PHP and IOP claims depend on hours, attendance and authorized units. We make sure every program day is documented, coded and billed correctly, and that the units are there to pay for it.
Payers expect minimum program hours per day and days per week. Short days and missed groups trigger denials.
IOP and PHP authorizations are usually a set number of days or units. Billing past them means unpaid days.
Some payers pay a per diem, others pay individual CPT codes for groups and sessions. Getting it wrong means rejections.
Virtual IOP needs the right place of service, modifiers and payer approval.
Urine drug testing billed with the wrong codes or without an order is a frequent denial source.
Clients moving between PHP, IOP and outpatient need authorizations that line up by date.
Hand us the full revenue cycle or just the parts that are breaking. Either way, one team is accountable for the result.
A reference to the codes commonly used at this level of care.
Codes, units and billing rules vary by payer, contract and state. We bill to your contracts and your payers' current policies.
One hour on your program, your numbers and your goals. You leave with clear options and no obligation.
We scope what you need, from one service like VOBs or authorizations to full RCM, and price it to the project.
We clean up denials and A/R, build and train your team or run billing every day, with weekly KPI reporting.
PHP is a higher level of care with more program hours per day and week, and it usually bills at a higher per-diem rate. IOP has fewer required hours. Payers set their own minimums, so we bill to each payer's requirements.
Yes, when the payer covers it. We set up the correct place of service, modifiers and authorization for telehealth programs.
Yes. We review orders, medical necessity and coding for presumptive and definitive drug testing before claims go out.
No. Many programs do. We make sure each client's authorization, attendance and billing match their current level of care.
Book a free one-hour discovery call. We will look at how your billing runs today and lay out your options: full RCM, consulting for your team or help with one piece, like VOBs or authorizations. Serving Utah treatment centers and programs nationwide.
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