Physical therapy billing services. Clear at every step.
William Avery’s PT billing services help outpatient physical therapy practices keep billing work moving, from benefits verification to unpaid claims. Your team gets clear responsibilities and a dedicated person to talk to.
Start with your workflow, your systems, and your priorities.
Our physical therapy billing services
The work, the handoff, and what comes next.
Outsourced billing works best when everyone can see where a task begins and ends. These are the service areas we discuss with your practice, along with the information each stage needs.
01
Before the appointment
Eligibility & benefits verification
We check coverage and benefits so your front desk can address unresolved questions before care begins. Recurring PT visits make it useful to establish when coverage is rechecked and how changes reach the scheduling team.
From your practice
Current registration and insurance information, planned services, and available referral or authorization records.
The next step
A benefits status and a clear route for unresolved coverage questions.
02
After the visit
Medical coding & claim review
We review billing information and supporting documentation for the services provided. Treatment minutes, units, diagnosis information, modifiers, and provider details need to agree with the record and the relevant payer requirements. Clinical ambiguities return to the treating team.
From your practice
Completed visit documentation, recorded treatment time, and accurate rendering-provider information.
The next step
Claims prepared for submission or specific documentation questions for your clinicians.
03
Through the clearinghouse
Claims submission & status follow-up
We submit reviewed claims and follow their progress. A rejected transmission needs attention before the claim can move forward. Keep the submission date, acknowledgment, and unresolved errors visible so a claim does not disappear between systems.
From your practice
Confirmed payer setup, system access, and the information needed to resolve submission errors.
The next step
Submission status and follow-up on claims that need correction or a payer response.
04
When the payer responds
Denial management & appeals
We investigate denials, pursue appropriate corrections or appeals, and bring repeated issues back to your practice. A useful work record connects the payer’s explanation with the supporting documents, relevant deadline, and next action.
Payer correspondence and requested records, with clinical input when the issue concerns the care delivered.
The next step
A documented action for the denial and visibility into recurring causes.
05
While balances remain open
Accounts receivable follow-up
We follow up on outstanding balances with attention to claim status and aging. Existing A/R needs an agreed starting inventory and ownership, particularly when another vendor has already submitted claims or started appeals.
From your practice
An opening A/R report, prior follow-up history, and access to the information behind each balance.
The next step
Open work organized by status, next action, and the items that need your team’s help.
06
At the practice review
Monthly reporting & account support
Your account lead reviews collections, denials, and days in A/R with you. We connect the numbers to the work: what is unresolved, what changed, and which decisions or documents are needed from the practice.
From your practice
Agreed reporting definitions, reconciliation responsibilities, and a practice contact for open questions.
The next step
A monthly review with priorities and a clear path for questions between meetings.
Define the service boundaries
Make the responsibilities part of the agreement.
“Full-service billing” can cover different work in different engagements. In addition to the service areas above, these responsibilities need to be assigned and priced explicitly during scoping.
Prior authorizations
Who requests approval, records approved services and dates, monitors remaining visits or units, and tells scheduling when action is needed.
Payment posting & reconciliation
Who records payments and adjustments, matches remittances with receipts, and investigates differences or unapplied payments.
Patient billing
Who confirms patient responsibility, sends statements, answers billing calls, and approves adjustments or refunds.
Credentialing & enrollment
Who maintains payer enrollment and provider details, and whether work for new clinicians or locations is a separate engagement.
Historical A/R
Which dates of service and balances are included, what history is available, and where the previous vendor’s responsibility ends.
We confirm what William Avery will handle, what remains with your practice, and whether additional support is needed before work begins.
Start with the work your team needs
PT billing services for the way your practice works.
The useful starting point is the work taking time away from your team. Use these scenarios to prepare for a scoping conversation about your staff, systems, and unresolved billing tasks.
Solo & new practices
Establish the responsibilities early.
When the owner also treats patients, small administrative tasks can compete with clinical time. Map who checks benefits, sends completed charges, answers documentation questions, and watches outstanding claims.
Bring to the conversation: your planned visit volume, payer enrollment status, software, and the tasks you intend to retain. Confirm whether any startup or credentialing work requires separate support.
