Premier Consulting Engagement · Credentialing to Collections

Credentialing to Collections.

A white-glove consulting engagement for clinicians and practices that want to stop losing revenue to credentialing gaps, miscoded encounters, denial backlogs, and audit risk. We work alongside your team to build — or fix — the revenue cycle from PECOS enrollment through paid claim.

PMHNP-centric · adaptable PECOS · CPT 2026 · 99214+90833 Audit defense Implementation, not slides
Why this engagement exists

Most practices don't have a billing problem. They have a system problem.

The 2026 CMS rule changes, the redesigned E/M psychotherapy add-on workflow, and tightened telehealth modifiers have moved the goalposts again. Most clinics we see are still running 2022 workflows on 2026 rules — and the gap shows up in denials, takebacks, and unpaid 90833 add-ons.

This engagement is not a course or a webinar. It is a hands-on partnership in which Dr. Baker and the TheraPsych team work directly inside your practice to enroll the providers, fix the coding, rebuild the documentation templates, train the front office, and stand up the denials & audit workflows. You keep everything we build.

You're considering this engagement because…

Six revenue-cycle problems we fix in the first 90 days

01 · Credentialing
Providers are out-of-network when they shouldn't be.

PECOS 2.0 changed the application path. New hires are working uncredentialed days; existing providers have lapsing CAQH attestations and missed re-credentialing windows.

02 · Coding
The 99214 + 90833 add-on is missing from most visits.

Prescribers are documenting psychotherapy but only billing E/M. The most common single revenue leak we find — usually six figures over a year on a four-prescriber team.

03 · Telehealth
Telehealth modifiers and POS codes are inconsistent.

Modifier 95, GT, POS 10 vs. POS 02 — payer-by-payer rules in 2026 don't match what most EHRs default to. We rebuild the rule set and test it end-to-end.

04 · Denials
There's no denial workflow — just a backlog.

Denied claims sit in a worklist. We install a five-template appeal library, an escalation tree, and a weekly denials huddle that closes the loop within payer timely-filing windows.

05 · Audit risk
99214 documentation won't survive a payer audit.

We pull a representative chart sample, score it against 2026 MDM rules, and rewrite the templates so the documentation supports the level billed — before someone else does the audit for you.

06 · Reporting
Leadership has no view of the revenue cycle.

We stand up a one-page weekly dashboard: clean-claim rate, denial rate by payer, days-in-AR, 90833 capture rate, credentialing status by provider. You see leakage the day it appears.

Adaptable for other disciplines

PMHNP-built. Adapted for the rest of behavioral health.

The frameworks — PECOS enrollment, CPT-aligned documentation, 2026 telehealth modifiers, denial & appeal workflows, audit defense — are the same across behavioral-health disciplines. The examples, code sets, and documentation templates are customized to your clinicians' scope of practice and your state's regulations.

If your practice is multi-disciplinary, we build one revenue-cycle system that serves all of your clinician types — not five parallel ones.

LCSW · LMSW

90791, 90834, 90837 workflows; collaborative documentation; supervision billing.

LPC · LMHC

Medicare enrollment under the 2024 expansion, panel strategy, scope-aligned coding.

MD · DO

Full E/M (99202–99215), psychiatric add-ons, interactive complexity, prolonged-services.

PA · NP (non-PMHNP)

"Incident to" rules, split/shared visits, supervision documentation, state-by-state scope.

The workstreams

Nine workstreams. What we'll build together.

Every engagement opens with a discovery sprint to confirm which workstreams are in scope. Most practices need six of nine. Mature practices need two or three.

01
Credentialing infrastructure

PECOS 2.0, NPI Type 1 & Type 2, CAQH hygiene, panel-selection strategy, re-credentialing calendar, malpractice review.

Foundation
02
2026 CPT & E/M update implementation

2026 code changes, behavioral-health-specific updates, MDM scoring under the current AMA rules, time-based vs. MDM decision logic.

Coding
03
99214 + 90833 add-on workflow

When the add-on applies, what the documentation must show, and how to build it into the visit template so it's captured in real time — not retro-coded.

High-yield
04
Telehealth modifiers & POS rules

Modifier 95, GT, POS 10 vs. POS 02 — payer-by-payer rule set, EHR configuration, and audit-ready documentation patterns for hybrid practices.

