We investigate behavioral health claim denials, analyze underpayments, and prepare Level 1 and Level 2 internal appeals, so your practice is paid for the care it already delivered.
Serving providers in multiple states · Commercial claims worked · Medicare and Medicaid reviewed and reported
Revenue cycle management and claims recovery for providers in Pennsylvania, New Jersey, North Carolina and other states, plus government contract experience in Louisiana.
Recovery engagements open with a monthly retainer, credited toward a percentage of what we recover. Consultations, evaluations, and advisory services are billed separately.
Medicare and Medicaid claims are analyzed and reported so your practice can correct and rebill.
Coastal Practice Medical Management assists behavioral health providers with claim investigations, denial analysis, payment recovery efforts, and insurer internal appeal submissions. Services are limited to carrier-level appeals — Levels 1 and 2 — and do not include external review, arbitration, legal representation, or clinical utilization review services.
We understand the nuances of commercial payer billing in Pennsylvania and New Jersey, the documentation demands of psychiatric E&M codes, and the specific patterns that cause solo therapists to have their 90837s denied without cause.
Our clients range from solo practitioners and small group practices to community mental health centers, treatment centers, and substance use programs across Pennsylvania, New Jersey, and beyond. Every engagement is handled directly and personally.
"Mental health providers do life-changing work. They deserve to be paid for every session, every claim, every time."
We bring claims-recovery expertise to the front end of your billing process and stay with you when claims need recovery.
Fees: monthly retainer, credited toward a percentage of recovered funds. Terms confirmed in your signed agreement. A signed BAA is required.
Prefer to keep your billing in-house? Get expert guidance on specific problems. We review your billing workflows and show your team what to fix, while your staff continues to submit and manage claims.
Fees: flat fee per engagement, quoted in writing before work begins. A signed BAA is required.
A one-time diagnostic that finds the root causes of your denials and the recoverable revenue in your aged claims.
Fees: flat fee by practice size, quoted in writing. A signed BAA is required.
Out-of-network patients don't have to mean lost revenue. We handle OON reimbursement work and negotiate Single Case Agreements with commercial payers.
Fees: per case or by engagement, quoted in writing. A signed BAA is required.
Limited enrollment for behavioral health practices seeking ongoing commercial billing support.
Medicare and Medicaid claims are analyzed and reported, not billed.
Fees: pricing is quoted after a Fit Call or Intake review. A signed BAA is required.
Medicare and Medicaid claims fail for technical reasons that are easy to miss and costly to repeat. We review your denied, rejected, or underpaid Medicare, Medicaid, and managed Medicaid claims, find exactly what went wrong, and give your team a written correction report to fix and rebill. We do not bill, rebill, or appeal these claims; your practice stays in control of every submission.
Fees: flat fee per claim batch, quoted in writing before work begins. A signed BAA is required.
Pay once, submit your question, and receive a clear written answer from a specialist with 23+ years in behavioral health billing and claims. Still need to talk it through? Book a follow-up call.
No patient information needed.
Secure PayPal checkout, payable to Raven Tide Holdings, LLC. Your receipt includes a transaction ID.
A short form: payer, codes, what happened. No patient names or member IDs.
Delivered to your email within 2 business days.
Optional paid follow-up call, booked after your answer is delivered.
One billing, coding, denial, or reimbursement question answered in writing. Each question is limited to one payer and one specific issue. Additional questions or issues require a separate request.
Refund policy: Written Answer: non-refundable once your answer is delivered.
Credit toward an engagement: If you sign a recovery engagement agreement within 30 days of your Written Answer or EOB/ERA & Claim Analysis, the amount you paid is credited toward your first month’s retainer. One credit per practice.
Pay for your answerAvailable after your written answer is delivered. The call is limited to discussion and clarification of the issue addressed in your written answer. After payment, you’ll receive a private scheduling link by email.
Refund policy: Cancel or reschedule at least 24 hours before your call for a full refund or new time. Late cancellations, no-shows, and completed calls are non-refundable. Unscheduled calls expire 30 days after purchase.
Credit toward an engagement: If you sign a recovery engagement agreement within 30 days of your Written Answer or EOB/ERA & Claim Analysis, the amount you paid is credited toward your first month’s retainer. One credit per practice. Follow-Up Calls are not included.
