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From residential stabilization to outpatient recovery, Revix MD provides specialized substance abuse billing solutions purpose-built for the current SUD regulatory environment. We synchronize your clinical documentation with payer specific medical necessity criteria to eliminate revenue volatility.
Substance abuse and Substance Use Disorder (SUD) billing require a sophisticated defense against aggressive payer compression. Facilities often lose 15–25% of expected revenue to preventable denials and unmanaged “Step-Down” transitions. Revix MD acts as your advocate, ensuring your facility is compensated for the life-saving care you provide.
We leverage the MHPAEA Final Rules (September 2024), which mandate that payers treat SUD benefits equitably with medical/surgical benefits. Our team is trained to identify and challenge non-quantitative treatment limitations (NQTLs) that lead to unfair residential or detox denials.
We utilize a clinical-first approach, anchoring our concurrent reviews and appeals in ASAM Level of Care documentation. By speaking the language of medical necessity, we legally challenge rejections and secure the authorized days your patients require.
We implement the latest federal privacy standards, allowing for seamless data flow between clinical and billing teams. Our systems ensure that 2026 single-consent requirements for SUD record sharing are tracked and audit-ready, preventing administrative stalls in the revenue cycle.
We implement strict “Order-to-Claim” reconciliation for lab billing. Our team manages the technical nuance of facility billing, ensuring correct Revenue Code mapping (e.g., 1002 for Detox, 1003 for Residential, 0905 for IOP) to prevent “Level of Care” mismatches.
Revix MD manages the high-acuity needs of the full addiction treatment and substance abuse continuum, from acute stabilization to long-term outpatient maintenance.
We perform a 90-day retrospective audit to identify documentation gaps and revenue leaks within seven days.
Our team applies deep technical expertise to securely plug into your Kipu, Sunwave, or ZenCharts platform, establishing encrypted connections without disrupting clinical workflows.
We align your Utilization Review strategy with MHPAEA Parity rules and 1115 SUD Waiver requirements for state-specific Medicaid compliance.
Go live on Day 15 with 48-hour claim submissions and real time dashboard visibility into your occupancy to revenue ratio and net collections.
We utilize encrypted “Redaction Protocols” during the appeals process. This allows us to provide the clinical evidence required to win an appeal while remaining in total compliance with federal SUD privacy restrictions.
We operate on a transparent percentage-of-collections model. This ensures our success is tied directly to yours; we only succeed when you collect your earned revenue.
Yes. Revix MD manages multi-state Medicaid and commercial billing, including the idiosyncratic authorization and room-and-board carve-out rules for state-specific 1115 SUD Waivers.
Absolutely. We manage the entire lifecycle of facility enrollment and contract negotiation, helping you expand into new states or add new levels of care to your existing payer agreements.
We manage the “Good Faith Estimate” (GFE) process and ensure all billing for non-contracted patients meets the transparency requirements of the No Surprises Act, protecting you from financial penalties.
