PT claims fail in specific, predictable ways. Units miscounted against the 8-minute rule. Visits billed past a cap nobody was tracking. Authorizations that expired mid plan-of-care. None of that is a coding accident, and all of it is preventable.
Generic billing services treat every claim the same. These are the patterns we look for first in physical therapy practices.
Direct one-on-one time has to be totalled correctly across timed codes before units are assigned. Get it wrong and you either underbill every visit or invite a payer audit. We calculate units from the documented treatment time, not from habit.
Medicare therapy thresholds and commercial visit caps both require the KX modifier or an authorization extension at the right point. Missing that turns a covered visit into a write-off.
A plan of care that outlives its authorization produces a run of denials that all look like separate problems. We track auth end dates against the scheduled plan, so extensions are requested before the visit, not after the denial.
Separately identifiable services get bundled when the modifier is missing. This is the single most common recoverable PT denial we see.
Benefits and authorizations checked before the visit, not after the denial.
CPT, ICD-10 and modifiers validated against your documentation, with 100% audits for new clients.
Categorized by root cause, appealed with evidence, and fixed upstream so they stop recurring.
Oldest and largest first, with payments validated against your contracted fee schedule.
Payer enrollment and re-credentialing as part of the standard package, not an add-on.
Accuracy, turnaround and collections sent to you, not buried in a portal.
Whether you are a solo PT who just got your NPI or a multi-site practice with aging A/R, the first step is the same and it is free: send your aging report and we will tell you what is recoverable.
Request a free A/R review