Professional review of submitted EOBs/ERAs to identify denials, underpayments, processing issues, and reimbursement concerns. Includes findings and recommended next steps. Additional research, payer follow-up, appeals, claim corrections, or recovery services are scoped separately.
Signed BAA and secure document upload required.
Refund policy: Full refund if requested before your review begins. Non-refundable once review has started or findings are delivered. If the signed BAA and documents are not received within 30 days of purchase, the purchase expires.
Credit toward an engagement: If you sign a recovery engagement agreement within 30 days of your Written Answer or EOB/ERA & Claim Analysis, the amount you paid is credited toward your first month’s retainer. One credit per practice.
Pay for a Claim AnalysisAll payments are made to Raven Tide Holdings, LLC. Coastal Practice Medical Management is a division of Raven Tide Holdings, LLC.
One question = one issue. Multiple issues need multiple questions. Complex cases are referred to a recovery engagement or Denial Pattern Analysis. Fees are non-refundable once your answer is delivered.
Enter your PayPal transaction ID so we can match your payment. Questions without a matching payment are not answered.
We don't split our attention across 15 specialties. Every engagement is rooted in behavioral health billing.
Your monthly retainer is credited toward a percentage of what we recover. Our incentive is to recover as much as possible.
No call center, no junior associate. Your work is handled by a specialist with 23+ years in behavioral health claims.
Every engagement starts with a signed agreement that sets the scope, term and fees. No surprises.
Commercial payer experience across Pennsylvania, New Jersey, North Carolina and other states, plus Medicare and Medicaid review.
We work remotely and fit into your existing workflow, from solo therapists to multi-provider groups and CMHCs.
PA · NJ · Other States Welcome. Commercial payer work travels well across state lines.
18+ years of direct billing experience with providers in North Carolina, New Jersey, and Pennsylvania, plus government contract experience in Louisiana.
Tell us about your practice and what you need. We review every intake and send a written proposal with scope and pricing within one business day. Providers outside PA and NJ are welcome.
Practical guidance on claims, billing, and revenue cycle, written for mental health and psychiatric practices.
Recovery engagements open with a monthly retainer, credited toward a percentage of what we recover. The retainer keeps work moving each month and reduces what is owed when recoveries are reconciled.
The retainer amount, the recovery percentage, and all payment terms are set in your signed agreement before work begins. All payments are made to Raven Tide Holdings, LLC.
Yes. Practices considering a recovery engagement can request one free 15-minute Fit Call by emailing info@cpmmllc.com. We learn about your practice, payers, and denials, and recommend the right service. One free call per practice.
The Fit Call is not a billing consultation. Specific billing, coding, or denial questions are answered through a Written Answer for $175, with optional follow-up calls from $150.
We analyze and report on Medicare and Medicaid claims. We identify what went wrong and document what needs to be corrected, and your practice corrects and rebills. We do not bill, rebill, or appeal Medicare or Medicaid claims.
Commercial claims (Aetna, Cigna, UnitedHealthcare, Blue Cross plans and others) are worked through Level 1 and Level 2 internal appeals.
For recovery clients, we investigate denied or underpaid claims and coordinate recovery and appeal work with your existing team; your practice remains responsible for routine billing and claim submission. For enrolled billing-services clients, CPMM handles the agreed workflow, including commercial claim submission, under the service agreement and signed BAA.
Behavioral health providers of all sizes: solo practitioners (LCSWs, LPCs, LMFTs, psychologists, psychiatrists, PMHNPs), group practices, community mental health centers, treatment centers, and substance use programs.
Yes. We serve providers in multiple states, including North Carolina. Claims recovery, Denial Pattern Analysis, and OON / Single Case Agreement work follow commercial payer policies, which carry across state lines. Ask about your state through the Provider Intake.
It depends on the payer and the denial. Level 1 internal appeals typically take 30 to 60 days for a determination, and Level 2 may take another 30 to 60 days. We provide regular status updates and a written outcome report.
No. If you have a few denied claims, start with a Written Answer or EOB/ERA & Claim Analysis. If you have a backlog, a Denial Pattern Analysis or recovery engagement is usually the better fit.
