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Dedicated revenue cycle management for behavioral health providers, designed to strengthen billing accuracy, support reimbursement, reduce unit-rounding discrepancies, and streamline authorization workflows.
Keeping Revenue Moving
At Reside RCM, our mission is to provide ABA and autism therapy providers with reliable, detail-focused revenue cycle management that supports stronger billing operations and reduces administrative burden.
We take a meticulous approach to the details behind every claim,
including documentation, timed units,
payer requirements, authorizations, claim submission, and follow-up.
By strengthening these critical billing processes,
we help providers maintain greater accuracy,
keep claims moving, and dedicate more time to what matters most:
delivering quality patient care.
Who We Serve
Specialized Billing Support for Healthcare Practices
Who We Serve
Specialized Billing Support for Healthcare Practices
Reside RCM works with specialized healthcare practices and providers across the following areas:
ABA & Autism Therapy
ABA practices and autism therapy providers with specialized service models,
provider roles, timed services, and authorization requirements.
Behavioral Health
Behavioral health and mental health practices serving patients across clinical, outpatient, and telehealth settings.
Pediatric Healthcare & Therapy
Pediatric practices and therapy groups supporting children across multiple disciplines and care settings.
Home & Community-Based Care
Providers delivering healthcare and supportive services in patients' homes and community settings.
Revenue Cycle Services
Revenue Cycle Services
Billing Accuracy
Billing Accuracy
Strengthening every claim before submission
Focus on documentation, codes, units, payer requirements, and claim details to identify potential issues before they become denials.
Unit & Documentation Review
Unit & Documentation Review
Connecting service time to accurate billing
Reviewing timed services, units, and documentation for consistency helps reduce billing discrepancies and avoidable claim issues.
Authorization Support
Authorization Support
Keeping authorization requirements on track
Reviewing authorization details and payer requirements to help ensure billing aligns with approved services, units, and coverage parameters.
Claims & A/R Management
Claims & A/R Management
Keeping claims moving and revenue flowing
Supporting claim submission, corrections, denials, follow-up, and A/R activities so outstanding claims don't get overlooked.
Pre-submission Auditing Scenarios
How We Identify Potential Billing Issues Before Claims Are Submitted
A pre-submission quality review examines the details that support a claim, including documented service time, billed units, coding details, authorization parameters, patient and provider information, place of service, and payer-specific requirements.
Billing Details Align
Billing Details Align
Scenario
An RBT provides 4 units of CPT 97153 at POS 11. The patient's active authorization reflects sufficient units available for the service, and the corresponding service record includes documented start and end times and the required provider documentation.
Quality Review
The service record, billed units, authorization status, provider details, and claim information are reviewed for consistency before submission.
Outcome
Ready for submission
No apparent discrepancy identified during the pre-submission review.
Authorization CAP Requires Review
Authorization CAP Requires Review
Scenario
A CPT 97151 assessment is being prepared for billing, but the patient's authorization shows only 4 units remaining, while the documented service represents 8 units.
Quality Review
The documented service and proposed billed units are compared with the remaining authorized units to identify a potential authorization shortfall.
Outcome
Held for review
The claim is not advanced until the authorization status and appropriate billing approach are verified by the practice.
Claim Details Require Correction
Claim Details Require Correction
Scenario
A claim is prepared for CPT 97155 at POS 12, but the available provider information, service documentation, or place-of-service details do not appear to support the claim as entered.
Quality Review
The claim details are compared against the available documentation, provider information, service circumstances, and applicable payer requirements to identify the discrepancy.
Outcome
Correction required
The claim is held for clarification and correction before submission rather than allowing an unresolved discrepancy to move forward.
The Purpose of Pre-submission Review
The Purpose of Pre-submission Review
Identify potential billing issues early, while there is still an opportunity to review and address them before the claim reaches the clearinghouse.
Meet The Founder
Meet The Founder
Founder & Lead Revenue Specialist, Reside RCM
Judith founded Reside RCM to bring a hands-on, detail-focused approach to the revenue cycle,
with a particular interest in the billing challenges faced by specialized healthcare practices.
She believes strong billing operations begin with understanding the unique details behind each claim and creating a process that keeps critical billing information organized, accurate, and reviewable.
Interested in learning more about Judith and Reside RCM?
Connect with Judith on LinkedIn
See How Reside RCM Works
See How Reside RCM Works
Interested in seeing how our pre-submission review process works?
Our pre-submission review approach brings greater visibility to the details behind each claim.
Explore a sample billing scenario and see how key claim information is reviewed before submission.
Request a Free Demo
Or Contact billing@residercm.com to discuss your practice's revenue cycle needs.
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