Prior authorization for physiotherapy practices
Reviewers of therapy requests look for objective measures, progress so far and measurable goals. Genkō Prior Auth collects those in a plan-of-care form and drafts a payer-aware packet from them. Your team reviews, edits, locks and submits it.
Updated · Markdown version
What it collects
| Group | Fields |
|---|---|
| Diagnosis and progress | Treating diagnosis, onset date, functional measures (range of motion, strength, outcome scores with dates) and visits to date. |
| Plan | Plan of care (frequency, duration, interventions), measurable time-bound goals, and prior treatment. |
Procedure areas
Procedure codes (CPT and HCPCS) are searched from a curated list covering evaluations, supervised modalities, constant-attendance modalities and procedures, wound care, dry needling, strapping and testing, and equipment. Diagnoses use an ICD-10-CM search, and you can type a code that is not listed.
The packet
- A clinical justification that ties the objective measures and progress to the requested visits or services.
- A supporting-documentation summary, and a request letter to the reviewer.
- A list of what the payer may expect that you have not provided, such as a recent outcome score.
Where things stand
Early access, by invitation, on synthetic data only. No real patient information should be entered, and no HIPAA compliance claim is made. Request early access, or see Getting started.