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We offer a comprehensive solution to streamline physical therapy billing for your practice. Our certified coding specialists (CCS) and certified professional billers (CPB) are adept at handling all aspects of DME billing, from verifying patient insurance and obtaining pre-authorizations to submitting accurate claims and managing accounts receivable. We ensure compliance with industry regulations and use the latest technology to speed up the claims process, reduce errors, and minimize claims denials. Here is how our team does it for you:
- Use physical therapy-specific billing software that integrates electronic health records (EHR), electronic medical records (EMR), electronic data interchange (EDI), and practice management systems (PMS) to implement processes like electronic claims submission and electronic payments.
- Capture all the relevant patient information (patient demographic, medical history, initial evaluation, plan of care (POC), and insurance provider information (patient's insurance coverage, including eligibility, benefits, and any pre-authorization requirements, coordination of benefits (COB), etc.,) to ensure complete claims documentation.
- Expertise in handling various billing types, including value-based billing, telemedicine billing, capitation billing, episode-of-care billing, and others.
- Strict alignment with the American Medical Association-specified codebooks and modifiers (97000 series Current Procedural Terminology (CPT), International Classification of Diseases, Tenth Revision (ICD-10) codes, HCPCS codes, modifier 59, NCCI edit pairs)Â to accurately capture medical diagnoses and procedures units.
- Maintain code specificity while billing for various physical therapy procedures, including manual therapy, modalities, hydrotherapy, dry needling, kinesio taping, and more.
- Stay up-to-date with fee schedules, claims submission guidelines, and payment regulations of Medicare, Medicaid, other private insurance programs (Aetna, Humana, Tricare, etc.), workers' compensation insurance, Tricare, and others.
- Assign a dedicated professional to oversee claims status inquiries, serving as a liaison between the payer and healthcare company to monitor the claims adjudication process.
- Receive EOBs from insurance payers and verify it for claims denials. If any disputes, we resolve them and initiate the appeals process to gain reimbursement for uncovered services.
- Generate clear and comprehensive reports outlining charges, permitted amounts, deductibles, copayments, and coinsurance for every patient and notify them about payment responsibilities. This way we help our clients to prevent unpaid bills.
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