Curtis Neider, CEO , Illuminate Billing Advocates
Curtis Neider, CEO Medical billing for mental and behavioral health services is inherently more difficult than other areas of healthcare. Because the type of services, time, scope, and restraints placed on mental health treatments are unique to each individual, the billing becomes less structured and more complicated.

For instance, if a patient sees a doctor for a routine check-up, the patient will most likely undergo a standard series of examinations and tests. The billing process for that patient similarly goes through a standardized manner - the healthcare provider bundles the charges against each test and shares it with the patient/health insurer.

However, the same cannot be said regarding mental health or substance abuse treatments. It is difficult to standardize treatment, and consequently, its billing has been historically difficult to standardize. But with various governmental policy reforms improving access to mental health and substance abuse treatment, including the Affordable Care Act (ACA), insurance companies have made a considerable push toward standardized mental and behavioral health billing to help practitioners gain full reimbursement for their work, which in turn, will assist more patients gain more access to care.

Illuminate Billing Advocates is assisting the medical community in this endeavour. “We provide a full suite of medical billing services, with a particular focus on substance abuse and mental health treatment services. Our aim is to facilitate healthcare providers shape the body of billing and reimbursement while providers deliver value-driven care,” states Curtis Neider, CEO of Illuminate Billing Advocates.

An Illustrious Suite of Services

By maintaining a full suite of services, Illuminate facilitates seamless billing cycles and faster payments. One primary example is Illuminate’s verification of benefit (VOB) service, which acts as a pipeline between insurance companies and healthcare providers, making it possible for healthcare professionals to have accurate details of patients’ insurance benefits prior to patient admission.

Illuminate Billing Advocates: Simplifying Medical Billing for Mental and Behavioral Health Services

We provide a full suite of medical billing services, with a particular focus on substance abuse and mental health treatment services

The VOB service also aids healthcare providers in estimating insurance reimbursement before rendering patient care. Additionally, thanks to its ‘pre-authorization’ service, Illuminate advocates on behalf of each patient on a case-by-case basis for more authorized days of care, so the patients can maximize their insurance benefits and receive as much care as possible to assist in the road to recovery.

Furthermore, Illuminate’s online dashboard and analytics help healthcare providers track the status of all of their claims, 24/7. The dashboard provides a quick glance at all their outstanding charges, historical reimbursement rate from each insurance company, and an estimated reimbursement rate for each level of care that has been billed. “At the same time, if we start to see reimbursement rates going down from a particular payer, we use our reporting to identify those trends with the help of our billing team and enable our clients to recognize which payers will be better to add into their mix of an insurance network,” adds Neider.

An added feather on the cap, Illuminate specializes in collecting challenging claims. They believe that avoiding the collection of difficult claims sets a precedent with the insurance company and leads to lower future reimbursements. “For our business, we feel like it’s the right thing to do for our clients. And we go after those difficult claims and have collected 10 percent more claims than our competitors in certain circumstances, and that increases our client’s revenue,” asserts Neider.

As an example of Illuminate’s determination to collect difficult claims, one of Illuminate’s client’s decided to switch to a new biller. Despite losing this client, Illuminate continued pursuing this client’s claims through appeal up to the state insurance commission, eventually winning the appeal – all because of Illuminate Billing’s relentlessness. The client noted they hadn’t received that type of dogged support from the new biller and quickly contracted Illuminate to begin providing billing services again. Today, they remain Illuminate’s loyal client.

Riding on the coattails of such success stories and fostered by its innovative services, Illuminate Billing Advocates is focusing on shortening the time required for claims processing and lengthening authorization of care. Illuminate continuously looks for innovative solutions to bring more visibility and efficiency in medical billing management. “We have seen consistent growth year over year, and we are continuing to see a number of clients in our portfolio grow at an impressive rate as we continue serving clients throughout the country,” concludes Neider.