BHBI 1-on-1 Certification Training Program
A fully personalized, expert-led training experience designed for individuals and organizations that need direct guidance and accelerated mastery of behavioral health billing.
Work one-on-one with a BHBI expert to apply real-world workflows, solve complex billing challenges, and build confidence in high-level revenue cycle operations.
Course Content
Section 1: Behavioral Health Billing 101 Section 2: Verification Of Benefits / Eligibility
Welcome to The Behavioral Health Billing Institute
You don't currently have access to this content
S1 Lesson 1: Introduction to Behavioral Health Billing
You don't currently have access to this content
5 Topics
What is behavioral health billing (and why it matters)?
You don't currently have access to this content
Where BH services happen (settings & levels of care)
You don't currently have access to this content
The behavioral health revenue cycle—end to end
You don't currently have access to this content
Forms, files, and “the plumbing” (what you actually touch)
You don't currently have access to this content
Career tracks and entrepreneurship
You don't currently have access to this content
S1 Lesson 2 — The History of Behavioral Health Billing
You don't currently have access to this content
6 Topics
Before Parity (Pre-2008): “Second-Class” Benefits
You don't currently have access to this content
2008: The Mental Health Parity and Addiction Equity Act (MHPAEA)
You don't currently have access to this content
2010: The Affordable Care Act (ACA) and the Rise of Behavioral Health Coverage
You don't currently have access to this content
2016: Parity Extends to Medicaid and CHIP
You don't currently have access to this content
2021–2025: From Policy to Enforcement
You don't currently have access to this content
How to Use Parity in Daily Billing (The Biller’s Playbook)
You don't currently have access to this content
S1 Lesson 3 — Compliance Foundations for Behavioral Health Billing
You don't currently have access to this content
6 Topics
HIPAA Administrative Simplification: the “plumbing” of billing
You don't currently have access to this content
HIPAA Privacy, Security, and Breach (what billers must do)
You don't currently have access to this content
42 CFR Part 2: extra privacy for Substance Use Disorder (SUD) records
You don't currently have access to this content
The No Surprises Act (NSA): what behavioral-health billers do
You don't currently have access to this content
Daily revenue-cycle workflow with compliance “built in”
You don't currently have access to this content
Quick reference toolbox (bookmark or print)
You don't currently have access to this content
S1 Lesson 4 — Verification of Benefits (VOB) & Patient Registration
You don't currently have access to this content
7 Topics
The Role of VOB in Behavioral Health Billing
You don't currently have access to this content
Historical Context: How VOB Became Essential
You don't currently have access to this content
Registration Meets Verification
You don't currently have access to this content
Standard VOB Workflow
You don't currently have access to this content
Core Tools Used in VOB
You don't currently have access to this content
Common Pitfalls & Pro Tips
You don't currently have access to this content
Career Pathways & Professional Growth
You don't currently have access to this content
S1 Lesson 5: Authorizations & Utilization Review (UR)
You don't currently have access to this content
8 Topics
Why Authorizations Exist in Behavioral Health
You don't currently have access to this content
Key Concepts
You don't currently have access to this content
The Authorization Workflow
You don't currently have access to this content
Collaboration Between Billers & UR Teams
You don't currently have access to this content
Common Pitfalls & How to Avoid Them
You don't currently have access to this content
Real-World Example
You don't currently have access to this content
Career & Business Impact
You don't currently have access to this content
Lesson Summary
You don't currently have access to this content
S1 Lesson 6 — Claim Creation & Submission
You don't currently have access to this content
10 Topics
The Claim’s Role in the Revenue Cycle
You don't currently have access to this content
Claim Types in Behavioral Health
You don't currently have access to this content
Required Data for Claim Creation
You don't currently have access to this content
Claim Submission Pathways
You don't currently have access to this content
Common Claim Errors and Prevention
You don't currently have access to this content
Timely Filing Limits (TFL)
You don't currently have access to this content
The Claim Lifecycle
You don't currently have access to this content
Real-World Case Study
You don't currently have access to this content
Career Application
You don't currently have access to this content
Lesson Summary
You don't currently have access to this content
S1 Lesson 7 — Claim Status & Follow-Up
You don't currently have access to this content
8 Topics
Why Claim Follow-Up Matters
You don't currently have access to this content
Tools for Claim Status
You don't currently have access to this content
Structured Follow-Up Workflow
You don't currently have access to this content
Common Payer Delay Tactics & Counter-Strategies
You don't currently have access to this content
Tracking Systems & Performance Metrics
You don't currently have access to this content
