Physical Therapy is one of the most eluded concepts in the history of billing. Physical therapy was born out of the need to help people which meant most physicians who performed physical therapy don’t get paid what they deserve. Current Procedural Terminology (CPT) developed by American Medical Association (AMA) is the accepted medical nomenclature to report medical procedures and services. However, CPT doesn’t cover some of the physical therapy interventions but it does provide a framework.

For physical medicine and rehabilitation, CPT codes are located in section 9700.However, the physical therapist can bill under any code depending on the state laws. Legion Healthcare solutions have developed a framework for each of the states in US, to make physical therapy billing error-free.

Physical Therapy is the most interesting billing because there is always a fixed point in state law when it comes to reimbursement of a claim. We have developed a comprehensive framework when we deal with physical therapy based on a specific state, which helps us to reduce the denials and avoid appeals. However, we keep an open mind always communicate with physicians and payers about the therapy requirements and its cost.” - Billing manager for Physical Therapy.

“Legion communicates with insurance companies about the coverage and conveys it to the physical therapists so that the billing doesn’t go in appeals.”

– Certified Coder for Physical Therapy Billing at LHS

Time-Based Service

Physical therapy is a time-based service; many insurance companies apply the eight-minute rule. Most physical therapists find the eight-minute rule confusing hence Legion appoints a biller who communicates about eight-minute rule that’s equal to one unit. With mixed remainders and rule of eights, billers from legion give you a view of the amount that will be paid to you based on each therapy session.

Claim Management

When a physical therapist submits a claim it goes through a process of scrutiny before reaching a clearinghouse. It can take from 30 days to almost 180 days for you to get paid. At Legion solutions, we understand how important it is to maintain a tab over each claim whether it's in process or in appeal. Legion analytical solutions go over each claims AR day to route our resources.

Documentation of Body Part

Documentation of body parts covered under the physical therapy helps legion healthcare identify the correct set of codes for your procedure. Covering all the parts that went through physical therapy will not only help you get the complete payment, even layout cases when the patient comes back with other related problems in the body.

For prior authorization and co-payment a dedicated team built by Legion for ambulance billing.

Complete verification of patients' origin and destination to understand whether it will be co-payment or complete patient pay.

24/7 expert support for all physical therapists to assist with documentation and coding.

Analytical-based solutions to cope with claims and appeals.

Technology to support for EHR to make the billing cycle smooth.

API-and RPM-based solution for improved patient experience.