HRI Insights
We have written billing guides and answered claims questions from behavioral-health revenue-cycle work for years, first under the Axis IRG name. The older material stays up as an archive. We re-check the guides that still matter against current sources and update them.
Where the rules get written
Reviewed & maintained
Definitive Guides
Repeatable frameworks
HRI Methods
How payers behave
Payer Field Notes
Every article, labeled
The Library & Archive
The library & archive
The guides run from choosing a billing partner through the level of care you bill, the denials you fight, and the codes and payers behind them. Each entry carries its year and a label for how far to trust it.
How behavioral-health medical-necessity denials work, what documentation matters, and how providers can build stronger appeal packets.
Read the guide →What full-service covers, what to ask before you sign, and what a switch looks like.
The six questions that sort real behavioral-health billing specialists from generic medical billers, the red flags worth trusting, and when you shouldn't outsource at all.
Residential revenue is authorized days times per diem, minus everything that goes wrong in between. The six functions of a full-service RTC engagement and where a residential claim can break.
How each level pays, the codes and per-diems behind it, and where claims stall.
Behavioral-health IOP billing requires payer-specific code, claim-type, authorization and documentation checks. Medicare rules do not govern every plan.
A walk through partial-hospitalization billing for behavioral-health providers: what the day-treatment model means for claims, written as demand for mental-health services was climbing.
Why behavioral-health claims deny, what the payer is asking for, and how an appeal is built.
If your H0015 / IOP claims are denying for CO-197 / No Prior Authorization, normally this code does not require auth, but H0015 TG/PHP does. After working with a rep at…
Codes, claim forms, primary and secondary filing, and the errors that cost the most.
A plain guide to the UB-04 revenue codes behavioral-health programs bill under, with payer examples for IOP, PHP, detox and residential care.
How to match an eating-disorder diagnosis to the service, level of care, claim format and payer rule, without relying on an outdated code list.
Medication-assisted treatment (MAT) codes and the HF modifier for Medicaid, with New Hampshire Medicaid and its managed care organizations as the example.
Filing Medicare-primary, commercial-secondary claims for mental-health care in order: Medicare first, then the secondary, by Medicare crossover or with the Medicare remittance, with Empire as the worked example.
CPT codes used by professional clinicians and therapists for psychiatric evaluation, psychotherapy and E/M services.
Billing a psych visit alongside a per-diem IOP day when the plan allows it: the visit on the CMS-1500, the IOP day on the UB-04.
S9480 does not report telehealth by itself. Verify service eligibility, claim type, modifier, place of service and payer rules for the service date.
Is your treatment center experiencing financial difficulties? There are many billing errors that can cause claims to be denied. Payments being delayed, incurring fines, and…
Authorizations, payer behavior, and coverage questions from live claims work.
What parity, Medicare and state Medicaid rules say about paying for partial hospitalization and intensive outpatient care, and where that coverage breaks.
Your template for referring to PHP or other levels of care for behavioral health starts with the basic medical necessity criteria from insurance payers.…
The questions a payer asks on a behavioral-health authorization call, from birthdate, NPI and tax ID through clinical history, medications and the discharge plan.
The change will apply to medical and behavioral health services and impacts services that are already subject to prior authorization.
Follow-up, reimbursement speed, incident reports, and the operating habits that keep cash moving.
There are a lot of variables to insurance billing, each policy of a plan needs to be vetted and checked for limitations and criteria
Article labels
Archive notice: Older publications and community answers may reflect the payer rules, state requirements, coding guidance, systems, and information available when they were written. Current requirements should be verified for the applicable payer, plan, state, contract, provider, and date of service. On community discussion: Questions and replies reflect general operational discussion and are not individualized legal, clinical, coding, accreditation, or coverage advice.
Built from real work
Our partners bring 30+ years combined across behavioral-health operations, provider, payer and revenue-cycle work.
Facility experience covers RTC, detox, PHP, IOP, multi-level treatment, authorization and institutional claims.
Our partners have written articles and given public answers to facility billing questions.
Priority guidance is re-checked against payer documents, government sources, recognized standards and transaction evidence before we rely on it.
Featured article · Denials & Appeals
"Not medically necessary" is a plan- and product-specific determination a provider can document against and appeal. By Peter Busch · 6 min read.
Read the article →Definitive Guides
HRI Methods
Our frameworks diagnose stuck claims and rank the work most likely to produce a supportable result.
Payer Field Notes
Payer behavior rarely matches the manual. We record each pattern the same way and turn a rule change into an action on your claims.
What every payer note captures
The friction we watch for
Each of these wears down behavioral-health revenue. We map where it hits your claims and what it is worth to fix.
Reading about a problem you recognize?
A few lines on what keeps coming back are enough for the review. We read them against these same patterns and tell you which fixes are worth the most.
Last updated: October 25, 2026