Real-World Case Study
You don't currently have access to this content
Career Relevance
You don't currently have access to this content
Lesson Summary
You don't currently have access to this content
S1 Lesson 8 — Payment Posting & Reconciliation
You don't currently have access to this content
9 Topics
Why Payment Posting Matters
You don't currently have access to this content
Payment Sources
You don't currently have access to this content
Workflow: Posting & Reconciliation
You don't currently have access to this content
Understanding EOBs & ERAs
You don't currently have access to this content
Best Practices in Payment Posting
You don't currently have access to this content
Common Pitfalls
You don't currently have access to this content
Real-World Example
You don't currently have access to this content
Career Relevance
You don't currently have access to this content
Lesson 8 Summary
You don't currently have access to this content
S1 Lesson 9 — Denials & Appeals
You don't currently have access to this content
8 Topics
Why Denials Happen
You don't currently have access to this content
Decoding Denials
You don't currently have access to this content
The Appeals Workflow
You don't currently have access to this content
Using Laws in Appeals
You don't currently have access to this content
Templates for Appeal Letters
You don't currently have access to this content
Common Pitfalls in Appeals
You don't currently have access to this content
Real-World Example
You don't currently have access to this content
Career & Business Relevance
You don't currently have access to this content
S1 Lesson 10 — Compliance in Action: Documentation, Audits & Risk Management
You don't currently have access to this content
9 Topics
Why Compliance Matters in Behavioral Health Billing
You don't currently have access to this content
The Role of Documentation
You don't currently have access to this content
Types of Audits
You don't currently have access to this content
Responding to Audits
You don't currently have access to this content
Fraud, Waste, and Abuse (FWA) Risks in Behavioral Health
You don't currently have access to this content
Compliance Programs & the Biller’s Role
You don't currently have access to this content
Real-World Example
You don't currently have access to this content
Compliance Best Practices Checklist
You don't currently have access to this content
Career & Business Relevance
You don't currently have access to this content
S1 Lesson 11 — Patient Billing & Collections
You don't currently have access to this content
9 Topics
Why Patient Billing Matters
You don't currently have access to this content
Sources of Patient Responsibility
You don't currently have access to this content
Generating Patient Statements
You don't currently have access to this content
Patient Communication Strategies
You don't currently have access to this content
Legal and Compliance Framework
You don't currently have access to this content
Collections Workflow
You don't currently have access to this content
Common Pitfalls
You don't currently have access to this content
Real-World Example
You don't currently have access to this content
Career & Business Relevance
You don't currently have access to this content
S1 Lesson 12 — Advanced Topics: Coordination of Benefits, Secondary Insurance & Complex Scenarios
You don't currently have access to this content
8 Topics
Why COB Matters in Behavioral Health
You don't currently have access to this content
Determining Primary vs. Secondary Coverage
You don't currently have access to this content
Submitting Secondary Claims
You don't currently have access to this content
Complex Scenarios
You don't currently have access to this content
Common Pitfalls & How to Fix Them
You don't currently have access to this content
Real-World Example
You don't currently have access to this content
Career & Business Relevance
You don't currently have access to this content
Advanced Tips for Professionals
You don't currently have access to this content
S1 Lesson 13 — The Future of Behavioral Health Billing
You don't currently have access to this content
7 Topics
Growing Demand for Behavioral Health Services
You don't currently have access to this content
Regulatory Shifts Changing the Landscape
You don't currently have access to this content
Technology & AI in Behavioral-Health Billing
You don't currently have access to this content
Career & Entrepreneurial Opportunities
You don't currently have access to this content
Inspiration — Why This Work Matters
You don't currently have access to this content
Preparing for Lifelong Learning
You don't currently have access to this content
Closing Thought
You don't currently have access to this content
Section 1 Knowledge Check
You don't currently have access to this content
1 Quiz
Section 1 – Behavioral Health Billing 101 Knowledge Check
You don't currently have access to this content
S2 Lesson 1: Foundations of Verification of Benefits & Eligibility in Behavioral Health
You don't currently have access to this content
12 Topics
Understanding the Purpose of Verification of Benefits
You don't currently have access to this content
Why VOB Matters in Behavioral Health
You don't currently have access to this content
The Life Cycle of a Behavioral-Health Claim
You don't currently have access to this content
Key Terminology & Core Concepts
You don't currently have access to this content
Real-World Example: The Cost of Missing VOB
