Case study
Case study: a telehealth psychiatry practice billing in 23 states
A Georgia-based telehealth psychiatry and PMHNP practice with up to 5 providers sees patients in 23 states. Over 3 years, we completed 100+ payer enrollments and submitted $6M+ in claims for them, handling billing, credentialing, denials, A/R, virtual assistant and marketing support as one partner.
- 100+ payer enrollments across 23 states
- $6M+ in claims submitted
- 3 years working together
The situation
A small practice with a multi-state footprint
The practice is small, with up to 5 providers, but its telehealth model reaches patients in 23 states. That creates the paperwork of a much larger organization.
Each provider needs a license in every state where patients live. Each payer in each state needs its own enrollment. A claim only pays when the rendering provider is in-network with the patient’s plan in the patient’s state.
Psychiatric visits add coding work on top of that. Medication-management visits are often billed as an E/M code with a psychotherapy add-on, and telehealth place-of-service and modifier rules differ by payer.
The practice wanted one partner to handle all of it, so its providers could spend their time with patients.
What we did
Full revenue cycle, plus front-office and growth support
We took on the whole process, from getting providers in-network to collecting the last dollar on each claim.
Credentialing in every state
We enrolled the providers with payers across all the states they serve, tracking every open application to completion.
Learn more →Billing and claim submission
Charge entry, coding review of E/M and add-on codes, and claim submission within 24 hours of receiving charges.
Learn more →Denials and A/R
Every denial corrected, resubmitted or appealed within 5 business days, and steady follow-up on unpaid claims.
Learn more →Virtual assistant support
Virtual assistant support for the practice’s day-to-day administrative work.
Learn more →Marketing support
Marketing support to help the practice reach patients.
Learn more →Results
The results for this client
These figures are this client’s own results over our time together.
| Measure | Result |
|---|---|
| States where patients are seen | 23 |
| Payer enrollments completed | 100+ |
| Claims submitted | $6M+ |
| Time working together | 3 years |
| Scope | Billing, credentialing, denials, A/R, virtual assistant and marketing support |
We do not publish client-specific before-and-after denial or A/R figures for this practice.
Company-wide averages
How we perform across all clients
The figures below are company-wide averages across our active clients. They are not this client’s numbers.
| Measure | Company-wide average |
|---|---|
| Clean claim rate | 98% |
| Average days in A/R | 21 days |
| Denial reduction | 38% |
| Recovery rate | 89% |
Takeaways
What other telehealth practices can learn
- Credential before you market. Patients in a new state only turn into paid claims once each provider is in-network there.
- Track enrollments by provider, payer and state. At scale, a spreadsheet stops being enough; weekly status checks keep applications moving.
- Build payer rules into the claim. Telehealth place of service and modifiers differ by payer, so set them per payer rather than per practice.
- Keep one partner for credentialing and billing. When the same team does both, a denial caused by an enrollment gap gets fixed at the source.
Common questions
Who is the client in this case study?
A Georgia-based telehealth psychiatry and PMHNP practice with up to 5 providers. We keep client names private.
Are the 98% clean claim rate and 21-day A/R this client’s results?
No. Those are company-wide averages across our active clients. This client’s results are the enrollments, claims submitted, states and years shown above.
How long did credentialing in 23 states take?
The 100+ enrollments were completed over our 3 years together, as the practice added states and providers. Commercial payer credentialing commonly takes a few months per payer, and timelines vary by payer and state.
Can you do the same for a smaller practice?
Yes. We work with solo clinicians and groups. Credentialing starts at $80 per payer, and we credential 5 commercial payers free when you sign up for billing.
Do you only work with psychiatry practices?
No. Psychiatry, PMHNP and behavioral health are our core focus, and we also bill for other medical specialties nationwide.
Guides from our team
Learn more before you decide
PMHNP Credentialing: A Complete Guide for Psychiatric Mental Health Nurse Practitioners
PMHNP credentialing explained: behavioral health carve-outs, panel saturation, DEA and controlled substances, multi-state telehealth, and realistic payer timelines.
Read the guide →Telehealth Billing for Mental Health: POS 02 vs POS 10, and Modifier 95 vs GT
Which place of service and modifier to use for telehealth therapy and psychiatry visits, how audio-only visits are billed, and multi-state licensing.
Read the guide →Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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