Behavioral Health
Payers treat behavioral health claims differently. Your recovery partner should too.
Behavioral health carries denial burdens most medical practices never see: session limits, documentation standards that shift by plan, and medical-necessity reviews that second-guess clinical judgment session by session.
You, Specifically
You've watched payers demand treatment plans, progress notes, and outcome measures no cardiology practice would ever be asked for — then deny for 'insufficient documentation' against criteria they don't publish. Parity is the law; your denials queue says otherwise.
Most behavioral health practices are small, clinician-owned, and staffed for care, not combat. Which means the denials — often modest individually, relentless in aggregate — simply never get fought.
The Patterns
The denials we see in your world, over and over.
- Medical-necessity denials second-guessing level-of-care and session frequency
- Session-limit and concurrent-review denials mid-treatment
- Documentation denials against unpublished or shifting criteria
- Parity-suspect patterns: behavioral claims denied where comparable medical claims pay
- Telehealth place-of-service and modifier denials
The Engagement
What working with us looks like.
01
Appeals built on clinical documentation, with clinician-informed review of medical-necessity arguments.
02
Session-limit and concurrent-review denials tracked as patterns, not one-offs — payer by payer.
03
Documentation playbooks so your notes meet the criteria payers actually apply.
04
Same BAA-first, read-only-access onboarding as every Claimie engagement.
Pricing
Contingency pricing means modest-dollar behavioral claims are finally worth fighting — we absorb the labor and are paid only from recoveries. Flat-rate available in all states.
See both pricing models →Know your number before you sign anything.
The Recovery Audit is a $500 analysis — yours free, in writing, with an honest go/no-go. Limited slots each month.
Sources
- 1.50–65% of denied claims are NEVER reworked or resubmitted. — MGMA
- 2.Roughly two-thirds of denied claims are recoverable. — Advisory Board