Outpatient therapy clinics push clinicians to schedule overlapping patients and bill multiple one-on-one CPT codes per time block, which is mathematically impossible and violates AMA billing rules, but management justifies it by claiming private insurance doesn't follow Medicare rules.

Implied Software Gaps

• Billing compliance software that prevents double-counting of one-on-one time across overlapping patient schedules

TheraComply Billing Auditor

TheraComply Billing Auditor is a compliance tool for outpatient therapy clinics that flags potentially fraudulent overlapping billing. It automatically checks each scheduled time block against billed CPT units to ensure one-on-one codes are not double-counted across patients, and it provides real-time alerts to clinicians and billing staff.

Existing Solutions Mentioned