MindWise Health
Track and Monitor

Get paid faster with billing built for behavioral health

Providers lose an average of 15–20% of potential revenue to billing inefficiencies. MindWise Health eliminates that gap with integrated charge capture, real-time eligibility, automated claim submission, ERA auto-posting, and denial management — all purpose-built for behavioral health workflows.

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 integrations — Waystar and Stedi

MindWise Health connects to Waystar via SFTP and Stedi via API — giving you flexibility in how claims are submitted and how ERA/EOB data flows back. No manual file downloads. No copying numbers between systems.

Waystar SFTP integration — claims uploaded automatically, 277 status responses and 835 remittances downloaded and processed
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

$0

Per-claim clearinghouse fees with Stedi

Integrations

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Stedi
Waystar
Stripe

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

Schedule a demo and see how MindWise Health can transform your revenue cycle — from charge capture through payment posting.

See Billing in Action