rcm solutions Rehabilitation Centers facilities

Medical Billing And Revenue Cycle Management Solutions For Rehabilitation Centers

Rehabilitation center providers offer a wide spectrum of services and solutions aimed at helping individuals regain independence and enhance the quality of their lives after illness, injury, or disability. At StafGo Health, we are proficient in providing end-to-end medical billing and revenue cycle management (RCM) solutions designed specifically for the needs of rehabilitation centers. Our experts ensure accurate billing for your practice and minimize the occurrence of denials, whether your facility provides any kind of services like physical therapy, occupational therapy, speech therapy, etc. Our team has a deep understanding of payer-specific requirements, authorization processes, and compliance regulations that can allow your clinical staff to focus on patients' fast recovery, and we can handle the financial growth of your practice.

Precise CPT Code Management for Rehabilitation Centers Billing with StafGo Health

Our certified coders are well-versed in the application of majorly used codes in Rehabilitation Centers billing, which are 97110 for therapeutic exercises, 97112 for neuromuscular re-education, 97116 for gait training therapy, and 97530 for therapeutic activities—all of which are time-based and require precise billing practices. For more comprehensive assessments and progress tracking, codes like 97750 (physical performance test) and 97535 (self-care/home management training) are frequently used. Additionally, speech-language pathology services often involve codes such as 92507 (speech therapy) and 92523 (evaluation of speech sound production and language comprehension). Accurate use of modifier 59 and GP is critical to avoid denials.

Why Outsource Medical Billing And RCM To Stafgo Health For Your Rehabilitation Centers

Rehabilitation centers face a different set of billing problems because of time-based codes, multidisciplinary care teams, and diverse payer requirements. By outsourcing your medical billing to StafGo Health, you will have access to a dedicated and skilled team that understands and can solve the complexities of rehab-specific coding, documentation, and compliance. We make sure that our specialists are doing accurate billing for services such as therapeutic exercises, gait training, etc., while also handling authorizations, modifier usage, and timely claim submissions. Our team works dedicatedly to reduce the number of denials, enhance the reimbursement rate, and allow your staff to focus on patient outcomes, not paperwork.

Common RCM Challenges Faced by Rehabilitation Centers and Practices

Complex Insurance and Authorization Requirements - Rehabilitation services frequently have requirements of pre-approvals and detailed treatment plans stating that treatment is medically necessary. Navigating through these different requirements from different payers can slow down the payments and lead to more denied claims.
High Claim Denial Rates for Medical Necessity - Some of the rehab claims are denied by insurance companies because of vague and insufficient documents or exceeding the visit limits. These denials affect the complete billing process; this not only delays payments but also requires time-consuming appeals and rework.
Time-Based Coding and Billing Errors - Billing for rehab services mainly depends on how much time the procedure took or what level of service is provided. Submission of an accurate claim with accurate documents is highly important. Even a tiny error can result in underpayments, audits, or compliance issues.
Inadequate A/R Management and Follow-Up - Many rehab centers find it difficult to keep a record of unpaid or underpaid bills and follow up with insurance companies. This led to more unpaid accounts and reduced cash flow.
Lack of Trained RCM Staff - Smaller or independent rehab centers usually do not have specialized and dedicated billing experts. This increases the chances of mistakes, risks with following rules, and revenue loss due to inefficient processes.
Poor KPI Visibility Across Providers and Services - In the absence of effective customized dashboards, many rehab practices face difficulty tracking performance indicators like: Average reimbursement per visit, Days in A/R, Patient no-show rates, etc.

Solving Your Rehabilitation Center's Challenges with StafGo Health

Comprehensive Insurance Verification & Pre-Authorization - Our experienced team makes sure that each and every patient is pre-verified and properly authorized before services start, which reduces front-end rejections and ensures speedy claim approvals.

Expert Coding for Time-Based and Therapy Services- Our certified coders are proficient in therapy billing and application of time-based CPT codes to enhance reimbursement against the applied claims and ensure compliance with CMS and commercial guidelines.
Real-Time Denial Management & Appeals Our team proactively tracks and addresses the denied claims using efficient appeal strategies made specially for your practice. This significantly enhances your claim recovery and reduces interruptions to your cash flow.
Full A/R Oversight and Faster Payments- Our experienced and dedicated Accounts Receivable (A/R) team proactively follows up on unpaid claims and patients' remaining balances. This can help you reduce the time it takes to receive payments and enhance your overall financial performance.
Therapy-Specific Reporting and KPI Dashboards Our team provides you with full visibility into your performance with the help of therapy-specific reporting and KPI Dashboards that highlight metrics like claims paid by unit, authorization lag time, denial rates, and net revenue per visit.
Customized KPI Dashboards for Transparency - With the help of automatic tools, you can gain visibility into vital metrics like Days in A/R, Collection rates by therapist, Visit-to-authorization ratio, etc. With the help of our dashboards, you can make data-driven future decisions.