Session limits and level-of-care denials, handled for you.
Behavioral health faces denial patterns that look nothing like physical medicine: session caps, level-of-care disputes, and parity enforcement gaps. We build appeals specific to behavioral health billing.
Denials we see most in behavioral health.
Every specialty has its own denial patterns. Here's what we typically find in behavioral health practices.
Session limit denials
Therapy and counseling sessions beyond a payer's initial authorized count require documented medical necessity to continue.
Level-of-care disputes
Intensive outpatient and partial hospitalization claims are frequently denied when documentation doesn't clearly justify that level of care over standard outpatient.
Medication management vs. therapy coding
Combined medication management and therapy visits are often denied or split incorrectly when coded together.
Mental health parity issues
Some denials reflect payers applying stricter limits to behavioral health than to comparable physical health services, which can itself be grounds for appeal.
The same done-for-you service, built for your specialty.
We pull your denials
Connected to your billing workflow, reviewed as they come in.
AI drafts, specialists review
Every appeal is cited to payer policy and reviewed by a billing specialist before it's sent.
We handle payer follow-up
Calls and re-submissions your staff doesn't have time for.
You see what's recovered
A simple monthly report on what was appealed and what came back.
See what your behavioral health denials are costing you.
Send us a sample of your recent denials. We'll show you what we'd appeal and what it could recover, free.
Get my free denial audit →Frequently asked questions.
Can you appeal session-limit denials for ongoing therapy?
Yes, we document medical necessity for continued sessions beyond the payer's initial authorization.
Do you handle level-of-care disputes for IOP or PHP programs?
Yes, these require detailed clinical justification for the level of care, which we build into the appeal.
What about mental health parity violations?
Where a denial appears to apply a stricter standard than comparable physical health coverage, we flag and appeal on that basis too.
Do you work with solo practitioners or only group practices?
Both, pricing and onboarding scale to your practice size.