Brace Health resources

Direct answers for running a healthier therapy practice.

Practical guidance authored by the people who work on billing and practice operations every day.

7 resources

Results for “Payer response”

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Billing Operations

A Pre-Send Audit for Therapy Practice Patient Statements

Before sending a patient statement, confirm the claim has been processed, the payer response and adjustments are posted, the balance is supported, and the statement is going to the right person through an approved channel. Hold unclear or disputed balances for review.

  • Patient statements
  • Billing quality
  • Practice operations

Updated

Denial Investigations

Claim Rejection vs. Denial in Therapy Billing

A claim rejection generally means the claim was not accepted for adjudication. A denial reflects a payer's decision not to pay all or part of an adjudicated claim. Check the actual response before deciding whether to correct, submit again, or appeal.

  • Claim rejection
  • Claim denial
  • Payer response

Updated

Billing Operations

How to Find Therapy Claims That Aren’t Progressing

A therapy claim is not necessarily stalled because it is old. Look for a missing acknowledgement, an overdue response, unresolved information, or a next action with no owner. Compare the actual claim history with the expected step—not just its aging bucket.

  • Stalled claims
  • Accounts receivable
  • Claim tracking

Updated

Denial Investigations

Physical Therapy Denials: Investigate the Root Cause

To investigate a physical therapy claim denial, start with the payer's actual response, compare it with the submitted claim and supporting records, and choose the next action under the applicable instructions. A denial code is a starting point—not a complete root-cause diagnosis.

  • Claim denials
  • Root-cause investigation
  • Therapy billing

Updated

Denial Investigations

Therapy Claims: Correct, Resubmit, Appeal, or Call?

Choose the next step for a therapy claim from its actual status, payer response, and submission history. Correct inaccurate data, follow the required submission route, challenge a decision through the appropriate review process, or seek clarification when the evidence is incomplete.

  • Corrected claims
  • Claim appeals
  • Payer follow-up

Updated

Billing Operations

How Often Should Unpaid Medical Claims Be Worked?

Unpaid claims should be reviewed continuously, but not every claim needs the same follow-up interval. Set each claim’s next action from its current status, expected payer response window, filing or appeal deadline, value, and unresolved blocker.

  • Unpaid claims
  • Accounts receivable
  • Claim follow-up

Published

Billing Operations

What billing work remains after a clean claim?

A therapy EMR can prepare and submit a clean claim, but it does not finish the revenue cycle. A billing owner still needs to resolve payer responses, underpayments, secondary claims, patient balances, and recurring workflow failures.

  • Therapy EMR
  • Physical therapy billing
  • Revenue cycle

Published

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