scrubbed claims and relentlessly worked denials recover dollars an in-house desk writes off.
Behavioral Health billing · Virginia
Behavioral Health Billing Services in Virginia
Behavioral health billing services in Virginia carry a wrinkle no generic biller is ready for: Project BRAVO rebuilt the state's behavioral-health benefit around enhanced services that each carry their own authorization and registration rules, all delivered through five Cardinal Care MCOs. Miss a BRAVO registration, route a claim to the wrong MCO, or file H-code units that don't match the note, and the payment never arrives. 247 Medical Billing Services handles those calls up front so your practice gets paid instead of appealing.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill Behavioral Health across Virginia
Outpatient Therapy
Psychiatry & Med Management
Intensive Outpatient
Case Management
Telehealth
And More
Virginia behavioral health billing at a glance
A quick map of the Virginia payer terrain we navigate on every claim:
| Virginia billing factor | What it means for your claims |
|---|---|
| Medicaid program | Cardinal Care / DMAS |
| Delivery model | Managed care (5 MCOs) + FFS |
| Behavioral health plans | Aetna, Anthem HealthKeepers (Elevance), Molina, Sentara, UnitedHealthcare |
| Appeals window | 120d hearing / DMAS final in 90 days |
We hold all of it to a 99% clean-claim rate, ~99% net collection, sub-25-day A/R, and up to a 40% drop in denials. Get a revenue review measured on your own remits.
Why a Virginia practice should outsource the billing
Delivering that outcome is what our nationwide behavioral health billing services are designed around.
first-pass claims become deposits in weeks instead of dragging through rebills.
eligibility checks and complete BRAVO documentation stop denials at the front end, before submission.
one transaction-based fee replaces salaries, software seats, and turnover.
the MCO and BRAVO registration work moves to us; the caseload stays with them.
Why Virginia providers pick 247MBS
Hiring us isn't hiring a general biller who happens to accept behavioral health work. It's hiring a team that already knows how Cardinal Care and Project BRAVO actually route and pay.
enhanced behavioral-health services registered and authorized before care starts, so they don't reject on the back end.
Aetna, Anthem HealthKeepers (Elevance), Molina, Sentara, and UnitedHealthcare each carry their own authorization and payment rules.
the correct managed-care assignment confirmed before every claim.
IOP, PHP, and residential requests documented to survive prior authorization and concurrent review.
Virginia board licensure and plan credentialing (psychologists, LCSW, LPC, LMFT, PMHNP) kept current so nothing rejects on provider eligibility.
a named account manager and a live dashboard on every account, with no long-term lock-in.
247MBS next to a general billing company
A generalist learns Cardinal Care and BRAVO on your claims. We show up already knowing them.
| Capability | General billing company | 247MBS |
|---|---|---|
| Project BRAVO enhanced-service registration | ❌ | ✅ |
| Cardinal Care routing across 5 MCOs | ❌ | ✅ |
| DMAS eligibility verification | ❌ | ✅ |
| IOP/PHP/residential PA & concurrent review | Limited | ✅ Full |
| CCBHC PPS billing | ❌ | ✅ |
| H-code unit reconciliation | ❌ | ✅ |
| Dedicated account manager | Sometimes | ✅ Always |
Revenue review
Put a dollar figure on what your behavioral health claims are leaving behind.
A certified behavioral health billing specialist reviews your coding, unit counts, authorizations and aged A/R against the payers you actually bill in Virginia — and puts a number on what your current process is leaving on the table.
- Authorizations tracked to expiry, per plan, before the unit is delivered
- Payer routing checked against the member's actual managed-care plan
- Credentialing and rendering-provider setup verified plan by plan
HIPAA & SOC 2
Back to you within one business day
No long-term lock-in
Request a Revenue Review
Tell us about your practice.
A behavioral health specialist will reach out within one business day.
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A behavioral health specialist will reach out within one business day.
Our Virginia behavioral health billing services
Everything it takes to move a Virginia claim from intake to paid, run by one certified team:
— Cardinal Care MCO, FFS, or BRAVO enhanced-service eligibility confirmed via DMAS before the visit.
— enhanced services and IOP/PHP/residential requests built to clear on the first submission.
— sessions, CCBHC encounters, and unit-based H-codes mapped to Virginia's defined units.
— scrubbed and filed within 24 hours.
— worked to root cause and to the 120-day hearing deadline.
— aged claims chased across every MCO and commercial payer.
— Virginia licensure and MCO enrollment kept current.
It all runs inside our behavioral health medical billing practice — one team, one dashboard, one point of contact.
How we bill Virginia behavioral health
1. Confirm the plan — Cardinal Care MCO, FFS, or a BRAVO enhanced service, verified via DMAS at eligibility. 2. Document diagnosis and medical necessity up front. 3. Register & authorize — complete BRAVO registration and level-of-care requests before enhanced, IOP/PHP, or residential care begins, then manage concurrent review. 4. Code & scrub to each plan's coverage, parity, and unit rules. 5. Submit & track — filed to the MCO or DMAS within 24 hours and followed to payment. 6. Work denials & recover A/R across every plan.