Every recovery engagement is governed by a signed agreement that sets the scope, term, retainer, and recovery percentage. One-time services such as Written Answers, EOB/ERA & Claim Analysis, and Denial Pattern Analysis need no ongoing commitment.
A one-time diagnostic. We review your denied and aged claims, identify the root causes behind most of your lost revenue, and deliver a written report with a prioritized action plan and a line-item list of recoverable claims. It is priced as a flat fee by practice size.
A one-time contract between your practice and a commercial payer that lets you be paid an agreed rate for a specific out-of-network patient. We handle the negotiation, from network adequacy documentation and gap exception requests to final agreement confirmation.
Written Answer: non-refundable once your answer is delivered.
EOB/ERA & Claim Analysis: Full refund if requested before your review begins. Non-refundable once review has started or findings are delivered. If the signed BAA and documents are not received within 30 days of purchase, the purchase expires.
Follow-Up Calls: Cancel or reschedule at least 24 hours before your call for a full refund or new time. Late cancellations, no-shows, and completed calls are non-refundable. Unscheduled calls expire 30 days after purchase.
Yes. If you sign a recovery engagement agreement within 30 days of your Written Answer or EOB/ERA & Claim Analysis, the amount you paid is credited toward your first month’s retainer. One credit per practice. Follow-Up Calls are not included.
Yes. CPMM is now enrolling a limited number of behavioral health practices for mental health billing services. Services include eligibility and benefits verification, claim submission, payment posting, denial follow-up and accounts receivable, and monthly reporting.
Medicare and Medicaid claims are analyzed and reported; we do not bill them. Pricing is quoted after a Fit Call or Intake review. A signed BAA is required before services begin.
CPMM is an independent, specialist-led practice, not a staffing firm. We are now enrolling a limited number of practices for Mental Health Billing Services, where we manage agreed billing workflows. Recovery clients engage us for denied or underpaid commercial claims and internal appeals. We do not place staff with practices.
Every engagement starts with payment or a signed agreement. Billing and service questions are answered through a paid Written Answer or a signed engagement. Considering a recovery engagement? Your first 15 minutes are free.
Pay for a Written Answer and submit your question. Follow-up calls are scheduled after payment.
Ask a Specialist — $175Complete the Provider Intake. We review it and reply within one business day with the next step.
Start the Provider IntakeExisting clients, agreements, invoices, and administrative requests.
We respond within one business day. Do not include patient information in email.
Claims & Appeals
CPT 90837 is the 60-minute psychotherapy code, and it is one of the most audited codes in behavioral health. When it keeps coming back denied, the service is rarely the problem. The claim, the documentation, or the payer's rules usually are.
90837 is billed for psychotherapy of 53 minutes or more with the patient. A session of 38 to 52 minutes is 90834. If your note doesn't show the time, the payer has no way to confirm the longer code, and many will deny or down-code it.
Add a required time field to your note template, check each payer's policy on 90837, and watch how often each clinician bills it. A pattern of denials on one payer usually has one root cause.
General information only. Payer policies vary and change; always check the current policy for the plan involved.
Parity Law
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires most health plans to cover mental health and substance use care on terms no more restrictive than medical and surgical care in the same category. Many behavioral health denials quietly break that rule, and most practices never raise it on appeal.
Obvious differences, like a higher copay for therapy, are rare now. The problems are usually in "non-quantitative treatment limitations," the rules that limit care without a number attached:
Since 2021, federal law has required plans to complete written comparative analyses showing their treatment limitations meet parity, and to provide them on request. A 2024 federal rule added more requirements, but in May 2025 the federal agencies paused enforcement of the new 2024 provisions while they reconsider them. The underlying law and the earlier rules still apply. Check the current status before relying on any specific provision.
Parity doesn't apply to every plan. Traditional Medicare, for example, is not subject to MHPAEA, and some small or government plans have exceptions.
General information only, not legal advice. Parity rules are changing; confirm current requirements before filing.
Telehealth
Telehealth is now a normal part of behavioral health, but the billing rules still differ by payer and have changed many times since 2020. Most telehealth denials come from a mismatch between how the session happened and how it was coded.
Some commercial payers instead want the place of service you would use in person (such as POS 11) with modifier 95. Always follow the specific payer's telehealth policy.
