Revenue cycle
Know what you're owed, per payer, per code.
Contracted rates stored per payer and per service, so the expected payment is on the claim before it goes out and underpayments are visible the moment the remittance posts.
Fee-for-service and case rates. Per-session, per-diem, and episode structures supported.
The fee schedule
What the contract says, next to what the payer actually sent.
Load the rate once per payer, per code, with effective dates. Every claim then carries an expected amount — and every remittance gets compared against it automatically.
Three structures
Behavioral health does not bill one way.
An outpatient practice bills per session. A day program bills per diem. A residential facility bills a case rate on a UB-04. A platform that only understands the first one turns the other two into manual work.
Individual, group, family, and assessment codes billed per encounter at the contracted rate.
PHP and IOP days billed as a bundled rate, with attendance driving whether the day is billable.
Residential and detox billed per day or per episode against the authorized length of stay, on a UB-04.
The negotiation
Bring volume, outcomes, and what you were actually paid.
Renegotiating a rate is a data conversation. Knowing you delivered 1,400 IOP days, improved 68% of episodes, and were underpaid on 6% of claims is a different meeting than asking for more money.
Works with
It runs on the same record as the rest of the platform.
Clinical
Outcome measurement
Twenty-four standardized assessments go out before and after sessions, score themselves, and trend against the patient's baseline.
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Remittance & bulk posting
Read the ERA, match the lines to the claims, post the payments and adjustments, and route what didn't match to the denials queue.
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Claim scrubbing
Validation runs before the claim leaves, highlights the exact field that will get it kicked back, and says why in plain language — not a rejection code you have to look up.
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