Track and Monitor

Get paid faster with billing built for behavioral health

Behavioral health practices typically lose 15 to 20% of potential revenue to billing inefficiencies — late charge capture, eligibility surprises, denied claims that never get worked. MindWise Health closes that gap with integrated charge capture, real-time eligibility, automated EDI 837 submission, ERA auto-posting, and denial management workflows built around how behavioral health actually bills.

Charge capture that starts in the session — not after

Most billing errors happen because charges are captured long after the session ends. In MindWise Health, CPT codes, modifiers, diagnosis pointers, and units are captured directly in the session workflow — before the provider moves on to the next patient.

CPT codes with up to 4 modifiers per service line — pre-configured for behavioral health (90834, 90837, 90847, H0015, and more)

Diagnosis pointers (A–L) mapped to up to 12 ICD-10 codes per session

Rendering and supervising provider auto-populated from session assignment

Prior authorization code attached at the session level with expiry tracking

Place of service auto-set for in-person vs. telehealth sessions

Group session billing with per-member charge allocation and rollup support

Real-time eligibility verification — before you see the patient

Don't find out a patient's insurance lapsed after you've already provided the service. MindWise Health verifies eligibility in real time via Stedi integration, with automatic enrollment management and configurable payer-specific eligibility codes.

One-click real-time eligibility checks with benefit details, copay, deductible, and plan status

Automatic provider enrollment with payers — Stedi manages enrollment status (provisioning, live, rejected) with daily status polling

Default eligibility service type codes configurable per payer — no guessing which code to use

Eligibility transaction history with full request/response audit trail

Prior authorization report — flag authorizations expiring within 30 days with remaining visit counts

Automatic scheduled eligibility checks for enrolled patients — catch lapses before appointments

Automated claim submission with pre-submission scrubbing

Claims are validated, converted to EDI 837 format, and submitted to your clearinghouse automatically — every 4 hours. Professional and institutional claim types are both supported, with primary, secondary, and tertiary sequencing handled automatically.

Automated 837 EDI generation — professional (CMS-1500) and institutional (UB-04) claim types

Pre-submission validation catches errors before claims leave the system — duplicate CPT codes, missing fields, invalid modifiers, and payer-specific rules

Primary, secondary, and tertiary claim sequencing with automatic COB (Coordination of Benefits) tracking

Claim resubmission codes supported — Original, Corrected, Replacement, and Void

Claim filing indicators for every insurance type — PPO, HMO, POS, Medicare, Medicaid, and self-pay

Complete claim transaction history — audit trail from draft creation through submission, payment, and closure

Clearinghouse integration with Stedi

MindWise Health connects to Stedi via API for claim submission and ERA/EOB return flow. No manual file downloads. No copying numbers between systems. The integration is built around webhook-based event processing so claim status and remittance data are reflected in real time.

Stedi API integration — webhook-based event processing for real-time 277 (claim status) and 835 (remittance) updates

EDI 277 claim status responses parsed and mapped to individual claims — know exactly where each claim stands

EDI 835 remittance advice auto-processed with claim-level and service-line level payment details

Retry logic with exponential backoff for clearinghouse API calls — no lost transactions

All raw EDI payloads stored for compliance and audit purposes

ERA auto-posting — payments applied without manual entry

When an ERA (Electronic Remittance Advice) comes in, MindWise Health automatically matches it to the original claim, posts the payment, calculates patient responsibility, and closes the claim if the balance is zero. Manual payment entry is available for non-electronic remittances.

Automatic ERA-to-claim matching — payer paid amount, patient responsibility, and allowed amount posted at the service-line level

Claim-level and service-line adjustments tracked with ANSI 835 group codes (CO, PR, OA, PI) and 95+ reason codes

Auto-close claims when patient balance reaches zero — no manual claim closure needed

Manual ERA recording for paper EOBs — search and map payments to existing claims

Payment reconciliation dashboard — Mindwise funds vs. external funds split tracking

Remittance status workflow — New, Recorded, Needs Review — for team-based ERA processing

Denial management — route, track, and resolve

Denied claims cost behavioral health practices thousands in lost revenue. MindWise Health gives you configurable denial routing rules, team-based assignment, timeline tracking, and batch reprocessing — so denials get worked, not ignored.

Configurable denial routing rules — route denials to specific team members based on payer, provider, or denial code category

Denial groups with team assignment — organize your billing staff into denial workgroups

Denial code categorization — group denial reasons into actionable categories for faster triage

Denial notes timeline — track every action, note, and status change on a denied claim

Batch reprocessing — resubmit multiple corrected claims in a single action

Batch write-off with reason codes — Contractual Adjustment, Timely Filing, No Auth, Bad Debt, Small Balance, and more

Rollup billing for per-diem and bundled services

Group homes, residential treatment, and intensive programs often bill per-diem or monthly bundled rates. MindWise Health rolls up individual session CPT codes into a single billing line — daily or monthly — so you capture the right revenue without manual aggregation.

Define rollup rules — map multiple source CPT codes to a single rollup CPT code

Daily or monthly rollup periods with configurable units per period and charge rates

Per-patient rollup enrollment — enable rollup billing for specific patients without affecting others

Modifiers applied to rollup codes automatically

Rollup claims generated automatically from individual therapy sessions

Patient payment collection — integrated with Stripe

Collect copays, deductibles, and outstanding balances directly through MindWise Health. Patients can pay online via the client portal, or your front desk can process payments at check-in — all integrated with Stripe for secure processing.

Stripe-integrated payment processing — credit card, debit card, and ACH

Saved payment methods for recurring charges and auto-pay

Copay collection at session check-in with automatic claim linkage

Patient payment history with full audit trail — charge, net, fee, and refund tracking

Refund processing with reason tracking and audit trail

Payment request via client portal — patients pay outstanding balances on their own schedule

60+

Automated pre-submission checks

95+

ANSI adjustment reason codes

4hr

Auto-submission cycle

Per-claim clearinghouse fees with Stedi

“We were working out of four systems just to have one functional EMR. MindWise Health lets us work out of one system.”

Kyle Short

Ally Psychiatry

Stop leaving revenue on the table

See claim submission, ERA auto-posting, denial routing, and patient payment collection run end-to-end in a personalized demo.

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