Telehealth
05
Documentation templates & chart hygiene

Initial eval, follow-up, psychotherapy add-on, telehealth, controlled-substance, and risk-assessment templates rewritten to support the codes you bill.

Compliance
06
Denials, appeals & takebacks

Five-template appeal library, escalation tree by payer, weekly denials huddle SOP, and a 60-day push to work the backlog before timely-filing windows close.

Recovery
07
Audit defense playbook

Representative chart audit (10–20 charts), decision tree for refund-vs-defend, response-letter templates, and a quarterly internal audit cadence to stay ready.

Risk
08
Front-office & eligibility workflows

Real-time eligibility checks, copay collection at point of service, no-show policy enforcement, and an intake script that closes the financial conversation cleanly.

Operations
09
Revenue-cycle dashboard & cadence

One-page weekly KPI report (clean-claim rate, days-in-AR, 90833 capture, denial rate by payer, credentialing status), and a 30-min weekly leadership huddle SOP.

Leadership
How we work together

Three engagement shapes

Pricing is shared during the fit call so it reflects scope, team size, and timeline rather than a published menu. Every engagement begins with a written scope and a fixed fee.

Document & Chart Review
Diagnostic engagement
2–3 weeks
  • 10–20 chart sample reviewed against 2026 rules
  • Template & superbill audit
  • Credentialing status snapshot (all providers, all payers)
  • Written memo with prioritized fixes & revenue-impact estimate
  • One 60-minute debrief with leadership
Request a fit call
Fee quoted after scope call.
12-Week Launch
New-practice engagement
12 weeks · full launch support
  • Entity, EIN, malpractice & insurance scaffolding
  • Full PECOS & payer credentialing for all founding providers
  • EHR selection, configuration & template build
  • All nine workstreams scoped & deployed
  • Front-office hiring & training playbook
  • First-30-days launch checklist with daily standups
  • 60-day post-launch operating support
Request a fit call
Limited to 4 launches per year.
The process

How an engagement runs

01

Fit call (30 min)

A short, free conversation about where the revenue cycle is breaking, who's involved, and whether this engagement is the right tool. If it isn't, we'll point you toward what is.

02

Written scope & fixed fee

If we move forward, you receive a one-page scope document defining the workstreams, the deliverables, the timeline, the team, and the fixed fee. Nothing starts until you've signed it.

03

Discovery sprint (week 1)

Chart sample, billing report pull, credentialing status, EHR walkthrough, and stakeholder interviews. We come out of week one with a confirmed work plan and the first set of deliverables already in flight.

04

Weekly working sessions

60- to 90-minute video sessions on a published cadence with clinicians, billers, and leadership as needed. Every session has an agenda, an outcome, and follow-up actions captured in a shared workspace.

05

Hand-off & durability

You keep every template, SOP, dashboard, and appeal letter we build. Final week is a documented hand-off so your team owns the system — not us.

Be honest about the fit

Who this engagement is — and isn't — for

A strong fit
  • Solo or group psychiatric/behavioral-health practices (2–15 clinicians)
  • PMHNP-led groups expanding into multi-disciplinary teams
  • Primary-care practices adding behavioral health
  • Practices that have already done some of the homework and want a thinking-and-building partner
  • Leadership ready to dedicate one operations point-of-contact to the engagement
Not the right fit
  • Solo clinicians who would be better served by the self-paced Foundations II course
  • Practices looking to fully outsource billing (we build the system; we don't run it indefinitely)
  • Legal, tax, or accounting work (we refer to licensed professionals)
  • Active payer audit defense without legal counsel already engaged
Not ready for a consulting engagement?

The self-paced course covers the same material at a clinician scale.

If you're a solo clinician or a small practice owner who wants the frameworks, templates, and 2026 update without the white-glove implementation, the self-paced PMHNP Foundations II · Credentialing & Billing course teaches the same material in nine modules with all 20+ templates included.

See the self-paced course → View the curriculum
Start with a fit call

Tell us where the revenue cycle is breaking. We'll tell you whether we can help — and how.

Every Credentialing-to-Collections engagement starts with a free 30-minute fit call. If it's a match, you'll receive a written scope and fixed fee within three business days. If it isn't, we'll point you toward the right resource.