Addiction treatment billing for Ohio SUD, IOP and PHP programs

Substance use disorder programs bill some of the most complex claims in Ohio Medicaid: per-diem levels of care, group services, statement-period claims and frequent authorization rules. We bill them every month.

Programs we bill for

• Intensive outpatient (IOP, ASAM level 2.1) and partial hospitalization (PHP, ASAM level 2.5) programs
• Outpatient SUD counseling, group counseling and case management
• Peer recovery support services
• Programs that combine mental health and SUD services under one certification

Where SUD billing loses money

Level-of-care mismatches. A per-diem IOP or PHP day billed with the wrong code, modifier or unit count is denied, or paid at the wrong rate. We check every line against the level of care documented for that day.

Attendance not matching claims. Billing has to follow the days a patient actually attended. We build claims from attendance in your EMR, so claims and records agree.

Authorizations. Missing or expired authorizations cause denials that are often recoverable if they are caught quickly. We flag them before claims go out and work the ones that come back.

Plan switches. Patients in early recovery change Medicaid plans often. We verify eligibility every cycle so claims reach the right plan.

Built for statement-period and per-diem claims

We bill monthly statement-period claims with many service lines per patient, the kind of claims that take a general medical biller hours to get right. Each one is checked for codes, modifiers, place of service, units and diagnosis pointers before it is submitted.

Start with a free A/R review

We'll show you which unpaid IOP, PHP and outpatient claims are still billable, which denials are worth appealing, and what is close to its filing deadline. Then we charge a small percentage of what you collect, lower than most billing companies. More on denials and A/R recovery.

Frequently asked questions

Do you bill per-diem IOP and PHP claims?

Yes. We bill per-diem and statement-period claims for intensive outpatient and partial hospitalization programs to every Ohio Medicaid managed care plan.

Do you bill group services?

Yes. Group counseling and group-based program services are a large part of the claims we bill each month.

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