Substance use disorder and behavioral health billing requires more than claim submission. It requires payer strategy, authorization alignment, denial management, and structured revenue oversight.
Mediclaim Pros provides comprehensive medical billing and revenue cycle management services designed specifically for SUD and behavioral health providers operating in complex regulatory environments, including California and Florida.
Generic billing companies often lack the clinical and payer insight required for behavioral health reimbursement. Our work is built around medical necessity standards, authorization timing, parity considerations, and contract enforcement. We support providers with:
• Full scope revenue cycle management
• Claims management and appeals
• AR recovery and legacy receivables
• Contract negotiation and payer relations
• Utilization review alignment
• Credentialing and enrollment oversight
• Executive level strategic advisory support
Our experience navigating payer systems in California and Florida allows us to anticipate common denial patterns and reimbursement challenges before they impact cash flow.
Behavioral health reimbursement is often disrupted by:
• High denial rates
• Medical necessity disputes
• Authorization gaps
• Underpayments
• Aging accounts receivable
• Contract misalignment
• Limited internal bandwidth
Without structured oversight, earned revenue can remain uncollected.
A. Review a selected sample of denied or underpaid claims
B. Analyze denial patterns and root causes
C. Evaluate documentation and authorization alignment
D. Identify recovery pathways and systemic gaps
E. Deliver a structured action plan
All audit activity is conducted through secure, HIPAA compliant protocols. Our team is HIPAA certified and trained in structured data protection procedures.Patient confidentiality and regulatory compliance are foundational to every engagement.
If you choose to move forward, we provide integrated support across the entire revenue lifecycle:
• Eligibility verification and benefits analysis
• Charge capture and coding review
• Claims submission and monitoring
• Denial prevention and workflow optimization
• Appeals management
• AR and legacy receivable recovery
• Payer contract analysis and negotiation
• Utilization review support
• Financial reporting and executive summaries
Our approach is built to strengthen reimbursement integrity and long term operational stability.
Denied claims represent revenue already earned. A structured review can reveal recoverable funds and highlight operational improvements that strengthen future reimbursement.
Request Your Courtesy Denial Audit
Submit a limited sample of denied claims and receive a confidential, no obligation action plan within 7 to 10 business days.Protect your revenue. Strengthen your systems. Gain clarity before writing claims off.