For audio-only care, note where the patient was, why video wasn't used (for example, the patient couldn't use video or declined it), the patient's consent, and the time spent.
List each payer you bill with its required modifier, place of service, and audio-only rules. Review it whenever a payer updates its policy. Medicare's telehealth rules in particular have changed with each federal extension, so confirm the current rules before billing.
General information only. Telehealth rules vary by payer and change often.
Medicare & Medicaid
Resubmitting a Medicare or Medicaid claim without understanding why it failed usually produces the same result, or a duplicate-claim denial. The fix starts with reading the error correctly.
The group code tells you who is responsible: CO (the provider, not billable to the patient), PR (the patient), OA or PI (other or payer-initiated adjustments). The claim adjustment reason code (CARC) tells you why, and the remark code (RARC) adds the detail.
Confirm eligibility and enrollment, fix the specific error the codes point to, choose the right submission type, and log the date so you stay inside the filing limit.
General information only. Program rules vary by state and contractor.
Practice Management
When you are the clinician and the billing department, a denial can feel personal. It isn't. Most denials for solo practices fall into a few predictable types, and what you do in the first 30 days decides whether the money comes back.
General information only. Appeal deadlines depend on the plan and your contract.
Revenue Cycle
You don't need a full audit to know whether you have a billing problem. Pull these five numbers from your billing system or clearinghouse reports.
Denied claims divided by claims submitted over the last 90 days. Many practices aim to keep this under about 5 to 10 percent.
The share of your outstanding balance that is more than 90 days old. A common target is under about 15 to 20 percent. Old balances are the hardest to collect.
The share of claims paid on first submission without corrections. A low rate means errors are going out the door.
How many days pass between the session and the claim being sent. Delays shrink your time to fix problems before filing limits.
How many denials have no action taken, and the date of the oldest appeal deadline among them.
If two or more numbers are off, you likely have a pattern, not bad luck. Benchmarks vary by practice type and payer mix, so use them as a starting point, not a verdict.
General information only. Targets vary by specialty and payer mix.
HIPAA
In February 2024, HHS finalized changes that bring the confidentiality rules for substance use disorder records (42 CFR Part 2) closer to HIPAA. The compliance date was February 16, 2026. Practices that haven't updated their policies and Notice of Privacy Practices should act now.
General information only, not legal advice. Consult a healthcare attorney about your specific obligations.
HIPAA
In January 2025, HHS proposed the largest update to the HIPAA Security Rule since it was written. As of this writing it is still a proposal, and the timing of a final rule is uncertain. Much of what it proposes is already good practice, and preparing now costs little compared with a breach.
Psychotherapy and substance use records are among the most sensitive data in health care. Small practices are frequent targets because they often lack basic protections like multi-factor authentication.
General information only, not legal advice. Check HHS for the current status of the Security Rule.
Effective April 26, 2026 · Coastal Practice Medical Management, a dba of Raven Tide Holdings, LLC
Coastal Practice Medical Management is committed to protecting the privacy of individuals who visit our website and organizations that engage our services. This Privacy Policy explains how we collect, use, disclose, and safeguard your information.
We collect information you voluntarily provide when you contact us, complete a form, or engage our services, including name, title, practice name, contact details, payer information, and payment information.
When you visit our website, we may collect technical information including IP address, browser type, pages visited, and date and time of visits through standard web server logs. We do not use cookies for advertising.
CPMM operates as a Business Associate under HIPAA when serving covered entities. Any PHI accessed in connection with services is governed by our Business Associate Agreement, not this Privacy Policy. Do not submit PHI through any website form.
We do not sell, rent, or trade your personal information. We share it only with trusted service providers under confidentiality obligations (including our payment processor), as required by law, or in connection with a business transfer.
We use reasonable administrative, technical, and physical safeguards, including encrypted transmission, password-protected access, and limited authorized access. No method of electronic storage is 100% secure. We will notify you of any breach as required by law.
Business records are retained for at least seven (7) years after an engagement closes. PHI is retained per HIPAA requirements and applicable Business Associate Agreement terms.
To exercise any right, contact info@cpmmllc.com. We respond to verified requests within 30 days.
We may update this Policy from time to time. Material changes will be posted here with a revised effective date.
