ProsperityEHR

10/30/2026

This Halloween, the scariest claim in behavioral health billing isn’t the one that gets denied, it’s the one that gets paid.

A denied claim screams loudly. A downcoded one just slips to a level lower, with no denial or reason code, and nothing on a worklist. The ghosts in your revenue cycle are the dollars you missed out on, and you can’t haunt a payer for money you never saw leave.

ProsperityEHR surfaces every downcode by payer and code, so the shortfall shows up on a worklist instead of vanishing into the remit.

What’s hiding in your remits this season? 👻

10/28/2026

According to Behavioral Health Business, providers in Montana, Illinois, and Alabama are now reporting the same thing: evaluation and management (E/M) claims quietly paid a level lower than the documentation supports. In Illinois alone, at least a dozen mental health provider organizations independently flagged downcoding issues, and one large group had more than 2,000 claims downcoded in August and 1,400 in July.

While several states have passed laws to curb automated downcoding, most don’t take effect for a year or more (e.g., Illinois regulations don't start until January 2028). Your outpatient practice can wait for future legal protections, or you can see what’s happening on your own remits now using ProsperityEHR.

10/22/2026

Most billing teams don't lose denials. They lose track of them.

47% of respondents in our 2026 Mid-Year Behavioral Health Reality Check survey named claim denials and appeals their heaviest revenue-cycle burden. Many find the cost isn't just in the denial, it's the chase. Finding it, figuring out why, pulling the supporting note, writing the appeal, and remembering to follow up three weeks later.

In ProsperityEHR, when an electronic remittance posts, denied lines drop into a single worklist automatically, grouped by payer and reason, with the supporting documentation one click away. Nobody builds the list. The list builds itself.

Behind it, our revenue cycle team works denials and appeals inside the same system, and runs a denial rate under 4%.

09/28/2026

Plenty of vendors will hand you a worksheet for building a sliding fee grid. Here's how ProsperityEHR handles it differently:

💵 For insured patients, a responsibility estimator pulls from your fee schedules, the eligibility response, and payment history to produce a number before the visit, with a confidence level attached so your staff knows how firm it is.

⚖️ For self-pay patients, Federal Poverty Guideline tiers are built into the system. Discount by percentage, dollar amount, or flat rate, set a minimum fee so nothing bills at zero, and carve out the CPT or custom codes you won't discount. The adjusted amount applies when the charge is entered, not as a correction after the statement goes out.

09/25/2026

Today is . It's been around since 2012, a day set aside to talk about therapy out loud and celebrate the people who do it.

Two key things clinicians told us in our mid-year survey: 94% of respondents expect to still be working in behavioral health a year from now, and 61% say their patients increasingly want to sit in the room together again.

People are choosing this work and continuing to show up for it. Our part is everything wrapped around the session, so practices can stay financially healthy and clinicians can stay focused on the work they came here to do.

To every therapist, counselor, and psychologist reading this: thank you for the important work you take on every day. 💚

09/22/2026

We're live at Behavioral Health Tech in Nashville at Booth 813 through Wednesday this week. 🤠

Practice management, the clinical record, e-prescribing with DrFirst, and the patient portal all in one platform, plus a U.S.-based revenue cycle team working claims inside the same system.

09/17/2026

📉Quick check for anyone running billing at a behavioral health practice: Your team already jumps on denials, but have you looked at what's getting paid short?

Downcoding is when a payer quietly pays your 99214 as a 99213. The visit's documented fine, nothing gets denied, the check just comes back smaller.

It's not small money. Behavioral health providers hit by one plan's downcoding this year reported losing $60 to $110 per claim, and one psychiatrist spent nearly 23 hours in a single month appealing them by hand. (BHB, 2026)

Simple thing to ask at your next billing review or vendor call: "Can you show me submitted code versus paid code, by payer?" If the answer is "we don't track that," that's where the revenue leak is.

ProsperityEHR flags those underpayments automatically, by payer and code, so catching them doesn't cost your team a weekend of appeals. Book a demo today to see how your practice can avoid the leaks.

09/09/2026

Verifying coverage at intake isn't verifying coverage. Plans change. Policies term. Employers switch carriers. None of it tells your practice.

40% of respondents in our mid-year survey named eligibility verification a top revenue-cycle burden.

In ProsperityEHR:

- Checks run on a scheduled basis configured by your practice.

- Results show at booking and at check-in to front desk staff

- Benefits are filtered to behavioral health

- Batch eligibility results display in one place for easy follow-up

See your payer results today: https://www.prosperityehr.com/demo/

08/05/2026

The 2026 Behavioral Health Mid-Year Reality Check is published: https://www.prosperityehr.com/resources/ebooks/the-2026-mid-year-reality-check/

Of the seven major industry predictions, several key findings stand out:

📈The denial surge everyone predicted isn't happening. 62% report stable or decreased denial rates. The payer pressures are real, but it's the work of appealing back-end denials caused by upstream eligibility verification and documentation gaps that seem to be burdening practices most.

📋Value-based care arrangements are increasing, where 57% of respondents earn more than 10% of revenue from these contracts. Top barriers to measurement-based care include patient compliance and engagement and clinical priority, not lack of tooling or technology support.

👨‍💻Fragmentation and lack of interoperability is costly as 70% of respondents run four or more separate software systems on a typical day.

💟The "attrition crisis" narrative doesn't hold. 94% of responding clinicians intend to stay in the field a year from now. The roles reported as a challenge to fill are experienced, licensed clinicians and supervisors, not a mass exodus of people leaving the field.

The industry made several major predictions for behavioral health in 2026. We asked operators and clinicians running outpatient practices what’s […]

08/03/2026

Three days until hosted by the American Psychological Association and a few things will be waiting for you in Booth #621 of the Solutions Center:

🖥️ A first look at what's new in the ProsperityEHR platform including the supervision suite, defensible documentation tools, and real-time revenue views.

📊 Pick up a copy of our 2026 Behavioral Health Mid-Year Trends Report, a collection of industry insights from respondents practicing across the U.S.

👋 Face time with our team. Say hello to Melissa Tran, Megan Mitchem, and Ben Pearson about what they're learning from the 50+ practices who use ProsperityEHR every day.

Before you begin your travel, make sure to reserve time with us. We'd love to meet in person to further discuss your practice's needs: https://calendly.com/prosperityehr-sales/30min