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From Claim to Care: How RCM Powers Access, Advocacy, and Healing

Recovery doesn’t begin with therapy or end with discharge. It starts the moment a call is placed for help — and behind the scenes, a chain of people works to keep that call from becoming a dead end.  

At Hansei, our mission is personal. Many of our team members have lived experience with recovery—either firsthand or by supporting a loved one—and that connection fuels our work every day. We’re not just solving revenue challenges; we’re helping real people access life-saving care. 

Strengthening the Recovery Chain Behind Every Step of Care

Revenue Cycle Management (RCM) is often thought of as back-office work, but the truth is: every function in RCM plays a role in access to care and the recovery journey. Each team touches a critical point in the process, helping ensure that individuals receive the treatment they need, when they need it. 

Our goal is to strengthen the behavioral health system from the inside out: making care financially sustainable for providers and accessible for those who need it most. Whether we’re supporting a claim or securing a contract, our work is about one thing—keeping recovery moving forward.

This National Recovery Month, we’re spotlighting the unsung heroes of the recovery chain—the RCM teams behind the scenes who fight for coverage, clarity, and continuity, turning a single call for help into a full continuum of care. 

Account Management

Our Account Managers serve as strategic liaisons between treatment providers and payors, playing a critical role in both onboarding and ongoing support.

Each client is assigned a dedicated Account Manager who works closely with internal teams to establish workflows, clarify documentation requirements, and streamline communication from day one. They ensure that every claim is clean, compliant, and positioned for approval—minimizing denials and delays before they happen. But their role goes far beyond billing – they proactively analyze trends, flag discrepancies early, and engage directly with payors to resolve underpayments and secure accurate reimbursement.

The Account Management team also helps educate insurance partners on the nuances and value of behavioral healthcare—ensuring the care delivered is properly understood and compensated.

By providing consistent, informed communication and strategic oversight, our Account Managers help sustain the financial health of providers—supporting long-term access to care across all levels of service. They don’t just manage accounts—they strengthen the entire recovery continuum.

Brenna, one of our Account Managers, shares how collaboration, consistency, and compassion all play a role in moving recovery forward. 

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Verification of Benefits

In Admissions, the recovery journey begins the moment a patient or loved one reaches out in crisis. The VOB process plays a critical role at this stage—confirming if a patient’s insurance plan covers behavioral health treatment, what level of care is authorized, and any out-of-pocket costs.

Speed, accuracy, and empathy are essential. A clear and timely VOB can mean the difference between someone entering treatment or walking away. For families navigating an overwhelming moment, this first step builds trust, offering clarity and reassurance that help is not only available—but accessible.

Meet Cynthia from our VOB team, who shares what it means to show up with compassion and clarity when someone takes that first step toward treatment.

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Negotiations & Credentialing

This work often happens behind the scenes but lays the groundwork for everything that follows. Before a patient ever walks through the door, these teams are securing the contracts and credentials that allow treatment to begin.

By collaborating with payors — not just pushing back — you help shape a network where more patients can afford care and providers can offer it with confidence. You navigate complex reimbursement structures, ensure accurate representation in directories, and help facilities expand their footprint in meaningful ways.

Credentialing isn’t just paperwork — it’s what allows clinicians to show up on day one. Negotiation isn’t just about rates — it’s about sustainability and access. Together, this team builds the long-term infrastructure for recovery to happen.

Utilization Review

Utilization Review is where clinical insight meets advocacy. After a patient enters treatment, UR specialists step in to secure authorizations from insurance—reviewing documentation, speaking directly with payors, and justifying each level of care.

“Here at Hansei, we advocate for clients to be able to get the help they need, while maximizing the use of their insurance benefits to minimize financial impact on the client. This enables clients to focus on the treatment they need, rather than worry about how they will afford the necessary treatment.”

– Lauren Jensen, Director of Utilization Review at Hansei

This work ensures patients aren’t discharged too soon or denied services they urgently need. It’s not just about checking boxes; it’s about defending the clinical necessity of treatment so individuals have the time and support required to truly begin healing.

By challenging denials and pushing for appropriate lengths of stay, UR professionals help prevent premature discharge and relapse. You make sure care aligns with a person’s needs—not the limitations of a system.

Jessica, one of our Utilization Review leaders, shares her recovery story—a powerful reminder that those advocating for care often have a deeply personal connection to the recovery journey.

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Billing  

The Billing team turns the care that’s been delivered into claims that sustain the future of treatment.

By ensuring that every service is correctly coded, billed, and submitted on time, they help providers stay funded — and patients stay supported. This team’s work reduces delays, prevents denials, and keeps the revenue cycle moving forward.

Billing may happen behind the scenes, but its impact is front and center. It translates care into compliance, complexity into clarity, and financial risk into operational stability. Without effective billing, the system stalls.

Accounts Receivable

The Accounts Receivable (AR) team steps in when claims stall or go unpaid — often digging through denials, rejections, and red tape to get providers the reimbursement they’ve earned.

Every unpaid claim represents more than a financial gap — it can mean limited resources for staff, services, and future patients. By resolving balances and tracking down missing payments, you help stabilize operations and protect access to care.

These individuals also relieve pressure from families who may be overwhelmed by confusing bills or unexpected balances. Their work brings clarity, resolution, and support at a time when recovery should remain the priority.

In short, AR keeps the system sustainable — making sure those who deliver care can keep doing it.

Medical Records

Accurate, timely documentation is more than a compliance requirement — it’s a critical connector across every stage of a patient’s care.

From the first note to the final discharge summary, your work supports authorizations, appeals, audits, and transitions between levels of care. Without thorough records, treatment progress can stall, reimbursement can be delayed, and continuity of care can break down.

This team provides the clinical backbone that helps justify the care delivered, advocate for extended stays, and protect both patients and providers. In short, the Medical Records team doesn’t just document recovery — they help preserve it.

The revenue cycle process is not just a series of tasks — it’s a coordinated chain of advocacy. From the first call to final reimbursement, your role helps transform a system known for red tape into one that supports real recovery.

This Recovery Month, we honor every link in the chain. Because when revenue cycle management works, people heal.

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