NoTexas behavioral healthAvailable now
Get paid for every session.
Notes, scheduling and insurance billing built for therapy, psychiatry and case management. Authorizations are counted, claims are built from the signed note, and denials are worked with their deadlines instead of sitting in a drawer.
- Every session counted against its authorization, and the renewal flagged before it lapses
- 90837, telehealth and Texas Medicaid rules applied per payer, from the note
- Every denial on a worklist with its reason, its dollars and its appeal deadline
$95 per clinician a month. Support staff free. What the bundle carries.
The checklist is on its way.
It goes to within one business day, with a note on what to look at first.
Read onWhere the money goes
The five denials every Texas therapy practice gets.
Behavioral health denials are not random. The same five reasons come back on almost every remittance, and each is preventable before the session or recoverable after it.
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CO-197 · CO-15
The authorization ran out on session seven
Medicaid managed care plans and most commercial plans cap sessions per authorization. Nobody notices until the remittance comes back.
- Every session is counted against the authorization that covers it
- The renewal is flagged before it lapses, and the next visit is held if nothing covers it
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CO-151 · downcoding
90837 paid as 90834
A sixty-minute session is paid as forty-five when the note does not show the time and the medical necessity for it.
- Time in and out and the necessity are fields in the note, not prose to hunt for
- The claim's code comes from the signed note, so the two never disagree
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CO-4 · CO-5
Telehealth billed with the wrong place of service
A virtual session needs the right place of service and modifier for that payer, and the payers do not agree with each other.
- Place of service and modifier follow how the session was held and who the payer is
- Video visits are inside the record, so the claim knows the session was virtual
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CO-16 · CO-18
Claims sent before credentialing finished
A new clinician sees clients for weeks before the payer has them on file. Those claims are denied, or paid to nobody.
- Each clinician carries their enrollment with every payer
- Scheduling says so when a client's plan does not yet know the clinician
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CO-29
Timely filing missed
Ninety-five days for Texas Medicaid, longer for most commercial plans, and a denied claim left in a drawer is gone for good.
- Every denial lands on a worklist with its reason, its dollars and its deadline
- The appeal letter is drafted from the claim and the note, and sent with one more click
How it works
From the session to the payment, one record.
The note, the claim and the denial are the same thing seen three ways. Nothing is retyped, so nothing drifts.
Signing the note creates the claim
Code, time, place of service, modifier and the authorization it draws on all come from what the clinician signed. It goes to the clearinghouse the same day.
- Note signed, claim created, sent and accepted: one timeline
- The client's copay collected at the visit, through Navia or at the desk
| Service | Code | Charge | Collected |
|---|---|---|---|
| Psychotherapy, 53 min | 90837 | $165.00 | — |
| Client copay | — | $40.00 | $40.00 |
- Note signedOct 9, 10:31 am
- Claim createdOct 9, 10:31 am
- Sent to the clearinghouseOct 9
- Accepted by the payerOct 10
Authorizations counted as they are used
Sixty units authorized, thirty-eight used, twenty-two left, and the renewal date in plain sight. The session that would go past the end is the one that gets stopped.
- A burn-down for every authorization on the client's record
- Renewals flagged before they lapse
Case management · Sep 1 to Nov 30
On this record
- Case managementSep 1 to Nov 30 · 38 of 60 unitsRenew
- Therapy · individualJul 1 to Dec 31 · 9 of 24 unitsActive
- Case managementJun 1 to Aug 31 · 60 of 60 unitsEnded
| Denied | Client | Payer | Reason | Denied | Appeal by | Status |
|---|---|---|---|---|---|---|
| Oct 7 | Lindqvist, Tomas | Superior | CO-197 · No authorization on fileCase management, 4 units past the end date | $384.00 | Nov 527 days | Open |
| Oct 6 | Beaumont, Celia | BCBS of Texas | CO-151 · Paid as 90834Note shows 53 minutes | $35.00 | Jan 487 days | Open |
| Oct 3 | Soto, Gabriel | Amerigroup | CO-4 · Modifier missing for telehealthPlace of service 10, modifier 95 | $130.00 | Nov 123 days | Corrected, resend |
| Sep 30 | Okafor, Amara | Aetna | CO-16 · Rendering provider not on fileEnrollment approved Oct 2 | $165.00 | Mar 29171 days | Appealed Oct 4 |
| Sep 26 | Nakashima, Ren | Molina | CO-197 · Units exceededGroup, 2 sessions past the authorization | $110.00 | Oct 2516 days | Open |
| Sep 18 | Aldana, Mateo | Superior | CO-29 · Filed lateNot appealable | $96.00 | — | Written off |
| Sep 12 | Oyelaran, Bisi | Amerigroup | CO-197 · No authorization on fileRenewal was on the record; sent with the appeal | $220.00 | Oct 112 days | Won, $220.00 |
The denials worklist
Every denial from every remittance, with the reason in plain words, the dollars, and the days left to appeal. Appealing one drafts the letter from the claim and the note.
Sample data.Start here
Find out what your denials are costing you.
Send us ninety days of denials, as a report from your current system or as remittance files, and we send back one page: which denials are worth appealing and by when, which will keep happening and why, and the dollars in each.
Nothing to install
You stay on whatever you use today. The review is done on your files, and the page is yours whatever you decide.
Files through a secure link
We send you a place to put them. Nothing goes as an email attachment, and your data is deleted after the review unless you ask us to keep it.
Then twenty minutes, if you want them
If the page shows money worth going after, we show you how Nuvero works it, on your own numbers.
Please do not put a client's name or anything about their care in this form. The secure link is the place for files.
We have your request.
Somebody at Novarra will write to within one business day with the secure link for your files.
Questions
What practices ask us first.
Do we have to move our practice onto Nuvero for the free review?
No. Send a denial report or your remittance files from the last ninety days and we send back the one-page findings. The denials worklist itself runs inside Nuvero, so the review is also how you see whether it fits.
Does it handle Texas Medicaid managed care plans?
Yes. Superior, Amerigroup, Molina and the others bill through the clearinghouse like any other payer, with their authorization rules and filing windows tracked per plan.
We are a new practice. Is this for us?
Especially. The first year is when the enrollment, credentialing and authorization mistakes happen. The checklist walks through getting set up to be paid, and the bundle is priced per clinician, so a solo practice pays for one.
How long does it take to switch?
A solo or small group practice is usually seeing clients in Nuvero within two weeks. We bring over your client list and schedule, and each clinician gets an hour of training.
What does it cost?
The Behavioral Health bundle is $95 per clinician a month, with Therapy or Case Management added per clinician and support staff free. No long contract. Every price is on the Behavioral Health page, and the plan builder shows your total before it asks for an email address.
Every session you deliver
should be a session you are paid for.
Start with the free review, or build your plan and see the total first.