―NEXTGEN Billing Partner
NextGen Behavioral Health Billing & RCM Services That Improve Cash Flow in 30 Days
We work inside your NextGen system as an extension of your team, not a replacement for it. Purpose-built behavioral health billing expertise, applied directly to the platform you already run on.
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The NextGen + BehavioralProz Advantage
Your practice is already invested in NextGen. We make sure that investment pays off in fewer denials, faster reimbursement, and less staff time spent chasing claims. Our team works inside your NextGen PM daily, no separate portal, no duplicate data entry, no learning curve for your staff.
01
Charge Review Rules Engine Fluency
We monitor your Charge Review Rules Engine output daily, not monthly. Errors and mismatches get corrected before they ever reach a claim.
02
AI Rules Engine Configured for Behavioral Health
NextGen's AI Rules Engine catches generic edits. We configure the rules behind it for time-based psychotherapy codes, H-codes, and carve-out payer requirements.
03
Authorization & Eligibility Edits
We manage authorization and eligibility edits inside your Charge Review Rules Engine, tracking session limits and expiration dates so care doesn't get interrupted by a lapsed auth.
Services Designed Specifically for NextGen Users
Your practice is already invested in eClinicalWorks. We make sure that investment pays off in fewer denials, faster reimbursement, and less staff time spent chasing claims. Our team works inside your eCW instance daily, no separate portal, no duplicate data entry, no learning curve for your staff.
Charge Review Rule Configuration
We build and maintain behavioral health-specific edit rules inside your Charge Review Rules Engine covering time-based CPT codes, H-codes, and payer-specific requirements before charges reach a claim.
835 Remittance Reconciliation
We manage 835 remittance auto-posting through your Clearinghouse & EDI hub and reconcile it against expected reimbursement, flagging underpayments your front office wouldn't otherwise catch.
Authorization & Documentation Tracking
We track authorization edits flagged by the AI Rules Engine against session counts and treatment plan periods, so billing stays aligned with what's documented in the chart.
837 Claim Accuracy
We audit your 837 claim batches before transmission so front-desk and billing staff submit the correct codes and modifiers the first time.
Denial Management & AR Follow-Up
We work denials surfaced in your AR aging dashboard to resolution, single-click correction, resubmission, and payer follow-up instead of leaving them in a queue.
Telehealth Billing
We bill telehealth visits and group sessions correctly, including behavioral health group visit codes and applicable telehealth modifiers.
The Difference Title: Out-of-the-Box NextGen vs. BehavioralProz-Configured NextGen
| ✕ Out-of-the-Box NextGen | ✓ BehavioralProz-Configured |
|---|---|
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Generic AI Rules Engine edits
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Behavioral health-specific edit rules, built and maintained
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Manual authorization tracking
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Session limits and expirations tracked against rules engine edit logic
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|
Denials sit in the AR aging queue
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Denials worked daily to resolution and resubmission
|
|
Inconsistent multi-site charge capture
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Standardized coding and charge configuration across sites
|
|
835 remittance reviewed monthly
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835 remittance auto-posting reconciled daily against expected reimbursement
|
Common NextGen Billing Challenges We Solve
PT, OT, SLP, and IRF BehavioralProz manages the complete rehab revenue cycle across every clinical setting and every payer, with coding compliance and denial prevention built into every workflow.
Generic Rules Engine Edits, Specialty-Specific Denials
Out-of-the-box AI Rules Engine logic isn't built for 90837 time documentation or H-code billing. We rebuild the rule set around your specialty before charges leave your system.
Authorizations Flagged Late, Missed Silently
The rules engine flags expired authorizations at edit time, but nothing catches a session limit approaching mid-treatment. We track it so care isn't interrupted.
Dashboards Show the Problem, Not the Fix
Your AR aging and KPI dashboards surface denials and trends in real time, but someone still has to prioritize, correct, and resubmit each claim. We do that work.
Multi-Site Billing Consistency
Practices running multiple locations or providers on one NextGen PM instance often see inconsistent coding and charge capture across sites. We standardize it.
How We Work With Your NextGen System
Gap Analysis
We review your current NextGen configuration, Charge Review Rules Engine settings, AI Rules Engine edits, and authorization logic against behavioral health billing standards.
Rule Configuration
We rebuild or tighten the rules inside your system to match your specialty's CPT/HCPCS codes and payer mix.
Daily Claims Management
We work claims, We work claims, denials, and authorizations inside your existing NextGen PM; your staff keeps full visibility.
Ongoing Reporting
We review AR aging and KPI analytics data with you on a set cadence, so you always know where your revenue stands.
Your practice is already invested in eClinicalWorks. We make sure that investment pays off in fewer denials, faster reimbursement, and less staff time spent chasing claims. Our team works inside your eCW instance daily, no separate portal, no duplicate data entry, no learning curve for your staff.
Specialties We Support on NextGen
We bill for behavioral health practices across every setting and level of care:
ABA Therapy
H-code and Medicaid prior auth billing, tracked against session limits.
Substance Use Disorder (SUD)
HCPCS billing with 42 CFR Part 2-aware documentation handling.
Outpatient Mental Health
Time-based CPT code billing (90832, 90834, 90837) and documentation matching.
Psychiatric & Prescriber Services
E&M and psychotherapy add-on code billing for MDs and NPs.
PHP/IOP Programs
Per diem and per-service billing aligned to level-of-care changes.
Group Practices
Multi-provider, multi-site billing consistency across one eCW instance.
Telehealth Behavioral Health
TeleVisits and Meet billing with correct modifiers by state.
Child & Adolescent Behavioral Health
Family and individual session billing, including 90847.
FAQ's
Yes. We work inside your existing NextGen PM; we don’t require you to move to a separate billing platform or portal. This means no duplicate data entry and full visibility for your staff.
Yes. NextGen’s AI Rules Engine ships with general payer- and specialty-specific edits; we build behavioral health-specific rules on top, covering time-based psychotherapy codes, H-codes, and payer carve-out requirements.
BehavioralProz is not a NextGen reseller or certified partner. Our team has hands-on daily experience billing inside NextGen for behavioral health practices specifically.
No. You retain full access to your NextGen PM and dashboards at all times. We work as an extension of your team, not a replacement for your oversight.
Stop Losing Revenue Inside A System You Already Own.
We start with a no cost audit and billing configuration review with no commitment required to see where you stand.