Practice Owners: Revenue & Compliance
Business Health Analytics for Practice Owners
Owners are being asked for cost and payer data to support rate advocacy, while also bracing for 2027 fee schedule changes. Your own numbers tell you where you're exposed. ✨ Available on: Billing ? In MyTherapyWizard Analytics › Business Health: A/R ...
Payroll and Pay Rates for W-2 and 1099 Therapists
Pay questions run both ways in owner groups: what is fair per visit or per evaluation, and how to account for documentation and admin time. Talk with your accountant about W-2 versus 1099 classification. ✨ Available on: Billing ? In MyTherapyWizard ...
Authorization Limits, Units and Same-Day Services
Payers are adding limits: units per day, visits per plan of care, and reduced payment when more than one therapy is billed on the same day. Read each payer's current reimbursement policy for its exact rules and effective dates. ✨ Available on: Teams ...
Medicaid Audit Readiness: Your Prior Auth Is Not Your Plan of Care
A practice owner shared that a Medicaid auditor ruled their prior authorization submission "is NOT a plan of care." A prior authorization is a request to the payer. The plan of care is the clinical document it should be drawn from. With audits ...
Preventing Recoupments: Eligibility Checks and Retro-Terminated Coverage
Owners describe Medicaid plans recouping payments months later because coverage was retroactively terminated, even though the portal showed it as active. You can't prevent every retro-term, but saved eligibility responses are your best evidence in a ...
Working Denials: CARC Codes, Habilitative Exclusions and Missing Auths
A common trap: a benefits manager says habilitative therapy isn't covered so no authorization is needed, then the claim is denied for no authorization. Check the member's plan documents for habilitative exclusions, and record the reference number of ...
Catching Underpayments Against Your Fee Schedule
Owners report Medicaid managed care plans paying below the published fee schedule with no explanation. Short payments are easy to miss when ERAs are posted in bulk. ✨ Available on: Billing ? In MyTherapyWizard Enter each payer's expected allowed ...
CPT Code Changes: Updating Codes, Rates and Bundles
Code changes are the single biggest topic among practice owners, led by the proposed replacement of CPT 92507 with new timed speech-language codes for 2027. Final rules come from CMS and the AMA, and Medicaid and commercial payers decide separately ...