Physical Therapy Billing Services
Physical therapy approaches help patients get back to their favorite life by restoring motion and lowering discomfort, and the last thing you should lose from missed bills, wrong modifiers, or avoidable denials is lost income. Designed especially for outpatient clinics, home health PT, hospital-based therapy programs, and multisite rehabilitation groups, our Physical Therapy Billing Services at Sirius Solutions Global fit a variety of needs. By marrying actual billing expertise with contemporary automation, we let your doctors concentrate on treatment and your clinic on expansion.
Our full-service PT billing offering (what we do)
We don’t offer one-size-fits-all. We build a billing engine around how you practice.
End-to-end revenue cycle management for PT, including:
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Eligibility & benefits verification before the first visit — reduce surprises and upfront denials.
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Prior authorization for permanent medical equipment (DME), specialized treatments, and protracted treatment schedules.
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For HCPCS DME codes as well as for popular PT CPTs, including therapeutic exercises, manual treatment, neuromuscular reeducation, gait training, and modalities, proper coding and charge capture are crucial.
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Timed-unit documentation audits so minutes and units match billed charges.
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Claim scrubbing & payer edits using payer-specific rules to maximize first-pass acceptance.
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Denial management & appeals — root cause analysis, fast resubmissions, and well-documented appeals that recover revenue.
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Payment posting & reconciliation with underpayment detection and contract compliance reviews.
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Cash posting & patient billing — clear statements and patient-friendly payment plans.
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Management reporting & KPIs — AR days, denial rate, net collection rate, productivity per visit, top deniers, and payer mix.
We’ll tailor the package: small clinics may need claim processing + denials, while enterprise groups often add analytics, training, and integrations.
Typical outcomes what to expect
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Reduced denial rates (often 20–40% reduction in 3–6 months).
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Faster cash flow — decreased days in A/R with disciplined follow-up.
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Increased collections from recovered underpayments and improved first-pass acceptance.
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Lower operational costs vs. maintaining a large in-house billing team.
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Peace of mind with audit-ready documentation and fewer payer disputes.
Why physical therapy billing is different
Physical therapy billing is deceptively complicated. A typical PT visit might include therapeutic exercises, manual therapy, neuromuscular re-education, electrical stimulation, and a timed modality each with its own CPT/HCPCS rules, time thresholds, and documentation standards. Common pain points we see:
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Time-based services vs. untimed services. Proper documentation of treatment minutes is essential for billing timed CPTs.
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Modifier and unit errors. Wrong modifier or unit counts cause denials or underpayments.
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Bundling rules and NCCI edits. Some charges are bundled by payers; incorrectly unbundling triggers rejections.
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Insurance variability. Medicare, Medicaid, MVA (auto), workers’ comp, and private payers all have different rules.
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Telehealth & remote therapy changes. Rapid policy shifts require ongoing updates to billing workflows.
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High administrative burden. Staff turnover and limited training increase coding mistakes.
If your front desk and clinicians are wasting time fighting denials, there’s revenue sitting on the table.
Humanized support real people, real answers
Billing shouldn’t feel like a black box. You’ll have:
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A dedicated account manager who knows your workflows.
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A specialty-trained PT billing team available for escalations.
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Access to scheduled performance reviews and ad-hoc reports.
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Staff training sessions to reduce future errors.
We believe transparency fosters trust — and better financial outcomes.
Documentation & coding: the heart of better collections
Clean documentation is the fastest path to fewer denials. We help your clinicians document in ways payers accept without adding pointless paperwork.
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Minute-by-minute time capture templates for timed codes (we’ll show what to record and why).
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Medical necessity templates that clearly tie function, impairment, and plan-of-care to billed services.
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Modifier usage guides to ensure RT/LT, distinct procedural, and multiple-procedure modifiers are used correctly.
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Progress note templates for chronic care, re-evaluation, and discharge that support claims and audits.
We provide practical templates that your clinicians will actually use and training so the whole team understands the “why,” not just the “how.”
Compliance & risk management
We keep your billing practices audit-safe:
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Medicare & Medicaid compliance and adherence to local coverage determinations (LCDs).
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Workers’ comp and auto-no fault billing compliance and state-specific filing rules.
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HIPAA-secure workflows and encrypted data exchange.
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Periodic coding audits and corrective action plans to patch systemic problems.
When a payer asks for records, we make the response organized and defensible.
Technology & AI practical tools that reduce friction
We use technology thoughtfully automation for the repetitive and humans for the judgment calls.
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AI-assisted claim scrubbing: Flags mismatches between documentation and billed codes.
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Denial prediction models: Identify claims likely to be denied, so we fix issues before submission.
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EHR & PM integration: Automatic charge capture lowers manual data entry errors when EHR and PM integration occurs.
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Real-time dashboards: Provide at-a-glance AR, denial trends, performance of payers, and productivity information.
It’s not flashy for the sake of it it’s about releasing time for clinicians and reducing rework for billers.
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