Raven Tide Holdings, LLC (dba) Coastal Practice Medical Management
Location: Remote · info@cpmmllc.com
Effective June 25, 2026 · Coastal Practice Medical Management, a dba of Raven Tide Holdings, LLC
These Terms govern your access to and use of www.cpmmllc.com and any services provided by Coastal Practice Medical Management ("CPMM"). By using our website or engaging our services, you agree to these Terms.
These Terms are a legally binding agreement between you and Raven Tide Holdings, LLC, doing business as CPMM. We may update these Terms at any time. Continued use after an update means you accept the revised Terms.
CPMM provides behavioral health claims recovery and Level 1 and Level 2 internal appeals management, billing support, Denial Pattern Analysis, out-of-network and Single Case Agreement negotiation, and paid consulting services, including written billing answers, follow-up calls, and EOB/ERA and claim analysis. Medicare and Medicaid claims are analyzed and reported only; CPMM does not bill, rebill, or appeal them.
Recovery engagements are billed by monthly retainer, credited toward a percentage of recovered funds, under a separately executed Services Agreement. Other services are billed at posted or quoted rates. Paid consulting fees are non-refundable once the service is delivered. EOB/ERA & Claim Analysis: Full refund if requested before your review begins. Non-refundable once review has started or findings are delivered. If the signed BAA and documents are not received within 30 days of purchase, the purchase expires. Written Answer and EOB/ERA & Claim Analysis fees are credited toward the first month’s retainer if a recovery engagement agreement is signed within 30 days of the paid service (one credit per practice). Follow-Up Calls: Cancel or reschedule at least 24 hours before your call for a full refund or new time. Late cancellations, no-shows, and completed calls are non-refundable. Unscheduled calls expire 30 days after purchase. All payments are payable to Raven Tide Holdings, LLC.
You may use this website for lawful purposes only. You agree not to attempt unauthorized access, transmit harmful code, collect others' personal information, or use the website commercially without written consent.
All website content is the property of Raven Tide Holdings, LLC and is protected by copyright, trademark, and intellectual property laws. Reproduction without written permission is prohibited.
Submitting a form does not create a professional relationship. No obligation to provide services exists until a written Services Agreement is signed by both parties. Do not submit Protected Health Information through any website form.
THE WEBSITE AND ALL CONTENT ARE PROVIDED "AS IS" WITHOUT WARRANTIES OF ANY KIND. CPMM DISCLAIMS ALL WARRANTIES, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. Website content is for general information only and is not legal, financial, medical, or professional billing advice.
TO THE MAXIMUM EXTENT PERMITTED BY LAW, CPMM IS NOT LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES ARISING FROM USE OF THIS WEBSITE. CPMM'S TOTAL LIABILITY FOR WEBSITE-RELATED CLAIMS SHALL NOT EXCEED $100.00. Liability for services is governed by the executed Services Agreement.
Nothing on this website creates a professional, consulting, or business relationship. A formal relationship is established only by a written agreement signed by authorized representatives of both parties.
These Terms are governed by the laws of the Commonwealth of Pennsylvania. Disputes are subject to the exclusive jurisdiction of the courts of Northampton County, Pennsylvania.
Raven Tide Holdings, LLC (dba) Coastal Practice Medical Management
Location: Remote · info@cpmmllc.com
Effective June 25, 2026 · Required by 45 CFR § 164.520
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Coastal Practice Medical Management is committed to compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended, including the Privacy Rule, Security Rule, and HITECH Act provisions.
CPMM functions as a Business Associate when providing services to covered entities. As a Business Associate, CPMM:
A signed BAA is required before any service involving PHI begins. The BAA is separate from the Services Agreement.
Our website forms are for business inquiries only. Do not submit PHI through any website form. PHI needed for an engagement is transmitted only through secure, agreed-upon channels.
If a breach of unsecured PHI occurs, CPMM will notify the covered entity without unreasonable delay and no later than 60 calendar days after discovery.
You may file a complaint with CPMM or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be retaliated against for filing a complaint.
CPMM: info@cpmmllc.com
HHS Office for Civil Rights: 200 Independence Avenue SW, Washington, DC 20201 · 1-800-368-1019 · hhs.gov/hipaa/filing-a-complaint