Eligibility & benefits
We verify coverage, visit limits, copays and authorization rules before the patient is on your table.
Medical billing · Austin, Texas
Clean claims out. Cash in faster.
Codentra runs the whole billing cycle for physical therapy and other outpatient practices: eligibility, coding, claims, follow-up and denials. You treat patients. We chase the money.
CLAIM #PT-20418
DOS 2026-10-12
Payer Medicare Part B
| CPT | Service | Min | Units |
|---|---|---|---|
| 97110GP | Therapeutic exercise | 23 | 2 |
| 97140GP | Manual therapy | 15 | 1 |
| 97530GP | Therapeutic activities | 15 | 1 |
Scrubbed · ready to submit
53 min → 4 units
Sample claim for illustration. Not a real patient record.
Revenue cycle services
Every step between the visit and the deposit
One team owns the full cycle, so nothing falls between a front desk, a coder and a collector.
Medical coding
Certified-minded CPT, ICD-10 and modifier selection that matches what your notes actually support.
Charge entry & claim scrubbing
Every charge is checked against payer edits before it leaves, so errors die here and not at the payer.
Claim submission
Electronic filing through your clearinghouse, with rejections worked the same day they appear.
Payment posting
ERA and check posting, matched to the penny, with underpayments flagged against your contract rates.
A/R follow-up
Aging claims get worked in priority order by balance and age, so old money does not turn into write-offs.
Denial management
We find the root cause, appeal with the right documentation, and fix the upstream habit that caused it.
Patient billing
Clear statements and polite follow-up on patient balances, handled in your practice's voice.
Credentialing
Payer enrollment and revalidation tracked on a calendar, so a lapse never freezes your payments.
Reporting & insight
Monthly collections, denial reasons and days in A/R in a report you can read in five minutes.
Specialty · Physical therapy
Timed units are where therapy revenue leaks
Therapy bills in 15-minute blocks, and a few minutes of difference can change a unit count. We count minutes the way each payer does, attach the right modifiers, and keep certifications and progress reports from expiring.
GPPT plan of care
KXThreshold exception
CQPTA services
59Distinct service
Medicare unit math we apply
| Total timed minutes | Units billed |
|---|---|
| 8 – 22 | 1 |
| 23 – 37 | 2 |
| 38 – 52 | 3 |
| 53 – 67 | 4 |
Some commercial payers count per code instead. We set each payer's method in your account on day one.
| Code | What it covers | What we check |
|---|---|---|
| 97161 – 97163 | PT evaluation, low to high complexity | Complexity level matches the documentation |
| 97164 | PT re-evaluation | Change in status and necessity are recorded |
| 97110 | Therapeutic exercise | Minutes support the units billed |
| 97140 | Manual therapy | Paired-code edits and modifier use |
| 97530 | Therapeutic activities | Overlap with other timed codes in one visit |
| 97014 / G0283 | Unattended electrical stimulation | The code each payer expects |
| Plan of care | Certification and recertification | Signatures and dates before they lapse |
| Progress report | Required periodic reporting | Reports are on file before claims drop |
Onboarding
Five steps from first call to first deposit
A short, predictable start. You hand over access, we do the setup.
Intro call
We talk through your practice, payers and pain points, and explain exactly how we work.
Hand over the basics
You share provider details, insurance contracts and system access through a secure channel.
We wire it up
Your account, payer rules, clearinghouse and EHR connection are configured and tested.
First claims out
Claims go out, statuses are tracked and denials are worked from the first batch.
Steady rhythm
A named account manager and a monthly report keep your cash flow visible and improving.
Pricing
One flat fee. Every service included.
Your fee depends on your monthly insurance collections. There are no per-claim charges and no add-ons for denials, credentialing or reporting.
$
$0 – $10,000
Starter
$397per month
Start with Starter
$10,001 – $30,000
Growth
$897per month
Start with Growth
Above $30,000
Scale
$1,250per month
Start with Scale
Tiers are set by monthly insurance collections. Final terms are confirmed on your intro call.
Let's talk
Book a call and see what you are leaving on the table
Tell us about your practice and we will show you where claims slow down and what a clean cycle would look like.
346-656-6561CompanyCodentra Medical Coding and Billing LLC
Office5900 Balcones Dr, Ste 100
Austin, TX 78731-4298
Austin, TX 78731-4298
Websitecodentramcb.com