You don't currently have access to this content
The Verification Mindset: Accuracy Over Speed
You don't currently have access to this content
Legal & Ethical Framework
You don't currently have access to this content
Core Competencies of an Expert VOB Specialist
You don't currently have access to this content
Step-by-Step Overview of the Full VOB Process
You don't currently have access to this content
Mini-Lab 1 — Mapping the VOB Workflow
You don't currently have access to this content
Mini-Lab 2 — Cost Consequence Calculation
You don't currently have access to this content
Summary & Key Takeaways
You don't currently have access to this content
S2 Lesson 2 — Gathering Essential Information & Conducting Eligibility Verification
You don't currently have access to this content
9 Topics
Before You Verify: Building the Foundation
You don't currently have access to this content
Where Eligibility Data Comes From
You don't currently have access to this content
Step-by-Step: Performing Eligibility Verification
You don't currently have access to this content
Recognizing Red Flags During Eligibility
You don't currently have access to this content
Common Eligibility Mistakes and How to Fix Them
You don't currently have access to this content
Eligibility Verification in Behavioral-Health Context
You don't currently have access to this content
Documentation Standards for Eligibility
You don't currently have access to this content
Mini-Lab 1 — Portal Practice
You don't currently have access to this content
Mini-Lab 2 — Spot the Error
You don't currently have access to this content
S2 Lesson 3: Behavioral Health Carve-Outs and Network Verification
You don't currently have access to this content
13 Topics
First principles
You don't currently have access to this content
How to spot the carve-out (three-step method)
You don't currently have access to this content
Plan types (what “HMO / PPO / EPO / POS / ASO” mean in real life)
You don't currently have access to this content
What “network” really means (and why it’s two checks, not one)
You don't currently have access to this content
Levels of care (LOC) don’t always share the same network status
You don't currently have access to this content
BlueCard (for BCBS plans across states) — a quick explainer
You don't currently have access to this content
Out-of-network reality (what patients and programs need to know)
You don't currently have access to this content
Single Case Agreements (SCA) — when and how
You don't currently have access to this content
Step-by-step: run a carve-out + network check the right way
You don't currently have access to this content
What to document (so you pass any audit)
You don't currently have access to this content
Red flags you must catch (and what to do)
You don't currently have access to this content
Case studies (walkthroughs you can copy into your LMS)
You don't currently have access to this content
Mini-labs
You don't currently have access to this content
S2 Lesson 4 — Financial Analysis and Benefit Interpretation in Behavioral-Health Verification of Benefits
You don't currently have access to this content
11 Topics
Why Financial Mastery Matters in Behavioral Health VOB
You don't currently have access to this content
The Building Blocks of a Financial Profile
You don't currently have access to this content
In-Network vs Out-of-Network Financial Dynamics
You don't currently have access to this content
Behavioral-Health-Specific Financial Nuances
You don't currently have access to this content
Benefit Limits and Exclusions
You don't currently have access to this content
Financial Data Collection During VOB
You don't currently have access to this content
Calculating Patient Responsibility
You don't currently have access to this content
Communicating Financial Findings
You don't currently have access to this content
Red-Flag Indicators During Financial Verification
You don't currently have access to this content
Documentation Standards (QA Perspective)
You don't currently have access to this content
Practice Lab
You don't currently have access to this content
S2 Lesson 5 — Limits, Exclusions, and Red-Flag Detection & Escalation
You don't currently have access to this content
12 Topics
Why This Lesson Matters
You don't currently have access to this content
Understanding the Language: “Limit” vs “Exclusion”
You don't currently have access to this content
The Two Types of Limits
You don't currently have access to this content
Common Behavioral-Health Service Exclusions
You don't currently have access to this content
Facility and Population Restrictions
You don't currently have access to this content
Network-Design Limitations
You don't currently have access to this content
Recognizing “Red Flags” During VOB
You don't currently have access to this content
Escalation Pathways When a Limit or Exclusion Blocks Coverage
You don't currently have access to this content
Audit-Proof Documentation Standards
You don't currently have access to this content
Communicating Complex Limits to Non-Experts
You don't currently have access to this content
Hand-Offs to Other Departments
You don't currently have access to this content
Quality-Assurance (QA) Checklist — How to Self-Audit Your VOB
You don't currently have access to this content
Final Quizzes
Section 5 Claim Management Knowledge Check
You don't currently have access to this content
Section 1 Quiz
You don't currently have access to this content