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Get A Free Revenue Cycle Management Assessment

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Turning Denials into Cash Flow with AI-enabled IOP Billing Solutions

Best-in-class Cutting-edge IOP Billing Solutions for Behavioral Health Services and Substance Use Treatment Providers

AI-powered Technology

End-to-end Revenue Cycle Management

24/7 Support

Proven Success Record

Simplified IOP Billing for You

As the best medical billing company, Plutus Health simplifies IOP billing for behavioral health and substance use treatments. Our AI-powered revenue management solutions and 70+ RCM Bots accurately handle complex codes, submit error-free claims, and get you maximum reimbursements.

CMS Guidelines for IOP Reimbursement Eligibility

  • Supervision Required: The attending provider must supervise the patient at all times.

  • Adherence to Plan: Follow the initial treatment plan.

  • Diagnosis Focus: Address the diagnoses that require admission.

  • Best Practices: Maintain consistency with clinical best practices.

  • Duration: Expected treatment lasts 12 to 16 weeks.

Services We Cover in IOPs

Our Proven Results Speak for Our Services

Turn around time

Our clients have seen their average turnaround time drop to below 48 Hours

< 48Hours

Clean claim percentage

The clean claim percentage for our clients has reached around 95%

95%

Patient collection

Automatic payment collections have increased to 35%

35%

Contracted value collection

The average net collections have reached a remarkable 98%

>98%

Denial rates

Denial rates have been reduced to less than 5%

< 5%

A/R days

Accounts Receivable (A/R) days have decreased to just 25 days

25Days

Key Considerations for IOP Billing

Billing codes vary based on patient diagnosis and primary services

For dual diagnoses, generally, only one IOP session per day can be billed

Pre-authorization is typically required

Most payers require at least 180 minutes of active therapy per day for per diem rates

Clinical documentation is crucial for supporting claims

For dual diagnoses, generally, only one IOP session per day can be billed

Most payers require at least 180 minutes of active therapy per day for per diem rates

Billing codes vary based on patient diagnosis and primary services

Pre-authorization is typically required

Clinical documentation is crucial for supporting claims

Why Plutus Health is Your Best Partner for IOP Billing?

  • AI-powered, automated revenue cycle management solutions
  • Maximize reimbursement through accurate coding and clean claims
  • Comprehensive knowledge of IOP-specific billing codes and regulations
  • Proven track record of reducing claim denials and accelerating payments
  • Proactive approach to prevent and resolve claim denials
  • Customized solutions tailored to your practice's unique needs
  • Dedicated IOP billing specialists
  • Up-to-Date on the latest billing guidelines for various insurance carriers, Medicare, and Medicaid

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IOP Billing Challenges We Address

At Plutus Health Inc., we specialize in IOP billing, ensuring healthcare providers receive full and timely reimbursement for their valuable services.

Pre-authorization and Clinical Documentation

  • Timely submission of authorization requests

  • Comprehensive clinical documentation to support claims

  • Ongoing monitoring of authorization expiration dates

Avoiding Duplication of Services

  • Proper billing for patients with dual diagnoses

  • Integration of care plans to prevent claim denials

  • Clear communication with insurance carriers

Payer Guidelines for IOP Duration

  • Adherence to payer guidelines for IOP duration (typically 90 to 180 days)

  • Short-term, acute interventions

Physician Services Billing

  • Guidance on billing for physician services in different settings

  • Separately billed for hospital-based programs

Partner with Plutus Health and Watch Your Practice Grow

Simplify your IOP billing processes and support your practice's growth. Partner with Plutus Health, the best revenue cycle management company for expert IOP billing services tailored to your needs.

Contact Us Today for a Free Consultation