Physical therapy billing services for recurring visit workflows
Connect visits, authorization records, completed documentation and claims without replacing your EMR.
Actigy BPO provides physical therapy billing services for US clinics and billing companies that need a dedicated team in their existing EMR. Staff track visits and authorization records, check documentation completeness, prepare approved claims, post payments and follow denials. Therapists and coding reviewers retain treatment, time documentation, unit selection and clinical decisions.
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For clinics where repeat visits create repeated billing gaps
A physical therapy episode spans scheduled visits, completed treatment, authorization limits and documentation that may be finalized at different times. A general claims queue can lose that context. Actigy BPO is a fit when you want an assigned operations team to keep the visit-level work connected and give the clinic a clear list of what needs attention.
- A growing outpatient clinic: add billing capacity while the clinic manager keeps scheduling and patient financial policies.
- A multi-location therapy group: reconcile visits and open items by therapist, clinic and payer using consistent reporting.
- A billing company: assign production staff to therapy accounts through the billing-company operating model.
Follow the visit through to its billing outcome
| Workstream | Team output | Clinic decision |
|---|---|---|
| Visit reconciliation | Match completed appointments to approved treatment and billing records; flag missing or duplicate entries. | Confirm attendance, completed treatment and the authoritative record. |
| Authorization tracking | Maintain supplied approval dates, visit or unit limits and outstanding payer requests. | Resolve coverage uncertainty and decide whether treatment proceeds. |
| Plan-of-care documents | Track required signatures, certification records and missing documentation against the approved checklist. | The clinician establishes and approves the plan and clinical documentation. |
| Claim preparation | Reconcile approved time and unit entries, flag inconsistencies and prepare claims under written instructions. | The therapist and coding reviewer approve documented time, unit selection and modifiers. |
| Payments and follow-up | Post approved remittances and work payer-specific denial or unpaid-claim actions. | Approve clinical appeals, adjustments, patient balance policies and refunds. |
A scheduled visit, an attended visit and a billable completed record are separate states. The team records which state applies and why the next step is blocked. An authorization counter also needs the client's approved rules: a remaining visit count must not be treated as a guarantee of payment.
The CMS outpatient rehabilitation documentation resource explains the Medicare documentation framework. Your qualified reviewer applies the relevant payer rules. Staff do not alter treatment minutes or select additional units to make a claim payable.
Keep the EMR and make the episode history usable
The audit maps where the clinic stores scheduling, completed notes, plan-of-care records, authorization responses and remittances. We agree one source of truth for each field and test the workflow in your current electronic medical record (EMR) and billing system. A new therapy platform is not required by the staffing model.
Worklists identify the next owner for expiring approvals, missing signatures and unresolved visit records. An authorization team can receive a documented handoff rather than a vague request to “check coverage.” If you need that pre-service capacity separately, see prior authorization support and eligibility verification services.
Your clinic sets access permissions and retains the records. Billing operators use named accounts and approved payer-contact procedures. Review the security overview and agree the delivery locations before production access.
Pilot claims from one payer or one clinic
- Map the episodeTrace an approved set of patients' administrative records from authorization and completed visits to claims and payments in the permitted environment.
- Agree the worklistSeparate expiring approvals, documentation holds, rejected submissions, denials and older unpaid claims.
- Validate the next actionSample completed work with your clinic manager and coding reviewer before adding more sites or volume.
Measure unmatched completed visits, the age of documentation holds, timely authorization follow-up, posting accuracy and A/R movement by payer. Use the RCM KPI dictionary to define the reporting period and denominator. The eligibility checklist supports the benefits handoff, and the A/R aging worklist keeps legacy balances distinct from new claims.
The Actigy BPO telehealth RCM case is a company-reported example of process repair and measurement. Its results are not physical therapy results. Your pilot establishes the proposed team's accuracy and fit for the therapy workflow.
Price the visit workload and the exceptions behind it
Actigy BPO quotes staffing per full-time equivalent (FTE) based on clinic count, completed visits, payer mix, systems, documentation holds and required coverage. Identify whether you want a biller under your manager, a managed billing queue or a defined backlog project. Supervision, quality checks and included authorization work are stated in the written proposal.
We provide 24/7 administrative services and can staff teams up to 100 people in total. Your roster can support after-hours preparation, posting and handover; payer calls and therapist questions follow the relevant availability. The total capacity is not a promise of 100 simultaneous staff on a clinic account.
Delivery teams are in Poland, Romania, Bulgaria and Ukraine with access arrangements agreed for the engagement. If the clinic only needs payment-posting capacity, use payment posting services. If you need additional specialties under one scope, review medical billing outsourcing.
Physical therapy billing services: questions and answers
Can Actigy BPO work inside our existing physical therapy EMR?
Yes. The audit reviews your scheduling, notes, authorization records, billing system and clearinghouse before staffing is agreed. The pilot tests the real workflow and reporting in your current environment. Your clinic retains account and record ownership. Compatibility and access are confirmed for your particular setup rather than inferred from a software brand name.
How are visit limits and authorization records tracked?
The team maintains the supplied authorization references, approved date range and visit or unit limits according to your instructions. It flags upcoming limits, missing responses and inconsistencies for the designated owner. The clinic retains coverage interpretation and treatment decisions. A documented authorization or eligibility response is not treated as a guarantee that a later claim will be paid.
Who decides timed units and therapy modifiers?
The therapist and authorized coding reviewer retain those decisions. Operators reconcile the approved time and unit entries and flag missing or inconsistent records before claim preparation. They do not add treatment minutes, select unsupported units or alter clinical notes. Questions return to the reviewer with the relevant source record and a clear next action.
Can you follow up on missing plans of care and signatures?
Yes. The agreed documentation queue can track whether required records and signatures are present, who must supply them and when follow-up is due. Clinicians remain responsible for the plan of care, clinical content and required approval. The team records the hold and follows the approved escalation process instead of marking an incomplete record as ready for billing.
Can we outsource only physical therapy denials and older A/R?
Yes. A pilot can use a defined payer cohort, denial category or aging range while your internal team continues new billing. We establish the opening inventory and record each account’s reason, evidence, deadline and next action. Collections from the assigned backlog are reported separately from new claims and overall clinic revenue.
What determines the cost of a physical therapy billing team?
The main inputs are completed visits, clinic count, payer mix, system access, documentation backlog and the roles being assigned. Actigy BPO provides a per-FTE quote that specifies supervision, quality review and coverage. Authorization follow-up, payment posting and old A/R should be listed explicitly so the staffing plan matches the actual workload.
Define the queue you want the team to own
Share clinic count, completed visits per month, EMR and the main authorization or documentation bottleneck. Do not include identifiable patient records. We will review the workflow before proposing a written scope and paid pilot.
Scope your physical therapy billing pilot
What happens next
Share clinic count, completed visits per month, EMR and the main authorization or documentation bottleneck. Do not include identifiable patient records.