Introducing PhyxUp Billing Engine: RTM Claims, Validated Before Submission
PhyxUp Billing Engine brings RTM claims automation to PT clinics, validating every claim before submission to target a denial rate of 4% or lower.
From patient monitoring to reimbursement in one platform, with validation that happens before a claim ever reaches the payer.
The problem
Preparing a single rehab therapy claim means re-checking patient details, insurance information, treatment records, CPT codes, and treatment management time across several systems, then re-entering much of it by hand. Most billing tools are built to work after the visit is over, so errors usually surface only once a claim has already been denied.
Reworking denied claims is repetitive, slow, and a steady drain on the administrative time a clinic can least afford to lose.
What it is
PhyxUp Billing Engine is a new claims automation capability inside PhyxUp Health's existing RTM (Remote Therapeutic Monitoring) platform. It connects the clinical data captured during remote monitoring to the information a claim requires, and runs the whole flow in one place: eligibility verification, claim generation, pre-submission validation, payer submission, and reimbursement tracking.
Sangwon Lim
With this launch, the RTM platform becomes an end-to-end rehab therapy operations platform, covering everything from patient monitoring through claim and reimbursement management.
What makes it different
Clinical data connected directly to billing. The app-usage days, treatment management time, and therapist-patient communication records already in the RTM platform flow straight into the claim, cutting the re-collecting and re-keying that normally happens after a visit.
Caught before submission, not after denial. Instead of focusing on reworking denied claims, the engine finds errors before the claim goes to the payer, so accurate claims go out the first time.
Purpose-built for U.S. rehab therapy and RTM. Unlike general medical billing systems, it is designed around rehab therapy and RTM claim requirements, tying RTM-specific data such as treatment management time, app-usage days, and patient engagement records directly into the claim.
Key capabilities
Eligibility verification. Confirms coverage status, RTM coverage, and potential patient responsibility up front, before a claim is prepared.
Automated claim generation. Determines per-patient billability from RTM data and builds the claim, auto-populating 30+ claim fields across the 6 supported RTM CPT codes.
Pre-submission validation. Checks 40+ items before submission, including insurance and provider information, CPT codes, modifiers, ICD-10, date of service (DOS), and RTM claim requirements. It resolves what it can automatically and flags only what needs a biller's review.
Exception-based workflow. Ready claims move forward automatically; only claims that need a closer look are routed for review.
Claim status tracking. Follow every stage, from received through paid, on one screen in real time.
What we're aiming for
| Metric | Target |
|---|---|
| Claim generation, validation & submission readiness | Within 1 day |
| Claim denial rate | 4% or below |
| Claim prep time per patient | 70%+ shorter (~10 min → ~3 min) |
| Claims processed automatically | ~85% |
| Claims needing manual review | Up to 80% fewer |
All figures above are targets, not results to date.
From our CTO
"Billing isn't about creating a claim. It's about preparing the data a claim needs."
— Taeha Hong, CTO, PhyxUp Health
See it on your own claims
See what PhyxUp Billing Engine changes in your clinic's claim workflow. Book a demo, or if you'd rather talk it through first, we'd love to.
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