From level-of-care authorization on intensive outpatient programs to time-based therapy coding and parity disputes — SCALE delivers revenue cycle intelligence purpose-built for behavioral health groups, CMHCs, and MSOs.
Session-length codes (90832/90834/90837), add-ons & documentation
Level-of-care and concurrent-review authorization workflows
POS, modifier (95) and payer-specific telehealth rules
Denial workflows for behavioral parity and level-of-care disputes
Live dashboards via SCALE's analytics platform
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IOP, PHP, and inpatient levels require ongoing concurrent review that stalls revenue and consumes clinical time.
Session-length codes, add-ons, and crisis codes carry strict documentation rules that drive avoidable denials.
Behavioral claims face disproportionate medical-necessity scrutiny and parity-related denials that demand specialized appeals.
Core Service
We manage the full authorization lifecycle for IOP, PHP, and inpatient levels — including concurrent review and peer-to-peer.
AI-Powered
Automated review flags session-length mismatches, missing add-ons, and documentation gaps across therapy and E/M codes.
Specialty Coding
Correct POS/modifier application and crisis-code capture for telebehavioral services your team already delivers.
Denial Recovery
Payer-specific appeal templates for parity and level-of-care denials get you paid faster.
Automation handles volume and velocity. Our experts handle exceptions, edge cases, and strategic optimization — creating a closed-loop system that continuously improves performance over time.
We analyze 90 days of claims data to identify coding gaps, denial patterns, and authorization bottlenecks specific to your practice.
Seamless connection to your EHR and practice-management system — no new software for your team to learn or manage.
SCALE’s dedicated team takes over day-to-day RCM operations with transparent reporting from day one.
Monthly performance reviews, payer-policy monitoring, and AI-driven recommendations keep revenue growing over time.
Reduction in average days to pay across SCALE-managed client portfolios
Reduction in cost-to-collect through AI automation and workflow optimization
Reduction in A/R aging beyond 90 days through proactive denial management
Reduction in overall denial rates powered by DenialShield predictive scoring
