your practice.
Eligibility & Benefits Verification
Real-time checks on deductibles, copays, coinsurance, session limits and behavioral carve-outs before the first visit, then rechecked throughout care so coverage changes don't catch you by surprise.
Prior Authorization Management
We request, track and renew authorizations for psychological testing and any therapy that requires one, so sessions don't go unpaid because an auth lapsed.
Claims Submission & Scrubbing
Every claim is checked for coding, modifier and payer-specific errors before it goes out, and submitted within 24 hours of signed notes.
Rejections, Denials & Appeals
Claims rejected at the clearinghouse or payer are corrected and resubmitted promptly. Denials are worked to the root cause: we fix and resubmit, or file an appeal with the right documentation. We track rejection and denial reasons so the same mistake doesn't keep happening.
Payment Posting & Reconciliation
We post every payment and compare it to your contracted rate. Underpayments get caught and disputed, patient balances go to the right place, and secondary insurance gets billed.
A/R Follow-Up & Recovery
Any claim that goes unpaid past the payer's normal processing time gets a follow-up call or portal check. We also work older unpaid claims that are still within the filing window.
Patient Billing & Statements
Patient statements sent through your EHR when you want them, plus copay processing and answers to your clients' balance questions.
Reporting & Revenue Insights
Reports every two weeks on what's been billed and paid, what's outstanding, why claims were denied, and your payer mix.
Why CogniClaim
Specialists, not a generalist billing vendor
We work with behavioral health practices and nothing else, so we know your codes, your payers and where claims go wrong.
Behavioral health coding depth
Therapy, family and group therapy, psychiatric E/M with therapy add-ons, crisis sessions and psych testing. We make sure each one is billed correctly before the claim goes out.
More claims paid the first time
On top of your EHR and clearinghouse checks, we review every claim ourselves before it goes out, so fewer claims come back and you get paid sooner.
A dedicated account manager
A responsive, US-based person you know by name, who also knows your payers and your clinicians. No ticket queues.
Your data stays in your systems
We sign a BAA before any PHI is shared, then work directly inside your EHR, clearinghouse and payer portals. PHI never moves into a system of ours.
How it works
Four steps from first call to steady cash flow
- 1
Onboarding & practice assessment
We review your last 90 days of claims, plus a full year for Medicare and TRICARE since those can still be filed, to find the leaks worth fixing first: denials and sessions that never got billed.
- 2
Setup & access
We get access to your EHR, clearinghouse and payer portals and set up any payer enrollments you need. Most practices are up and running in 2 to 3 weeks.
- 3
Claims submission & tracking
We submit claims through your EHR and clearinghouse within 24 hours of signed notes, and chase anything that isn't paid on time.
- 4
Reporting & reviews
Every two weeks, we walk through your numbers together, flag anything that needs your attention, and recommend what to fix next, from problem payers to fees set below your contracted rates.
Our Standards
< 24h
From signed note to submitted claim
< 30
Average days in A/R
98%
Clean claim rate
100%
Denials worked
Bi-Weekly
Claim reporting
Pricing
A percentage-of-collections model with no hidden fees
We only get paid when you do. No setup costs, no per-claim charges, no surprise line items. Your rate is based on your practice size and claim volume, and you'll know exactly what you'll pay before you sign.
FAQ
Questions we get from practice owners
Contact
Get a free revenue audit
Send us a few details about your practice. We'll set up a quick call to learn about your billing setup, then dig into your claims data to show you the specific denials, underpayments, and auth gaps costing you money.
What happens next
- 1We reply within 1 business day.
- 2We find a time that works for you.
- 3We have a quick call about your billing setup.
- 4We review your claims and show you what we find.