As a physical therapy provider, you want your patients to continue their prescribed treatment until their care plan is complete. However, authorization limits or expiration dates can go unnoticed.
It’s hard to track authorizations because the limits differ by payer. One approval may be limited by number of visits, another by date range or specific services. In addition to this, submission windows, documentation requirements, and retrospective authorization rules also vary by plan.
Here is how PMB helped one of our clients, Care Physical Therapy, bring that tracking into one workflow.
The Problem: Tracking Authorizations Across Multiple Payers
Care Physical Therapy works with several payers, each with its own submission windows and documentation requirements. Approvals may be limited by visit count, date range, or specific services, giving staff more than an expiration date to track.
The front desk was managing this by hand. Staff had to:
- Log in to separate payer portals to check authorization status.
- Keep count of the visits remaining on each authorization.
- Decide when to request an extension.
With information spread across portals, staff had to piece together each patient’s authorization status and compare it with upcoming appointments. This made it harder to identify approaching limits and plan renewal requests.
The Solution: Bringing Authorization Tracking into One Workflow
Care Physical Therapy partnered with PMB to manage authorizations. The workflow brought together the practice’s schedule, authorization details, and alerts to help staff identify cases needing attention.
- EMR Connection: The system uses the connected EMR’s schedule and available case information to help identify upcoming authorization needs.
- One Report: Patient and case details, insurance plans, authorization numbers, status, dates, and upcoming appointments appear together. For visit-based authorizations, the report also shows approved, completed, and remaining visits.
- Alerts: Notifications flag when a new authorization is due. Staff can review authorization dates and remaining visits alongside scheduled appointments to plan the next steps.
How PMB Managed Requests & Renewals
PMB’s team used this information to prepare requests, submit them, and follow up with payers:
- Review Authorization Needs: The team reviewed upcoming appointments, authorization details, and relevant submission dates to prioritize requests and renewals.
- Prepare the Request: PMB selected available diagnosis and procedure codes from the patient’s case and attached available clinical documentation from the connected EMR, based on the payer’s requirements.
- Submit to the Payer: The team submitted requests through payer portals or by fax, as required, and recorded submission confirmations for follow-up.
- Track and Follow Up: PMB checked payer responses and updated authorization status in the dashboard. When additional information was requested, the team coordinated with Care Physical Therapy’s staff to gather it.
The practice could review authorization information through the report and alerts while PMB handled submission and payer follow-up.
Results
Since PMB took over authorization management, Care Physical Therapy has reported:
- Fewer visits scheduled without an active authorization.
- Fewer authorization-related denials.
- Less staff time spent on portal checks and status follow-up.
The front desk also noticed improvements in day-to-day tracking:
- Authorization status, end dates, and remaining visits are now available in one report.
- Staff can plan renewal requests around upcoming appointments rather than discover authorization gaps after the fact.
What Other PT Practices Can Learn?
Care Physical Therapy’s experience highlights the value of reviewing authorization details alongside upcoming appointments. This helps staff identify cases needing attention and coordinate requests with PMB.
A few takeaways for other PT practices:
- Track approved visits, authorization dates, and covered services rather than expiration dates alone.
- Review current payer requirements when preparing requests, including submission windows and required documentation.
- Compare remaining visits and authorization dates with upcoming appointments to identify renewal needs.
- Keep authorization details in one report so staff can review status and prioritize follow-up.
Get Support with Authorization Management
If your front desk is checking payer portals by hand and counting remaining visits on a spreadsheet, PMB can take over the submission and follow-up while your team can monitor authorization status through the dashboard.
Learn more about our authorization management service, or book a free consultation to review how PMB would handle authorizations for your practice.
You can also call (201) 585-7306.