Claim denials and rework due to pre-authorization errors

$1,000–$3,000/month (auto insurance coverage exhaustion causes mid-treatment cancellations, therapist downtime, rework); 10–20 staff hours/month on authorization re-verification and rescheduling • $1,000–$3,000/month (cancellations, no-shows, therapist downtime, wasted appointment slots); 10–20 staff hours/month on Medicare re-verification and rescheduling • $1,000–$3,000/month (no-shows, cancellations, therapist downtime); 10–20 staff hours/month on last-minute rescheduling and patient communication

Billers coordinate with front office and therapists via email to obtain narrative reports and detailed notes after a denial; they manually track disputed amounts in spreadsheets and reissue invoices or lien updates to insurers and attorneys. • Billers interpret CARC/RARC denial codes, cross-reference Medicare and MA policy PDFs, and then request additional documentation from therapists; they track appealed claims in spreadsheets and manually calendar follow-up dates to check payer portals and remittances. • Billers manually reconcile each EOB or remit with internal authorization notes, then contact adjusters or TPAs by phone or email to dispute denials and send supplemental documentation; they maintain case-specific spreadsheets to log conversations and resubmissions.