How claims are submitted and how to review outstanding balances

Planetrehab revenue cycle management is built for therapy claims. The billing team submits claims, watches responses, and keeps a daily view of what has not been paid. Clinics use that view to see where the business stands instead of waiting for a month-end report.

Before you send a claim

A claim needs a signed note, a payer, and codes that match the visit. If the therapist has not signed, the charge should stay in the ready list. Sending it early creates a denial that takes longer to fix than the original wait. Confirm the patient’s coverage is the plan you mean to bill, especially when a secondary payer is on the chart.

Patient responsibility, such as a copay already collected at the front desk, should be posted before the claim goes out so the balance later shown in the portal is not inflated.

Submit a claim

1. Finish and sign the visit note. Billing needs the documentation before the claim goes out.
2. Open the charge for that visit and confirm the payer, codes, units, and patient responsibility.
3. Fix any missing authorization or referring provider the payer requires.
4. Send the claim. Status moves from ready to submitted.

Submitted does not mean paid. Leave the claim on the worklist until the payer responds, and do not create a second charge for the same visit while you wait.

Review outstanding balances

1. Open the billing worklist or outstanding-balance view.
2. Sort by payer or by age so the oldest unpaid claims surface first.
3. Open a row to see whether it is waiting on the payer, denied, or waiting on the patient.
4. Follow up on denials, or ask the patient to pay their share through the portal.

Work the oldest claims first. A balance that has been open for weeks is more likely to miss a filing limit than one that was submitted yesterday.

Denials and patient balances

Read the denial reason on the claim before you change codes. A missing note, a wrong payer, and a therapy cap are different problems and should not all be “resubmitted” the same way. Correct the chart, then send the corrected claim.

• Payer denials stay with billing until the reason is resolved.
• Patient balances can be paid in the portal or at the front desk.
• Write off only the amounts the clinic has agreed to adjust.

When the balance hits zero, the visit can leave the active worklist. The claim history remains on the patient if you need to answer a later question about that date of service.