Residential programs live and die by concurrent reviews and per-diem coding. We keep authorizations current, bill each day correctly and fight the denials that come after day ten.
Reviews every few days mean one late submission can leave several bed days unauthorized.
Payers differ on revenue codes, HCPCS codes and whether room and board is billed separately.
Payers push for step-down. Without strong documentation, later days are denied for medical necessity.
Moving a client to PHP or IOP requires a new authorization before the first day of the new level.
Residential claims paid at a fraction of charges need reprocessing, appeals or single-case agreements.
High-dollar residential claims sitting in 60–120 day aging buckets with no follow-up.
Hand us the full revenue cycle or just the parts that are breaking. Either way, one team is accountable for the result.
A reference to the codes commonly used at this level of care.
Codes, units and billing rules vary by payer, contract and state. We bill to your contracts and your payers' current policies.
One hour on your program, your numbers and your goals. You leave with clear options and no obligation.
We scope what you need, from one service like VOBs or authorizations to full RCM, and price it to the project.
We clean up denials and A/R, build and train your team or run billing every day, with weekly KPI reporting.
It depends on the payer and the authorization. Many payers review every few days. We track every review date so authorized days don't lapse.
When the payer and contract allow it. Some payers pay an all-inclusive per diem, others require separate room and board billing. We bill to your contracts.
Yes. We review the documentation, coordinate peer-to-peer reviews and write medical necessity appeals.
Yes. We bill residential programs for substance use disorders, mental health and co-occurring conditions.
Book a free one-hour discovery call. We will look at how your billing runs today and lay out your options: full RCM, consulting for your team or help with one piece, like VOBs or authorizations. Serving Utah treatment centers and programs nationwide.
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