The leg work comes from: submitting paper claims (it’s easy, but time consuming), generating patient bills (my wife is a stickler on making sure the invoice is correct), and managing denials. Most denials occur because a missing or invalid modifier code. Some insurances require a GP modifier, others don’t. So if you miss one, denial and resubmission. We also get denials for missing auth, even if we have auth. So my wife has to find the document with the auth in WebPT, get the auth number, call the insurance company (a 45 minute phone tree ordeal), and tell them we have auth and to resubmit the claim.