The Virginia behavioral health denials we prevent
| Code / service | The denial it commonly triggers | How we prevent it |
|---|---|---|
| Project BRAVO enhanced service without authorization | Enhanced BH service billed without the required PA / registration → *authorization absent* (CARC 197) | We secure Project BRAVO authorization and registration up front |
| Wrong Cardinal Care MCO routing | Member in a different one of 5 MCOs or FFS than billed → *not covered by this payer* (CARC 109) | We verify the Cardinal Care plan via DMAS before every claim |
| 90837 — 60-min psychotherapy | Below the time threshold → downcode to 90834 or *not medically necessary* (CARC 50) | Time and medical-necessity locked at charge capture |
| Rendering provider not paneled | Not credentialed on the contract → *provider not eligible* (CARC B7) | We front-load licensure and plan credentialing |
| Unit-based codes vs documented minutes | Units don't match the note → *information doesn't support this many services* (CARC 151) | We reconcile every unit to documented time |
Every one of these is preventable at the front end rather than argued after the fact. Request a Revenue Review and we'll show you which of them is hitting your remits today.
As a behavioral health billing services company focused on this work, we make Cardinal Care and BRAVO routine rather than risky.
Onboarding: live in weeks, not months
Switching billers sounds like a project. With us it's a handoff.
we work inside your existing EHR/practice-management system; your staff keep their tools.
Virginia credentialing and MCO enrollment review run while your claims keep going out the door.
most practices are up within a few weeks, with a dedicated account manager from day one.
From kickoff we review your licensure and payer enrollment, map your Cardinal Care, BRAVO, and commercial mix, and take over billing with no gap in submissions — so the denial drop shows up quickly, not a quarter later.
Who we serve in Virginia
From a solo LPC in Richmond to a multi-site group spanning Virginia Beach, Norfolk, Chesapeake, and Northern Virginia (Arlington and Alexandria), we bill the full Cardinal Care, BRAVO, and commercial cycle statewide. For narrower specialties, see our mental health billing, substance use (SUD) billing, and community behavioral health billing pages.
LCSW, LPC, LMFT, and psychology group practices
intensive outpatient and partial hospitalization
The Virginia payer knowledge behind your billing
Virginia Medicaid runs as Cardinal Care, administered by DMAS and delivered through five managed-care organizations — Aetna, Anthem HealthKeepers (Elevance), Molina, Sentara, and UnitedHealthcare — plus fee-for-service. The defining feature is Project BRAVO, the state's behavioral-health redesign that expanded enhanced services, each with its own registration and authorization requirements. Medicaid is the largest single payer of behavioral care in the state, and confirming the MCO via DMAS, registering BRAVO services correctly, and matching H-code units to documented time is where clean payment begins.
Routine outpatient therapy is largely auth-light, while IOP, PHP, residential, and BRAVO enhanced services depend on prior authorization plus concurrent review. Medicaid appeals run to a 120-day hearing window with a DMAS final decision inside 90 days, and federal parity rules bar behavioral benefits from being covered less generously than medical ones (see Virginia DMAS). It matters because roughly 86% of behavioral health denials are preventable, and reworking a single claim costs $25–$118 (CMS/MGMA) — margin that front-end verification and correct BRAVO registration protect.
Medical Billing for Behavioral Health in Virginia
Virginia practices keep more of every session paid when medical billing for behavioral health is handled by a team that runs Project BRAVO correctly. 247MBS registers and authorizes each enhanced behavioral-health service before care starts, confirms the member's Cardinal Care MCO through DMAS — Aetna, Anthem HealthKeepers, Molina, Sentara, or UnitedHealthcare — and reconciles H-code units to documented time. IOP, PHP, and residential authorizations clear before care escalates, and denials are worked to the 120-day hearing deadline. The result is a 99% first-pass clean-claim rate, net collections near 99%, and A/R under 25 days for providers from Richmond to Northern Virginia. Request a revenue review.
Questions Virginia providers ask us
Frequently Asked Questions
We register and authorize each Project BRAVO service before care starts, so it never rejects for missing registration on the back end.
Usually a few weeks. We bill from your existing EHR with no migration, run Virginia credentialing and MCO enrollment review in parallel, and assign an account manager on day one.
Cardinal Care through all five MCOs — Aetna, Anthem HealthKeepers (Elevance), Molina, Sentara, and UnitedHealthcare — Medicaid FFS via DMAS, and commercial plans, each to its own rules.
Yes. We prepare complete medical-necessity documentation for prior authorization and concurrent review before care escalates, and appeal adverse determinations inside the 120-day window.
A revenue cycle run by certified coders who know Cardinal Care and Project BRAVO — fewer denials, faster payment, and a team that treats BRAVO registration and MCO routing as routine rather than a recurring problem.
authorization·payer routing·credentialing·utilization review
Ready to get more Virginia claims paid on the first pass?
Whether you are a solo practice or a multi-site group, we bill Behavioral Health across Virginia under one dedicated account manager and a live dashboard — and treat every counted unit, authorization and appeal as recoverable revenue until it is safely paid.
Prefer email? sales@247medicalbillingservices.com