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Elite Rehab Services

Physical Therapist

PT

200 Wellness Way, Denver, CO 80206

(303) 555-7777

Enhanced Provider Data
Professional Services
Service Date
Dec 14, 2025
Claim ID
EOB-2024-001006
Provider NPI
Not Available
Status
Approved

Financial Breakdown

Coverage Details

Covered Service
Part B
No Deductible Required

This service was not covered by your insurance plan. This could be due to the service not being covered under your plan benefits, requiring prior authorization, or being considered not medically necessary.

Cost Breakdown

Provider Charged:$150.00
Medicare Allowed:$0.00
Medicare Paid:$0.00
Other Patient Costs:$150.00
Your Responsibility:$150.00

Coverage Insights

Processing Details:
  • Claim denied due to lack of medical necessity documentation
  • Provider failed to submit required plan of care

💡 These insights are derived from Medicare's adjudication data to help explain your coverage details.

AI Summary

Physical therapy session denied due to missing medical necessity documentation. The provider failed to submit the required plan of care. Appeal recommended.

AI analysis is for informational purposes only and should not replace professional medical or financial advice.

Risk Flags

High Cost
Billing Error Detected
Potential Fraud
Duplicate Service
Missing Info

Insights

Ai Summary
This claim was denied because the provider, Elite Rehab Services, did not submit the required Plan of Care. Medicare covers physical therapy when it is medically necessary and a plan is established by a therapist. Since this documentation is missing, the entire cost has been passed to you. You should not have to pay this if it is a provider error.
Recommendations
  • Call Elite Rehab Services billing department immediately.
  • Ask them to submit the "Plan of Care" certification to Medicare.
  • Do not pay this bill until the provider has attempted to correct the claim.
  • If the provider refuses, file a Medicare appeal.
Related Articles
  • {"title":"Medicare Coverage for Physical Therapy","url":"https://www.medicare.gov/coverage/physical-therapy"}
  • {"title":"How to File a Claim Appeal","url":"https://www.medicare.gov/claims-appeals/how-do-i-file-an-appeal"}

Tags

appeal-opportunitynon-covered
M54.5(ICD_10)AI Enhanced
Primary

Low back pain

Low back pain. Pain in the lower back region.

Specialty
Orthopedics
Category
Musculoskeletal

Present on admission: No

97110(CPT)AI Enhanced

Therapeutic exercises

$0.00
Medicare Paid

Therapeutic exercises

Therapeutic exercises to develop strength and endurance, range of motion and flexibility.

Specialty
Rehabilitation
Category
Physical Therapy
Service: Dec 14, 2025
Provider charged
$150.00
Medicare Allowed
$0.00
Medicare Paid
$0.00
Your responsibility
$150.00

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