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Value-based care risk adjustment for therapy billing software. HCC scoring, SDOH capture, and structured outcome data built into billing workflows. Financial protection as reimbursement shifts from fee-for-service to value.
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Value-based care is coming to therapy, and the billing infrastructure that supports it looks nothing like fee-for-service. MyTherapyWizard is built so every claim can also carry outcome data, because in five years, the claim that pays will be the one that can prove it worked.
Every session produces a Goal Performance Index (how well the client performed against target, combined with how much support was required). Every session produces a Session Performance Index (aggregate of GPI across goals addressed). Every goal carries a structured baseline, target value, and mastery rule. That means the outcome side of a value-based contract, the structured, longitudinal, measurable change scores, is captured as a byproduct of doing therapy, not as a separate reporting burden.
The measurement framework is Rasch-ready: as the dataset grows, the scoring can be statistically calibrated to interval-level precision, the standard used in the most rigorous rehabilitation outcome measurement research. Denial Analytics, Authorization Analytics, and Business Health views already produce the payer-dimension and therapist-dimension aggregates that value-based contracts require, approval rate, denial rate by payer, approval-to-request visit ratios, outcomes by CPT, outcomes by discipline.
Product screens, workflow diagrams, and example outputs. Replace each slot with a real screenshot or illustration.
The technical architecture, API integration points, and data model that make this feature work the way it does.
GPI = function of (performance against target, support level required). SPI = aggregate of GPI across goals addressed in a session. Calculated at session-save time, stored as structured columns, queryable longitudinally per goal and per client.
Goals carry structured components (skill, measurement type, target value, support level, mastery rule, baseline). Performance data is interval-scaleable. As the cross-client dataset grows, the framework supports statistical calibration to interval-level precision, the standard used in ICF-aligned outcome measurement.
Denial rate per payer_id, per therapist_id, per proc_code. Authorization approval_rate = authorized/requested, per payer, per therapist. Rolling 90-day and all-time trends. Clickable rows drill down to the individual claims.
Income filtered by date range, broken out by payer source, discipline, CPT code. Filterable by district / school / site / therapist. The view most EMRs give you once a quarter, available live.
The structured session capture that drives your session notes also produces the GPI and SPI trajectories a value-based payer wants to see. One workflow, two outputs.
As the dataset grows, the scoring calibrates to interval-level precision, the same math used in the most rigorous outcome research in rehabilitation science. Future-proof by design.
Denial rates by payer, authorization approval rates by payer, visit-reduction patterns by payer. The data you need for contract negotiation, and for VBC risk adjustment, is in the system today.
Book a 30-minute walkthrough with our clinical team. We will show the exact workflow for your discipline and caseload.