Standardizing Denial Management in Behavioral Health: A Quantitative Audit Protocol for Practice Revenue-Cycle Maturity

Abstract: Behavioral health revenue cycle management (RCM) is frequently executed through non-standardized, practice-specific workflows, which can contribute to inconsistent eligibility checks, avoidable clearing house rejections and payer denials, and delayed accounts receivable (A/R) follow-up. This paper introduces the Velden Behavioral Audit Protocol (VBAP), a 20-control score-based framework designed to quantify RCM maturity across five operational pillars: (1) Leadership & Accountability, (2) Intake & Eligibility, (3) Claims Submission & Posting, (4) A/R & Denials, and (5) Compliance & Data Governance.VBAP scores each control on a 0–2 rubric (0=ad hoc, 1=inconsistent, 2=standardized) to generate an overall maturity score, pillar subscores, and a ranked gap profile to prioritize remediation. We describe the protocol design, scoring rubric, and a prospective validation plan using de-identified, aggregated operational metrics (e.g., eligibility-related denial share, rejection turnaround time, remittance posting latency, and net days in A/R).Note: This is a preprint describing a scoring protocol and proposed validation plan; it does not report patient-level data.Ethics/Privacy: No PHI is included; validation is planned using de-identified, aggregated operational metrics.