Compliance and risk management in a behavioral health setting requires specialized expertise.

Behavioral health professionals entered the field to help others, not to manage documentation, billing and coding, medical necessity determinations, and compliance program management. That is where LW Consulting, Inc., comes in.

Our team of certified compliance experts has an outstanding track record of aiding mental health providers with improving their billing and coding, responding to denials and appeals, and building compliance programs to protect the practice and those they serve.

Unlike DSM-IV coding, ICD-10-CM coding is accepted by third-party payers. Having a thorough understanding of common coding practices, and knowing what pitfalls to avoid, can be crucial for providers looking to build the practice and improve their revenue outcomes.

Sites Served

Our team has deep experience in assisting behavioral health providers across the full continuum of care delivery, including the following site settings:

  • Acute Inpatient Psychiatric Care
  • Outpatient Psychiatric Care
  • Inpatient Detox
  • Outpatient Detox
  • Psychiatric Physician Practices
  • Therapy Practices
  • Counseling Services
  • In-home Personal Support
  • Group Homes
  • Partial Hospitalization Programs (PHP)
  • Residential Psychiatric Care
  • Applied Behavior Analysis

Services Include

Medical Necessity Reviews
Determining medical necessity in a mental health setting can be subjective. Our team routinely reviews documentation to validate medical necessity for behavioral health services.

Emerging Treatment Management
Our team has developed specialized expertise in the management of emerging treatments, such as Ketamine / Estketamine, Transcranial Magnetic Stimulation (TMS), and psychedelics.

HIPAA Compliance
Just as in physical health settings, having a robust and comprehensive HIPAA compliance is important for maintaining client privacy as well as avoiding regulatory fines and penalties.

ABA Audits and Compliance
Receiving a notice of payer audit can be nerve racking for Applied Behavioral Analysis (ABA) providers of any size. LWCI has deep experience in navigating insurance and payer issues, and getting positive results.

Billing & Coding Audits
Many mental providers do not have the time or depth of knowledge to keep track of the always-changing requirements for proper coding. We stay up to date on the regulations to better assist providers in doing what they do best – care for others.

Expert Witness and Appeals
Several practices have reported coming under increased scrutiny from government regulators. Our team can assist in crafting and structuring an appeal to improve the chance of success.

Thought Leadership from LWCI

Case Study
Preparing for Unwelcome Scrutiny in a Behavioral Health Setting
(click to enlarge)

Need more info? We can help.