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Physical Therapy Billing Check Up – 3 things to do now

Physical Therapy Billing, simple things make a big difference

Physical therapy billing continues to be a mystery for many practices. There are lots of intracicies to billing – units, 8-minute rule, compliance requirements, not over-billing, not under-billing, modifiers, and more. With that being said, there are some very simple things that you can check for as low-hanging fruit.

Think of it as a quick billing tune-up. The three items in this blog post are some things that are pretty easy to take a look at but could have a big impact on your practice and help keep you out of trouble!

1. Do a review of your physical therapist staff's credentialing status with all insurances that you accept

Estimated time investment: 10 minute to 60 minutes depending on how many physical therapists you have

Credentialing is a real challenge for many practices. Some insurances are very slow to credential new staff or make it overly onerous to do so. Even though it’s a pain, it’s a very basic aspect to physical therapy billing. You should take some time and look into the insurances you accept and check to make sure that all of your staff physical therapists are properly credentialed as an in-network provider. If you find that a therapist isn’t with one or more insurances then you should immediately begin that process. It’s best to prioritize your insurances based on the volume of patients that you see from that insurance (meaning do your busiest insurances first).

2. Do a targeted billing records review of the last 5 visits for 5 random patients

Estimated time investment: 30 minutes
Pick 5 random patients. Then, look at the last 5 visits for each of those patients. You’re looking for some key things:
  • Are the charge codes appropriate relative to the documentation? Was everything document? Was anything documented but not billed?
  • Are all five visits exactly the same? Did the physical therapist use the same billing codes and units for all the visits? If so, was it appropriate to do so?
  • Were modifiers used appropriately?
If any of your patients or notes fail one of these checks then it’s time to take action to prevent these kinds of issues. This may be remedial training with the physical therapist or the biller, or both. It may also prompt you to do more frequent reviews if you identify an issue with a specific physical therapist. Last but not least, you should also leverage your physical therapy billing software and any tools it has to help you keep you on track.

3. Do some housecleaning, particularly on your accounts receivable

Estimated time investment: 15 minutes

Go through your physical therapy software and weed out any old and unused patients, unneeded insurance companies, referrers, etc. Keeping your house clean and in order will make for better reporting and tracking as well as reducing and eliminating errors.

Another major area that you should look at is your A/R reports. Any good physical therapy billing software will provide you with an easy to read A/R report that shows how much is outstanding and how long it has been outstanding. As painful as it may be, it’s key that you write-off old balances (whether patient or insurance) that you no longer expect to collect. You should have a regular and defined policy as to how long you’ll let things stay on your A/R before writing them off or sending them to collections, etc. Keeping really old balances on your A/R may promote a feeling that there is hope of collection but the reality is that it just clutters up your report and takes away attention from balances you can actually collect.

The bottom line

Don’t let physical therapy billing get you down. Take a few minutes and do these simple steps to give you some peace of mind and they’re really not that hard to do.

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