Physical Rehabilitation revenue cycle management
Multi-discipline rehab lives on authorizations, visit limits and recert deadlines - multiplied across PT, OT and speech. AI agents track each discipline separately and run the full billing cycle behind it.
Rehabilitation revenue leaks through lapsed authorizations, missed plan-of-care recertifications and timed-unit coding errors - each multiplied across PT, OT and speech. MedXFlow's agents track every discipline's authorized visits, flag recerts before they expire, validate every timed unit, and work claims, posting and denials.
Authorization & visit-limit tracking
- Auth request & renewal by discipline - Requests and renews authorizations for PT, OT and speech, each tracked separately.
- Visit-limit tracking - Tracks authorized vs. used visits per discipline and alerts before the cap.
- Concurrent review - Prepares concurrent-review documentation for inpatient and SNF settings.
- Cross-discipline cap coordination - Coordinates shared caps across disciplines so nothing double-counts.
Plan of care & recertification
- Recert deadline tracking - Flags plan-of-care recertification dates and missing physician signatures.
- Progress reporting - Prompts required progress notes and functional reporting at the right intervals.
- Discharge planning documentation - Assembles discharge documentation and outcomes.
Coding & compliance
- Timed-unit & modifier validation - Validates units under the 8-minute rule and discipline modifiers (GP, GO, GN).
- Co-treatment & group rules - Applies co-treatment and group-vs-individual billing rules.
- KX threshold tracking - Tracks the therapy-threshold amount and applies the KX modifier when appropriate.
- Functional-outcome coding - Captures Section GG / functional-outcome data in facility settings.
Eligibility & benefits
- Benefits & cap verification - Verifies therapy benefits and visit limits across disciplines.
- Secondary coverage detection - Detects secondary plans and coordinates benefits.
Claims, payments & AR
- Claim submission & scrubbing - Scrubs and submits claims through the clearinghouse.
- ERA auto-posting - Posts remittances and adjustments automatically.
- Cap, auth & recert denial recovery - Auto-appeals the recurring denials: exceeded cap, no auth, expired recert.
Patient collections
- Point-of-service collection - Collects copays and coinsurance at each visit.
- Statements & payment plans - Sends statements and offers payment plans.
Scheduling
- Booking & recurring series - Sets up recurring visit series across disciplines.
- No-show & waitlist backfill - Reminds patients and backfills cancellations.
Analytics
- Discipline utilization & denial dashboards - Tracks utilization and denials by discipline.
What you get
- Track PT, OT and speech authorizations separately
- Never bill past an authorized visit count
- Stay ahead of every plan-of-care recert deadline
- Get the 8-minute rule and discipline modifiers right
- Apply the KX modifier at the threshold
- Recover cap, auth and recert denials
Frequently asked questions
How are PT, OT and speech authorizations managed together?
Each discipline generally carries its own authorization and visit count, but some plans apply a shared cap across disciplines. Tracking them separately - and understanding where they interact - prevents one discipline from silently exhausting another's benefit.
What happens when a therapy authorization lapses?
Visits delivered after expiry are typically denied and hard to appeal. Because rehabilitation is recurring and multi-disciplinary, expiry dates need to be tracked per discipline and renewed before the last authorized visit is used.
How are timed therapy units calculated?
Under the 8-minute rule, billable units are derived from total minutes of direct one-on-one treatment. Accurate minute documentation per discipline is what makes the unit count defensible.
What drives denials in rehabilitation billing?
Lapsed or exhausted authorizations, missed plan-of-care recertifications, timed-unit errors, and cap coordination problems across PT, OT and speech - each multiplied by the number of disciplines involved.