Billing for outpatient mental-health practices
Billing at 3%.Every claim reviewed before it goes out.
Recoup runs the revenue cycle for outpatient mental-health practices inside the EHR you already use. The routine work runs on automated clearinghouse connections, a person works the exceptions, and you get a plain account of every claim and every dollar.
3% of collections · $1,000/month minimum · no setup fee · month to month
90837 · 53 minutes documented · date of service matches the encounter.
Check passed: Time supports the code
Eligibility verified before the visit · plan active · outpatient behavioral health covered.
Check passed: Coverage confirmed
Authorization on file · 6 of 8 approved visits used.
Check passed: Two visits remaining — renewal flagged
Note signed · intervention not tied to a treatment-plan goal.
Held: Held for review before submission
Illustrative, synthetic data — never a real client or a real claim. Every claim is read this way before it leaves; what is held goes back to you to decide.
Why this is different
The care was delivered. The money leaks on the way to the bank.
Between the session and the payment there is a pipeline, and it leaks at the seams:
- Coverage nobody checked — a session delivered on a plan that lapsed, or with a payer that was never in network.
- A note that does not support the code — the time or the content is not there, and the claim comes back — or gets paid and clawed back later.
- Encounters that never became claims — an unsigned note, a missed charge, a session that fell between the schedule and the biller.
- Rejections and denials nobody worked — the claim came back with a reason code and sat there until it aged past timely filing.
- Remits nobody posted against the contract — underpayments that were never noticed, because the payment was booked as whatever arrived.
Most billing companies are labor businesses wearing a percentage. The fee pays people to key claims and read remits, so it cannot come down without cutting the people — and the people who remain touch as few claims as they can while still getting paid. That is why the rate rarely moves and the aging report arrives when you ask for it.
Recoup is built the other way around. The routine work runs on automated clearinghouse connections, so the price is 3%. Every claim is read before it leaves, so less leaks. And a person works what is left, and tells you plainly what was billed, what was paid, and what is being worked.
The money that was earned should be the money that arrives.
How it works
The path of one claim.
From the note in your EHR to the payment posted against your contract — what happens, in order, and who does it.
The session is documented in your EHR.
You keep the system you run. We take the billing data from it — on a standard we publish, or through a connection we build for you at no charge — so nothing is rekeyed and nothing is missed between the schedule and the claim.
Every claim is reviewed before it goes out.
Coverage, authorization, the diagnosis, the dates and units, the modifiers — and whether the note supports the code and the time billed. What is missing goes back to you to fix or decide; nothing is coded for revenue. Then it goes.
It goes out through automated clearinghouse connections.
Submission, acknowledgment, and status are watched from the moment the claim leaves. A rejection is read the day it arrives, not discovered in next month’s report.
Payments are posted against what the contract says.
Every remit is reconciled to the allowed amount, so an underpayment is a line item rather than a mystery. Secondary claims and patient balances follow from there.
A person works every exception — and tells you plainly.
Denials, appeals, timely-filing risks, and payer quirks are worked by someone who knows the payer, and you get a plain account of what was billed, what was paid, and what is being worked.
Switching billers
No gap between billers.
The thing that actually loses money in a billing change is the handoff — a payer that stops sending remits, a claim that neither side owns, a month of old balances nobody is working. So the transition is a fixed sequence, and we tell you where you are in it.
We enroll with your payers, in order.
Claims first, remits last — a payer’s remit enrollment lives with one clearinghouse at a time, so it moves only when we are ready to receive it.
Your current biller’s claims in flight run out.
Nothing already submitted is abandoned; we do not send a duplicate, and we know which day the last of theirs was paid.
Old balances are snapshotted on day one.
Insurance receivables dated before we took over are worked under their own agreement — 10% of what we actually recover, nothing otherwise — so they are never mixed into the 3%.
Every claim from your first day goes through the review.
No “catch-up period.” The first claim we send is read before it leaves, the same as the thousandth.
What we need from your EHR
You keep your system. We connect to it.
If your EHR can export these on a schedule, we are connected in days. If it cannot, we build the connection — and that is on us, not a setup fee.
- Patient demographics and insurance
- Rendering and billing provider details
- Encounters: dates, place of service, units
- Diagnoses and procedure codes with modifiers
- Authorizations, where a payer requires them
Free Revenue Leakage Analysis
Find out how much revenue you’re leaving behind.