Established clinics
Separate the backlog from today’s work.
If your staff is balancing new claims with older balances, identify where the work stalls. Consider the information needed to continue follow-up and how retained staff will coordinate with an outside billing team.
Bring to the conversation: a high-level A/R summary, recurring denial categories, and a list of staff responsibilities. Agree on a cutoff for historical work and how open issues will be handed over.
Multiple locations
Make differences between locations visible.
Locations can use different registration processes, contacts, or reporting conventions. Document those differences before combining the billing work, and decide which questions belong to a local contact or a central practice lead.
Bring to the conversation: your location and provider structure, systems, escalation contacts, and reporting needs. Confirm which workflows can be shared and which need their own process.
These are planning scenarios. Service fit, system access, workload, and responsibilities are confirmed together before an engagement. Share patient-level records only through an agreed secure process.
Built around the therapy visit
Three checkpoints for the billing workflow.
Repeated visits, timed services, and clinical documentation create handoffs that deserve attention. Use these checkpoints to frame the process for your specific payers and practice setting.
01 / The time record
Match the units to the payer’s method.
Preserve the documented treatment minutes and identify the payer’s timed-code policy before calculating units. APTA distinguishes Medicare’s 8-minute method from other conventions; one calculation should not be applied to every payer.
CMS identifies documentation such as plans of care, required certification, progress reports, and treatment notes in its outpatient therapy guidance. Build a route for missing records and clinical questions rather than letting them sit in an unassigned queue.
A remittance explains payment and adjustments. CMS describes claim adjustment and remark codes, as well as adjustments at the provider level. Agree on who reviews that information and how unresolved differences reach the person responsible for reconciliation.
Apply current payer requirements to the actual record and date of service. For more on modifiers, thresholds, and evaluating a partner, see our PT billing company guide.
A report you can work from
Give the open work a place in the conversation.
A monthly collection total does not explain every unpaid claim. Alongside collections, denials, and days in A/R, agree on a way to review outstanding questions and decisions.
Use the agenda here to establish a baseline and decide which reports and work queues your systems can support.
People, systems & service scope
Your software holds the record. Your workflow assigns the work.
A billing platform can generate claims and display balances. A managed service also needs people responsible for reviewing exceptions, following up, and communicating with your practice. Confirm both the system access and the human responsibilities.
During the introduction, tell us where scheduling, clinical notes, billing, and remittances live. We’ll discuss access, retained staff responsibilities, and data-handling standards before defining the engagement.
PT billing services support the revenue cycle for physical therapy practices. William Avery’s service areas include eligibility and benefits, medical coding, claims submission, denial management, A/R follow-up, and reporting. We define the tasks and handoffs for your practice in the engagement scope. Authorization work, payment posting, patient statements, credentialing, and historical balances need explicit ownership rather than an assumption that everything is included.
Can we keep our front desk and some billing tasks in-house?+
Tell us which work your staff handles well and where you need support. We can discuss a division of responsibilities around that workflow and confirm whether it is a fit. The important detail is one accountable owner for each task, with a shared way to flag unresolved work.
Do we need new physical therapy billing software?+
We begin with your existing EMR, billing platform, and clearinghouse. Before agreeing to an engagement, we need to confirm system access, available reports, and how documentation and billing information move between your team and ours. A software change or integration should be evaluated explicitly, not assumed.
How do you scope the cost of outsourced PT billing?+
Start with visit volume, payer mix, systems, the tasks you want handled, and any existing backlog. Define included work and separate charges before comparing fees. Our billing company guide includes a detailed checklist for evaluating pricing and contract terms. Read the pricing checklist.Compare outsourced and in-house PT billing costs.
Does a billing service guarantee that every claim will be paid?+
No. Payment depends on coverage, the services delivered, documentation, payer rules, and applicable deadlines. The service should provide consistent follow-up and a clear account of what happened, including balances that require a decision from your practice.
Let’s map out the work
What does your practice need help with?
Bring your software names, approximate visit volume, payer mix, and the tasks taking time away from your team. We’ll start there.