Behavioral health billing services for Ohio practices

Gist Billing handles Medicaid billing for Ohio community mental health and addiction treatment providers. We build and submit claims, work denials, post payments and follow up on A/R, so your clinicians can focus on care.

Who we work with

We bill for Ohio-certified behavioral health providers whose revenue depends on Medicaid: community mental health agencies, substance use disorder treatment programs, intensive outpatient (IOP) and partial hospitalization (PHP) programs, youth and family services, and small group practices that have outgrown doing their own billing.

If your practice bills HCPCS H-codes, statement-period claims, per-diem or 15-minute units, or several managed care plans at once, that is the work we do every day.

What we handle

• Claim build and submission. Monthly CMS-1500 / 837P claims built from your EMR, with service lines, modifiers, place of service, units and diagnosis pointers checked before submission.
• Eligibility and plan verification. Coverage checks before each cycle, so claims go to the plan a member is actually enrolled in.
• Denial management. Every denial categorized by its reason code, corrected at the root cause and resubmitted. See denial management and A/R recovery.
• Payment posting and reconciliation. 835 remittance matched line by line to what was billed.
• A/R follow-up. Aging claims worked on a schedule, with a named next step for every open balance.
• A client workspace. A secure portal where your team sees what's paid, submitted and needs attention, by patient and by month.

Every Ohio Medicaid plan

We bill all of Ohio's Medicaid managed care plans, plus OhioRISE for youth with complex behavioral health needs. See Ohio Medicaid managed care billing and OhioRISE billing.

How pricing works

We charge 2.25% of what you actually collect, lower than most billing companies charge, with no setup fee and no long-term contract (see pricing). We only get paid when you do, and payments go straight to your bank account, never through us. Every engagement starts with a free A/R review: a one-page list of what's still billable, what is close to its filing deadline, and which denials are worth appealing.

Experience that shows up in the remittance

The Gist Behavioral Billing team has gotten more than $25 million in Medicaid claims paid for Ohio behavioral health programs, working directly in the plan portals, clearinghouse files and remittance data that decide whether a claim gets paid. We serve practices across Ohio.

Frequently asked questions

Do you work with small practices?

Yes. We work with programs of every size, from small group practices to multi-site agencies. Pricing is per claim, so a smaller practice pays for a smaller volume.

How do you charge?

2.25% of what you actually collect on current claims and 5.5% of what we recover on old claims, lower than most billing companies charge. No setup fee, no long-term contract, and payments go straight to your bank account, never through us.

Which EMRs do you work with?

We work from your existing EMR and its exports. We don't ask you to switch systems. During the free review we confirm what your EMR produces and how we'll pull attendance, diagnoses and member IDs from it.

Can you take over billing partway through the year?

Yes. Most new clients start mid-year. The free A/R review finds what is still billable from earlier months, so the handoff doesn't leave money behind.

How do we get started?

Email kgist@gistbilling.org or call (567) 868-9940 to set up a free A/R review. Please don't include patient information in email.

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