Before you change anything, we look at your own numbers and tell you, in writing, where revenue is being lost — and whether it is worth doing anything about. Then the next sentence is yours.
What you send
- An aging report (insurance A/R by payer and age)
- Recent remittances (835s / ERAs) or EOBs
- A claims export from your EHR or clearinghouse
Over a secure, BAA-covered channel we set up with you — never through the form on this site.
What you get back
- Aged A/R that looks actionable, and what does not
- Underpayments against your fee schedules
- Encounters that were never billed
- Claims at timely-filing risk
- Documentation gaps that put reimbursement at risk
- Authorization gaps
- Encounters where the note already supports a different code than was billed
We reply within one business day with a secure, BAA-covered way to share your data. The written analysis comes back within five business days of receiving it.
No obligation, no sales call required — and if there is little worth recovering, we will tell you that too.
3% of collections · $1,000/month minimum · no setup fee · month to month
Pricing
The whole price, on the page.
3% of collections
That is the entire price. Nothing on this page is quote-gated, and nothing is priced on a call.
- 3% of the insurance payments we collect for you
- Eligibility, claims, rejections, status, posting and reconciliation, denials, secondary claims, payer enrollment, reporting — and every claim reviewed before it goes out. Clearinghouse and transaction costs are ours, not a line on your invoice.
- Old balances: 10% of what we actually recover, worked separately
- Insurance receivables from before we took over are snapshotted on day one and worked under their own agreement. Recover nothing, pay nothing on them.
- $1,000 a month minimum · no setup fee · month to month
- If we have to build the connection to your EHR, that is on us. Leave with 30 days’ notice; there is no term to buy out.
Why 3% is not a stripped-down service
A rate this low usually means a biller who has cut the people who chase the hard claims. Ours is 3% because the routine work — eligibility, submission, acknowledgments, status, posting — runs on automated clearinghouse connections instead of a room of billers keying claims. A person still works every exception, we are paid on what is collected, and old balances are worked under a separate agreement where we are paid only if we recover. And you get a plain account of what was billed, what was paid, and what is being worked.
Month to month with 30 days’ notice, and no term to buy out. Every practice signs a BAA with us before any data moves, and the fee agreement is a plain document you read before you sign.
Why we built it
Get paid for the care you already delivered.
A practice earns its revenue in the room and loses it afterward — in the coverage nobody checked, the note that does not support the code, the claim that never went out, the denial nobody worked, the remit nobody posted against the contract. None of that is about the care. It is about the pipeline between the session and the payment.
Recoup is built by people who came up inside behavioral health billing — the payer rules, the timely-filing clocks, the fee schedules, and the remits that decide whether a session actually gets paid. We built the billing operation we wanted practices to have: the routine work runs on automated clearinghouse connections, a person works every exception, and every claim is read before it leaves.
We are a new company and we would rather say so than dress it up. That is part of why the price is published, the agreement is month to month, and the first thing we offer is a free look at your own numbers. You do not have to take our word for anything.
- 3% of collections
- The whole price is on this page. No quote, no call, no tiers to compare.
- Month to month
- Thirty days’ notice. If it is wrong for your practice, you leave, with nothing to unwind.
- Every claim reviewed
- Before it goes out: coverage, authorization, dates and units, and whether the note supports the code. Anything flagged goes back to you to decide. Nothing is coded for revenue.
Questions
Questions you’re probably asking.
Why is it 3% when most billing companies charge more?
Isn’t a rate under 4% a sign of a stripped-down service?
Do we have to change our EHR?
What happens in the handoff from our current biller?
What counts as “collections”?
What is separate from the 3%?
Who touches our PHI, and will you sign a BAA?
What does “reviewed before it goes out” actually check?
What do we get in the free analysis, and what do you need from us?
What if you look and there is little to find?
How do we leave?
Who is Recoup for?
Start
Start with your own numbers, not our claims.
Send us an aging report, recent remits, and a claims export over a BAA-covered channel, and within five business days you will have a written account of where revenue is being lost — and whether it is worth doing anything about. No obligation, no sales call.
3% of collections · $1,000/month minimum · no setup fee · month to month
Want to ask something first? hello@recoupclaims.com