Behavioral Health & Substance Abuse Centers
Support mental health and substance use disorder programs with compliant licensing, credentialing, and payer readiness.
We help behavioural health providers meet state, federal, and accreditation requirements to operate and bill confidently.
Program Types Supported
Outpatient, IOP/PHP, residential, and OTP programs (where applicable)
Renewals & Expirables Tracked
Facility licenses, accreditations, clinician licenses, DEA/CS (as needed), and payer rechecks
Payer Participation
Medicare, Medicaid/MCOs, and commercial behavioral health plans
Regulatory Readiness Isn’t Paperwork—It’s Patient Access
Behavioral health and SUD programs juggle strict privacy (42 CFR Part 2), evolving opioid treatment program (OTP) rules, medical-necessity standards (e.g., ASAM), time-based psychotherapy documentation, and heavy prior authorization. Missing any of these can pause admissions or payments. You need airtight records, on-time renewals, and consistent data across payers and directories to keep services moving.
Program Licensing & Accreditation
Prepare initial/renewal filings and maintain evidence for CARF or The Joint Commission Behavioral Health (as applicable) so surveys and payer checks don’t stall services. (Many plans look for recognized program standards.)
Clinical Documentation & Medical Necessity
Align intake, treatment plans, progress notes, discharge summaries, and level-of-care determinations (e.g., ASAM) so records support coverage and utilization reviews.
Authorizations & Utilization Management
Build prior-auth packets that include diagnosis, level of care, goals, frequency, and updates—reducing delays tied to incomplete requests. (Payer PA burdens are widely documented.)
Where behavioral health claims break—and how to prevent it
Identify common claim errors early, correct them before submission, and protect your reimbursement from costly setbacks.
Frequent Issues
-
Medical necessity not clearly linked to level of care
(e.g., ASAM details missing or outdated). -
Psychotherapy time not documented
for 90832/90834/90837 or add-on with E/M (90833/90836/90838). -
Prior authorization gaps
(service started before approval or updates not submitted). -
OTP-specific requirements missed
(if relevant): certification, DEA status, dosing/take-home documentation.
How We Support Behavioral Health Programs—End to End
Initial Program Review
Check facility licenses, accreditation status, clinician credentials, DEA/CS (if needed), payer contracts, and required documentation sets (intake → discharge).
Documentation Controls
Standardize templates (treatment plan elements, ASAM-based level-of-care notes, psychotherapy time, group rosters, UDT/tox logs) and set review cadences.
Authorization & Claims Packets
Assemble diagnosis, level of care, goals, schedules, and updates for faster UM decisions; close common gaps that lead to denials.
Monitoring & Renewals
Track expirables (licenses, accreditation, DEA/CS), maintain payer updates, and log audit trails so required evidence is always on hand.
How Behavioral Health & SUD Support Works
Compliance & Documentation Check
Verify program licenses, accreditation artifacts, staff credentials, NPIs/TINs, and required documentation sets.
Template & Policy Setup
Load standardized forms and policies: privacy/Part 2 consent & redisclosure text, incident reporting, level-of-care documentation.
Authorization & Payer Alignment
Submit auth packets and roster/location updates; correct data mismatches that cause rejections.
Renewal & Quality Cycle
Keep expirables current; run periodic record checks for psychotherapy time, ASAM alignment, and discharge documentation.
For Less Than The Cost of One Employee
The Silver Plan
$850.00
Per Month
- Human Resources
- Accreditation
- Credentialing Medicare
- Credentialing – Home State HME License
- Credentialing – Home State Medicaid
- Risk Management Assessments and Reporting Forms are provided to you for implement.
- Patient Experience Survey, Complaint and Grievance Forms are provided to you for implementation
Home State Only
Full H.A.R.P. Services Through Web Portal Only
The Platinum Plan
$1,550.00
Per Month
- Human Resources
- Accreditation
- Credentialing Medicare
- Credentialing – Home State HME License
- Credentialing – Home State Medicaid
- Credentialing – Out-of-State HME Licenses
- Credentialing – Out-of-State Medicaid Applications
- Credentialing – Commercial Insurance for In Network Benefits
- Risk Management Assessments and Reporting Forms are provided to you for implement.
- Patient Experience Survey, Complaint and Grievance Forms are conducted by QPI Healthcare Services
All States
Full H.A.R.P. Services Dedicated Program Manager
The Gold Plan
$1,250.00
Per Month
- Human Resources
- Accreditation
- Credentialing Medicare
- Credentialing – Home State HME License
- Credentialing – Home State Medicaid
- Credentialing – Commercial Insurance for In Network Benefits
- Risk Management Assessments and Reporting Forms are provided to you for implement.
- Patient Experience Survey, Complaint and Grievance Forms are conducted by QPI Healthcare Services
Home State Only
Full H.A.R.P. Services Dedicated Program Manager
Stay Inspection-Ready and Keep Your Revenue Flowing
Operating a behavioral health or substance abuse facility requires meeting strict compliance and licensing standards. Errors in documentation or processes can cause delays, inspection failures, and revenue loss.
Fewer Denials and Recoupments
By linking documentation to level of care and coding rules.
Faster UM decisions
With complete prior-auth packets and on-time updates.
Clear audit evidence
Via organized licenses, accreditation proof, and activity logs.
Need a program checkup on documentation, authorizations, or renewals? We’ll map your gaps and set up a practical plan.
Let's Talk Compliance
Frequently Asked Questions — Behavioral Health & SUD
What documentation supports medical necessity in SUD?
Use a recognized framework (e.g., ASAM) to justify level of care; keep plans, progress notes, and reviews current.
Do psychotherapy codes require time in the note?
Yes—Medicare guidance requires start/stop or total time for 90832/90834/90837; add-on psychotherapy with E/M has its own rules.
What changed in 42 CFR Part 2?
The 2024 final rule clarifies consent, redisclosure, and limits on using SUD records in investigations; programs must reflect these updates.
What’s new for opioid treatment programs?
SAMHSA’s 2024 OTP final rule updated take-home and access standards; compliance date October 2, 2024.
Are prior authorizations really driving delays?
Yes—recent surveys show high rates of care delays linked to prior authorization requirements.