What we handle for occupational therapy practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Timed and untimed codes
Treatment units calculated correctly from documented minutes under the applicable rule.
Plan of care compliance
Certifications and recertifications tracked so claims are not denied for an expired plan.
Therapy thresholds
Annual thresholds tracked with modifier KX applied when continued care is medically necessary.
Evaluation complexity
Low, moderate and high complexity evaluations billed to the documented findings.
Where occupational therapy claims usually go wrong
These are the four issues we see most often when we take over a occupational therapy practice.
Unit miscalculation
Treatment minutes convert to units under a defined rule. Rounding by hand is the most common cause of therapy underpayment and overpayment.
Expired plan of care
Care delivered after certification lapses is not payable. We track expiry dates rather than discovering them at denial.
Threshold and KX modifier
Once a patient crosses the annual threshold, continued care needs modifier KX and documented necessity.
Modifier 59 between disciplines
When OT and PT treat the same patient the same day, claims need correct separation or one bundles away.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Occupational Therapy billing questions
Something not covered here? Call (833) 305-5528.
Do you handle PT and speech therapy too?
Yes. The same timed-unit and plan of care rules apply and we bill all three.
Do you track therapy thresholds?
Yes, per patient per year, with KX applied when justified.
Can you bill school and home-based therapy?
Yes, with the correct place of service.