Heavy workers compensation and auto exposure, both of which are governed by state schedules rather than your commercial contracts. In Wisconsin that plays out against a specific set of rules rather than a general one.
Claims for Wisconsin providers are adjudicated by National Government Services (J6), which is also who hears the first level of appeal — so an appeal argument that works here works in every state that contractor covers.
At a glance
Coding driver
Timed treatment codes, where unit calculation is systematic rather than occasional — an error repeats on every visit.
Medicare contractor
National Government Services (J6)
Medicaid program
BadgerCare Plus
Auto injuries
Tort state — health plan sequencing applies
What changes in Wisconsin
Medicaid in Wisconsin runs as BadgerCare Plus and is delivered largely through commercial managed care plans, so most Medicaid claims are adjudicated by an insurer with its own filing window and its own authorization rules rather than by the state.
Where physical therapy claims fail
- Unit counts that do not match documented treatment time
- Visit caps reached without notice
- Provider did not re-certify the plan of care in time
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your Wisconsin physical therapy denials.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes segmented by payer and provider.
Physical Therapy Billing in Wisconsin — Frequently Asked Questions
Do physical therapy billing rules differ in Wisconsin?
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BadgerCare Plus is delivered through commercial managed care plans, each setting its own filing window and authorization rules.
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