AI-Powered RCM Built for Behavioral Health Practices
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.
Time-Based Therapy Coding
Session-length codes (90832/90834/90837), add-ons & documentation
IOP / PHP Authorization
Level-of-care and concurrent-review authorization workflows
Telebehavioral Billing
POS, modifier (95) and payer-specific telehealth rules
Parity & Necessity Appeals
Denial workflows for behavioral parity and level-of-care disputes
Real-Time RCM Analytics
Live dashboards via SCALE's analytics platform
Behavioral health billing is uniquely complex. We know it cold.
High-complexity care comes with high-complexity billing — and most generalist RCM vendors aren’t equipped to handle it. SCALE is.
Concurrent Review Burden
IOP, PHP, and inpatient levels require ongoing concurrent review that stalls revenue and consumes clinical time.
Time-Based Coding Complexity
Session-length codes, add-ons, and crisis codes carry strict documentation rules that drive avoidable denials.
Parity & Medical-Necessity Denials
Behavioral claims face disproportionate medical-necessity scrutiny and parity-related denials that demand specialized appeals.
How SCALE solves it
Behavioral Prior Authorization Management
We manage the full authorization lifecycle for IOP, PHP, and inpatient levels — including concurrent review and peer-to-peer.
Behavioral Coding & Charge Capture
Automated review flags session-length mismatches, missing add-ons, and documentation gaps across therapy and E/M codes.
Parity & Necessity Denial Management
Payer-specific appeal templates for parity and level-of-care denials get you paid faster.
Telehealth & Crisis Revenue Capture
Correct POS/modifier application and crisis-code capture for telebehavioral services your team already delivers.
End-to-end RCM for every Behavioral health encounter
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.
Discovery & Audit
We analyze 90 days of claims data to identify coding gaps, denial patterns, and authorization bottlenecks specific to your practice.
EHR Integration
Seamless connection to your EHR and practice-management system — no new software for your team to learn or manage.
Go-Live & Handoff
SCALE's dedicated team takes over day-to-day RCM operations with transparent reporting from day one.
Continuous Optimization
Monthly performance reviews, payer-policy monitoring, and AI-driven recommendations keep revenue growing over time.
Representative results across SCALE clients
Representative results across SCALE Healthcare clients. Individual outcomes vary by organization size, payer mix, and baseline RCM maturity.
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
Works inside the EHRs your team already uses
Let’s build your Behavioral Health RCM roadmap together
Book a free 30-minute strategy call with a SCALE Behavioral health specialist. We’ll review your current denial rates, authorization backlog, and coding performance — at no cost.