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Behavioral Health
Regional behavioral health network
40+ clinicians · outpatient network
Challenge
Complex payer parity requirements and high claim volume created backlog in claims processing and inconsistent authorization tracking.
Current Situation
The network's internal billing team faced capacity constraints during a period of rapid clinician growth, resulting in aging authorization requests and claim backlogs.
Our Approach
- Deployed a dedicated behavioral health billing and authorization team
- Implemented structured authorization tracking workflows
- Established denial root-cause reporting specific to parity-related denials
Implementation
Transition was structured around a defined cutover date with a two-week parallel support period for the internal team.
Process Improvements
- Authorization tracking centralized into a single workflow system
- Denial categorization refined to isolate parity-specific patterns
- Claims backlog addressed through a dedicated recovery sprint
Results
- Backlog reduction achieved within the defined recovery period
- Improved authorization turnaround consistency
- Clearer visibility into parity-related denial patterns
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