By Brandon Seigel, Chief Problem Solver · August 4, 2026 · 6 min read
Fix the front end first
Eligibility and authorization errors are the leading cause of therapy denials. Verify coverage before the first visit, and re-verify on a schedule — especially for Medicaid patients whose plans change often.
Documentation that supports the claim
Payers pay what the note supports. Timed minutes, medical necessity, goals, and progress all need to be clear. Regular coding audits catch habits before they become patterns.
Submit daily, work denials daily
Batching claims weekly delays cash and delays finding problems. Daily submission and daily denial follow-up keep issues small and inside appeal windows.
Track denials by reason
Group denials by cause so you can fix the root problem:
- Front-end: eligibility, authorization, demographics
- Coding: units, modifiers, diagnosis pairing
- Documentation: medical necessity, missing signatures
- Timing: timely filing, late certifications
Quick answers
What is the most common reason therapy claims are denied?
Eligibility and authorization issues are the most common, followed by coding and unit errors and documentation gaps.
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