Billing companies that work physical therapy claims every day. Describe your practice once and compare their proposals.
A few questions about the practice, then billing companies that fit send proposals. You are not committing to anything.
Hand off all of it or just the parts that are breaking. Say which in the form so the proposals match.
Charges entered, claims checked against payer edits, and sent daily so clean claims go out the first time.
Every denial worked, appealed, or corrected, with the root cause tracked so the same denial stops repeating.
Old balances called on and worked by payer and by age until they are paid, adjusted, or written off on purpose.
Certified coders assign CPT, ICD-10, and modifiers from your notes, or audit the codes your providers pick.
New providers enrolled with payers, CAQH kept current, and revalidations handled before they lapse.
Statements, online payment, payment plans, and the phone calls that come with them, handled in your name.
Eligibility checks, prior authorizations, and old AR cleanup go through the same request. If you only need one piece, say so.
There is no right answer for every practice. The usual tradeoffs:
Physical therapy looks like the simplest billing in medicine until you read a month of denials. The code set is tiny. The same handful, 97110, 97140, 97530, 97112 and 97035, ride on nearly every claim, and that repetition is the trouble: an edit that trips one visit trips them all. The worst offender is manual therapy billed beside other timed codes. The bundling edit wants a modifier and a note showing a separate region or a separate session, so front desks learn to put a 59 on everything, payers learn to look for it, and some deny on sight.
Then come the timed units. Eight-minute math sounds easy until a plan counts minutes differently from Medicare and your software rounds a third way. Add the GP modifier, the CQ modifier when an assistant did part of the visit, and the Medicare therapy threshold, past which the claim needs a KX and a note proving the care is still necessary. Visit caps reset on the calendar year at one plan and the benefit year at the next. Authorization is its own job, since many plans route therapy through a utilization vendor, and an approval for twelve visits does not pay twelve visits if the re-evaluation was never requested. In-house staff usually get eligibility right at the first visit and lose the thread by visit six.
A good PT biller checks visit counts against authorizations every day, reads remits for the pattern behind a denial, and chases the workers comp and auto carriers that pay slowly and ask for the same notes twice. Cash and hybrid clinics have a different mess in superbills and out-of-network claims. Outsourcing makes sense when the owner is posting payments at night, or when one front desk person quitting would stop the cash, and a second location with a different payer mix makes both worse. It makes less sense for a one-room clinic that already collects clean. In the form, give your therapist count, payer mix, software and visit volume, and say if you want full billing or only a cleanup of old AR. Billers price those jobs differently.
Three steps. Most practices hear from the first billing company within a business day.
Specialty, providers, claim volume, your software, and what you want handled.
Your request goes to billing companies that work your specialty and take on practices your size.
Compare fees, scope, reporting, and contract terms side by side. Pick one, or none.
What practice managers usually ask before they fill out the form.
Describe the practice once and compare proposals from billing companies that fit. No obligation.
Request proposals