Unbilled and Denied Psychotropic Prescriptions Due to Documentation and E-Prescribing Errors

Key Findings

• Financial Impact: 3–5% of annual practice income (e.g., $60,000–$100,000 per year on $2M billings) in typical outpatient settings; case audits have found $150,000–$300,000 of unbilled clinical services over 6–12 months in comparable ambulatory practices.
• Frequency: Daily
• Root Cause: Revenue cycle articles on mental health billing note that practices often submit claims but do not systematically follow up on rejected or denied claims, quietly write off underpayments, and allow filing deadlines to expire, leading to accumulating losses over months and years.[1] More general ambulatory revenue analyses show that when clinical documentation and billing systems for encounters and related orders (labs, injections, medication management) are not tightly integrated, large blocks of services never reach payers—one mid-sized clinic found $300,000 in potential revenue unbilled due to missed documentation of ancillary services, and another found over $150,000 in charges lost over six months because charges did not flow correctly from EMR to billing.[3] These findings extrapolate directly to prescription‑management visits in behavioral health, where medication management codes and related services depend on accurate, linked documentation between the e‑prescribing module and the billing system.