For Outpatient physical, occupational, and speech therapy clinics, from a single clinic to a small multi-site group
Spot therapy visits scheduled beyond the authorized visit count
Commercial and Medicaid plans approve a set number of visits over a set date range. The front desk books the patient's usual standing slot for the next month without checking how many visits are left. The overage shows up as denials weeks later, and the patient is surprised by a bill or a pause in care.
What it can cost you
Example: 8 patients scheduled 3 visits past their authorization each x $95 a visit = $2,280 in claims headed for denial.An illustration, not a promise. Your Opportunity Scan puts a real number on it.
What the system checks overnight
- Compares visits used plus visits scheduled with each authorization's approved count.
- Flags scheduled visits that fall after the authorization end date.
- Flags patients nearing their last authorized visit with no request for more logged.
- Tracks pending authorization requests by days waiting and by payer.
- Groups findings by location and front-desk team.
Where it reads from
- WebPT
- Prompt EMR
- Raintree
- Net Health
- TheraOffice
- Jane
- Fusion Web Clinic
- Google Sheets
What happens when it fires
The front desk and therapist decide whether to request more visits, adjust the schedule, or talk with the patient about coverage. The system drafts the auth request checklist.
Autonomy level: Draft for approval. The system prepares the message or task, and you approve it before anything goes out.
What we guarantee
Every scheduled visit is checked against its authorization nightly, and mismatches are flagged before the visit date. We agree on the metric before the Sprint starts and measure it over the first 20 business days after go-live. If we miss it, you get half your Sprint fee back. Dollar savings are tracked in your monthly saves log, reported rather than promised.
Questions
Does this push us to max out authorized visits?
No. How many visits a patient needs is the therapist's call. This only catches visits that would happen without coverage, so neither the patient nor the clinic is surprised.
Some of our auths live in a spreadsheet. Is that a problem?
No. It can read the EMR and a shared sheet together and will flag where they disagree.
Do I need new software for this?
No. The system reads from the tools you already use, with read-only access by default. A guardrail layer controls exactly which data the AI can see.
What does it cost?
A 3-week Sprint is $6,000 fixed and includes the morning brief plus one automation tied to an agreed metric. Ongoing support is $1,500 a month, or $500 a month to keep it running without new automations. If the agreed metric is missed over the first 20 business days after go-live, half the Sprint fee is refunded.
How is this different from a dashboard app or a free AI kit?
A dashboard app shows numbers when you go look. A free AI kit gives you the parts, and you do the setup, the upkeep, and the checking. Here the alarms are built for your kind of business, they watch outside data like market rates and rule changes alongside yours, and on Run or Keep-Running, the person who built them keeps them working and logs what they caught.
More alarms for outpatient rehab therapy clinics
Seven more things worth watching.
- Plans of care missing signatures or recertsTrack therapy plans of care waiting on physician signature, recerts coming due, and progress reports owed, before visits are put at risk of denial.
- Unsigned notes and unbilled visitsCount therapy visits with unsigned daily notes or no claim, by therapist and payer filing limit. Only note status is read, never note content.
- Denial patterns by payer and reasonGroup therapy denials by payer, CPT code, therapist, and reason each night, and flag Medicare patients nearing the therapy threshold before claims deny.
- Underpaid visits versus your contractsCompare every paid line on your remittances with your contracted rates by payer and CPT code, and flag short payments before they become normal.
- Cancellation and no-show spikesSpot rising cancellations and no-shows by clinic, therapist, and time slot against your own baseline, and see which ones were never rebooked.
- Patients dropping off their plan of careList patients with an active plan of care and no next visit booked, plus open plans past their end date with no discharge, by internal ID only.
- Referrals not scheduled for an evalFind therapy referrals with no evaluation booked, follow-ups that stopped after one call, and referring offices that suddenly went quiet.
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