ANAHEIM, Calif., September 30, 2026: Doctor Management Services, the medical billing, coding, credentialing, and revenue cycle management company, today released a new denial management report. It found that mental health practices are losing 22% of their claims to documentation gaps. The report looks at why behavioral health claims get denied, where the breakdowns begin, and what practices can do to protect their revenue.
Key Finding: The Problem Is the Paperwork, Not the Care
Most of these denials had little to do with the care itself. The sessions happened, and the services were delivered. The claim mostly failed because the documentation could not support what was billed. Payers tend to scrutinize behavioral health claims closely, so a note that is thin, late, or inconsistent can trigger a denial before anyone considers the clinical picture.”
Where the Documentation Gaps Show Up
Start with the session note. Plenty of progress notes never say when the session began or ended, and that’s a problem because 90832, 90834, and 90837 are billed by time. Without the minutes mentioned on paper, the payer got nothing to check the code against.
Treatment plans are the next issue. Many are out of date or missing altogether, so there’s no record of why the patient still needs care. Add-on codes run into the same wall. Interactive complexity, or psychotherapy billed alongside an E/M visit, goes out without a note explaining why it applied.
Telehealth claims get denied when the modifier or place-of-service code says one thing, and the note says another. And authorizations often get secured at the front desk but never reach the biller, so the claim goes out without the approval the payer expects to see.
Why These Denials Often Go Unnoticed
When working on these problems, they often don’t look like much of an issue until later, which is why they’re easy to miss. A therapist at the end of a 24-hour day is not concerned about whether a note will survive for 24 days until it is reviewed by payers. Once a denial is received, it is difficult to piece it all together. Small and mid-sized practices simply do not have time and staff to handle appeals, and claims that are denied and not reworked are permanent write-offs.
How DoctorMGT Leadership Can Help You Close Documentation Gaps and Recover Revenue
“Behavioral health providers are some of the most dedicated clinicians we work with, and many of them are doing everything right clinically,” said Waqas Alee, CEO of Doctor Management Services. “What we keep seeing is a gap between the care delivered and the documentation submitted. When one in five claims is affected, that is not a small billing issue. It changes whether a practice can hire, expand, or simply keep its doors open.”
Practical Steps Practices Can Take
The report also highlights actions practices can take without the need to redesign their practices. It suggests that, instead of adding documentation after a claim is denied, add it to the process before the claim is submitted. It recommends a standardization of note templates to ensure that time, medical necessity, and the intervention used are recorded for each session, and it encourages practices to look at denials from a root cause perspective rather than a claim-by-claim basis, because patterns typically indicate an issue that can be resolved, and also emphasizes maintaining consistency in the authorizations, eligibility verification, and telehealth information between clinical and billing staff.
“Most practices already have the information they need,” Alee added. “It just isn’t landing in the right place, in the right format, at the right time. Fixing that is far less painful than fighting the same denials month after month.”
Support for Behavioral Health Practices
DoctorMGT’s billing team includes more than 800 certified billers and coders across over 20 specialties, with each client assigned an individual dedicated biller. The team holds monthly training sessions so its members stay current with payer policy and coding updates, an approach that matters in a field where documentation requirements keep shifting.
The full denial management report is available for mental health practices, group therapy providers, psychiatry clinics, and behavioral health administrators who want a clearer view of where their claims are falling short. The report and more information about DoctorMGT’s denial management and behavioral health billing services can be found at www.doctormgt.com.
About DoctorMGT
DoctorMGT (Doctor Management Services) is a medical billing, coding, credentialing, and revenue cycle management company based in Anaheim, California. The company specializes in workers’ compensation billing, personal injury lien billing, and specialty practice management, supporting healthcare providers across the United States.
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