How growing PT/OT/SLP practices handle multi-location billing 

Monday morning, 8:07 AM 

You’re checking last week’s revenue before your first client arrives. 

One location looks on track. Another is noticeably behind — and not for the first time. 

Your biller Slacks you: “I’m reconciling remits — the payer sent them under the wrong entity again.” 

Now you’re not just looking at performance. You’re wondering how much cash is tied up — and how long it will take to fix. 

You opened that second location to grow — not to spend your mornings untangling tax IDs, remittance reports, and spreadsheets that didn’t exist a year ago. This is the part of growth no one warns you about. 

That’s why Fusion by Ensora Health now supports billing across multiple tax IDs as part of its core billing workflow — so growing practices don’t have to rely on workarounds and manual fixes just to get paid correctly. 

Why growing practices often have multiple tax IDs 

It’s not a problem — it’s a sign that you’re growing. Therapy practices operate under more than one tax ID when they: 

• Open new locations structured as separate legal entities 
• Acquire another practice that came with its own payer contracts and TIN 
• Create separate business lines for compliance, partnerships, or ownership structures 
• Maintain payer contracts tied to specific locations 

Each tax ID represents a distinct billing entity. Claims, remittances, and reports all need to flow to the right one. When your system can’t do that on its own, your team fills the gap — usually with spreadsheets, workarounds, and a lot of location-specific memory recollection. 

That works for a while. But as any billing coordinator who’s lived through a second acquisition will tell you: it’s not sustainable. 

What billing workarounds actually cost 

Here’s the thing about workarounds: they don’t show up as a line item. Nobody budgets for “time spent matching ERAs to the right entity in a shared spreadsheet.” But the costs are real — and they add up faster than most practice owners realize. 

That’s per claim. A multi-location practice submitting 2,000 claims a month with a 10% denial rate? That’s 200 reworked claims or at least $5,000 a month in admin costs just to recover revenue your clinicians already earned.  

And across the industry, the picture isn’t getting easier: 

• 41% of healthcare providers now face denial rates of 10% or higher — a number that’s climbed every year since 2022. 

• Up to 65% of denied claims are never resubmitted — no rework, revenue that’s just gone. 

• As many as 15% of claims submitted to private payers are denied or delayed on first submission. Though the majority of those are recoverable with the right systems and follow-up. 

Now imagine some of those denials are happening because a claim went out under the wrong tax ID. Not a coding error. Not a documentation gap. A structural mismatch between how your practice operates and what your billing system supports. 

Those are some of the most preventable denials your team deals with — and probably the most frustrating, because everyone already knows the fix. The system just can’t do it yet. 

What your billing system needs to keep up 

If your practice operates under more than one tax ID, here’s what your EHR should be handling without anyone building a workaround: 

1. Route claims to the correct entity automatically. Each location should be tied to its own tax ID and billing address at the system level — not as a note in a field. When a speech-language pathologist documents a session at your east campus, the claim should go out under that location’s TIN. No toggling between accounts or second-guessing. 
2. Post remittances by entity without a spreadsheet. When an ERA comes in, it should match to the correct tax ID automatically. Your billing team should only be reviewing rare exceptions, not cross-referencing a tracker to route every payment by hand. 
3. Filter reports by tax ID. Revenue, collections & accounts receivable (A/R) by location (without exporting to Excel). 

If your billing team keeps a spreadsheet to track which tax ID belongs to which location, your system wasn’t designed for the practice you’ve already become. And when your systems can’t keep up, it affects more than your billing team. 

How Fusion handles multi-location billing 

Fusion now supports multiple tax IDs as part of how the platform works — not as a bolt-on, not as a custom configuration. It’s built into the billing workflow so your team can focus on the work that actually moves the revenue cycle forward. 

Here’s what that looks like in practice: 

The bottom line: your billing team goes back to doing more high-value work — denial follow-up, payer negotiations, keeping your revenue cycle healthy — instead of maintaining a workaround. 

Growth should feel like growth 

You didn’t build a multi-location practice to spend your mornings debugging remittance mismatches. You did it because more locations mean more clients served — more people getting the physical, occupational, or speech therapy services they need. 

If your system still treats every location like it’s the only one, it might be time to see what Fusion can do for a practice like yours. 

See how Fusion simplifies billing for growing practices with multiple Tax IDs. 

Request a demo → 

Already a Fusion customer? 

Learn how to set up multiple tax IDs in your platform. → 

—

Frequently asked questions

Why do therapy practices use multiple tax IDs?

A tax identification number (TIN) is the federal identifier tied to a business entity for tax reporting and claims submission. Therapy practices typically operate under multiple TINs when they’ve grown into multiple locations structured as separate legal entities, acquired a practice that maintains its own payer contracts, or need to separate business lines for compliance or partnership structures. Each TIN represents a distinct billing entity, so claims, remittances, and financial reports all need to align to the correct one.

What happens when a claim goes out under the wrong tax ID?

A claim denial due to entity mismatch occurs when the tax ID on a submitted claim doesn’t match the payer’s records for the credentialed clinician or contracted rate at that location. The payer rejects the claim — not because the service wasn’t legitimate, but because the billing entity doesn’t match. If timely filing windows close before the correction is made, the revenue is lost permanently.

When should a practice start looking for multi-tax ID support?

A practice should evaluate its billing infrastructure for multi-entity support when the organization operates more than one location under separate TINs, the billing team maintains a spreadsheet to track entity assignments, claims have been denied due to entity or credentialing mismatches, or leadership needs financial reporting by location and the current system can’t produce it without manual data extraction. These are signs that the system was designed for a single-location structure and hasn’t kept pace with the organization’s growth.