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Flat-Rate vs. Per-Unit Reimbursement: Reading Your Payer Contract Correctly
It’s a scenario that makes every private practice owner’s stomach drop. You pull your weekly remittance advice, expecting a healthy reimbursement for a complex patient session where you billed multiple units or multiple distinct codes. Instead, the payment that hits your account is a fraction of what you calculated. Your first instinct? Call it an underpayment, blame a payer glitch, and gear up for a timely filing appeal. But before you spend hours on hold or drafting appeal
Tony Kain
Jul 315 min read


Medicare Telehealth for PT, OT, and SLP: What's Actually Covered Through 2027
If you have been wondering whether Medicare still reimburses virtual therapy visits, the direct answer is yes. Physical therapists (PTs), occupational therapists (OTs), speech-language pathologists (SLPs), and audiologists remain fully eligible to bill Medicare for Telehealth services through December 31, 2027. While political debates and temporary funding fights caused confusion early in the year, Congress officially resolved the status of therapy Telehealth. Here is what ha
Tony Kain
Jul 294 min read


Why Are My Insurance Claims Stuck in Pending?
You submit a batch of claims through your clearinghouse, check your dashboard a week later, and notice a handful are marked as pending. Another week passes, then a month, and nothing moves. The money sits in administrative limbo while your practice overhead keeps running. For solo and small group mental health, physical therapy, occupational therapy, and speech-language pathology practices, watching revenue freeze behind an insurance wall is one of the more demoralizing parts
Danielle Wagar
Jul 36 min read


SimplePractice Free Credentialing: What Happens After the “Free” Part?
SimplePractice's free credentialing gets your applications submitted, but it will not build the billing system that gets you paid. Here is what is actually missing, and what to do about it.
Danielle Wagar
Jun 246 min read
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