RCM agents for outpatient mental health
Your billing on autopilot. Claims scrubbed and filed within 24 hours, eligibility checked before every visit.
Results vary by payer mix, documentation quality, and specialty.
Benefits checked before every visit
Agents re-verify two days before each session and surface only what changed: a visit limit already half used, a deductible the patient does not know about, a plan that quietly terminated.
- Reading tomorrow's schedule42 sessions
- Re-checking eligibilityAvaility
- Sending changes to the front desk
- Plan
- Aetna Behavioral Active
- Copay
- $40 (was $25)
- Sessions used this plan year
- Covered 18 / 20
- Visit limit
- 2 sessions remaining
- Plan on file terminated 14 Aug
- Copay $25 → $40 at renewal
Notes and codes that always agree
Session notes, treatment plans and intake notes, aligned to what your payers require in your state. The code is written from the note, so a note that can't support it gets corrected before filing, not appealed after.
- PassSession length in the note47 minutes documented
- FlagCode matches the time90837 needs 53+ minutes
- PassSignature and credentialsLCSW · same day
- Billed
- 90837 · 53+ min
- Supported
- 90834 · 38–52 min
47 minutes documented. 90837 is the most common downcoding trigger in outpatient.
- Recoded to 90834 · claim released
Clean claims, filed the same day
Code against the documented session length. Validate the add-on against the same-day E/M. Confirm the modifier and place of service for telehealth. Then file, the same day.
- PassPlace of servicePOS 10 · telehealth
- FlagTelehealth modifierGT sent · plan requires 95
- PassAdd-on against same-day E/M90833 with 99213
- PassUnits match the time1 unit
- Sent
- 90834 · GT
- Required
- 90834 · 95
This payer retired GT. The rule now applies to every claim in the batch.
- Modifier replaced · claim released
Denials worked, not queued
Agents pull the denial reason, assemble the documentation, and file the appeal. Specialists take the payer conversations. The same cause usually sits behind dozens of claims, so the fix goes back into the scrub, not just the claim.
- Reading the remittance835 ERA
- Checking the payer's policyGT retired · 95 required
- Correcting and refilingAll 23 claims
- Denial reason
- CARC 4
- Claims affected
- 23
- At stake
- $4,240
Fixed at the source. One root cause behind all 23 claims. Fixed as a batch, written back into the scrub.
- $4,240 refiled · rule now runs pre-submission
Frontier agents + experts in the loop
Human RCM experts work alongside the agents on complex edge cases, so your cash is always maximized.
Who we bill for
Billing that does not need a full-time biller to run it.
Per-site reporting with one operation across every location.
E/M with add-on psychotherapy, coded and validated together.
Base and add-on unit maths against documented administration time.
Place of service and modifier rules held per payer, per policy cycle.
Credentialing-aware billing that scales without adding billers.
Works on top of your existing software
Agents log into the systems you already run. No migration, no new EHR, no implementation project.
Integrates with all major mental health EHRs
& many more
Read access to your EHR and remittances, your payer list and fee schedules.
Agents learn your codes, your payer rules and how your clinicians document.
Agents verify tomorrow's schedule and file today's claims.
Once you're onboarded, going live takes 3 days. Outpatient billing has fewer moving parts than residential, so there is nothing to migrate and nothing to wait for.
Customer testimonials
More client stories
See what your billing is leaving behind
Ninety days of paid claims, reconciled against what you should have been paid. You keep the findings either way.
Our agents review 90 days of your paid claims and tell you three things:
- 01What you were underpaid.
Every claim reconciled against what your payer actually owed under your contracted rate.
- 02What's denying, and why.
Usually one root cause is sitting behind dozens of claims.
- 03Where your coding is exposed.
Sessions billed at 90837 that your notes only support at 90834, the most common downcoding correction in outpatient.
You keep the findings in writing, whether or not you work with us.
FAQs
AI agents that run your billing. They verify benefits for every appointment, file your claims, work your denials, and yes — even call payers on your behalf.
