Secrets to Billing Success for Therapists

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If you’re relying on therapy staff for billing, you may be losing money

In 2003, Physical Therapy Center of Bristol, Conn. opened, and a second location in Southington, Conn. followed three years later. Now the company is part of Fyzical Therapy and Balance Centers, a nationwide franchise with 140 clinics in 28 states. With a combined staff of 10, the locations are Fyzical’s first in Connecticut and each serves 60-65 patients daily.

After several years of operating with a paper-based documentation and scheduling system, FyzicalCT decided to go digital. Handwritten scheduling was cumbersome to track or change with accuracy. Furthermore, because therapists routinely completed their paper documentation at the end of the day, attempting to remember the length and types of treatments for each appointment often resulted in incomplete and sometimes inaccurate information.

Billing, managed in a similar way, was also a challenge. Therapists would put off their billing tasks until the end of a long day of seeing patients. Once they were submitted, an in-house biller would then handle the rest of the process. After signs of leaking revenue and inefficiencies began to surface, the need to go digital took on a new level of urgency.

The first step in the move away from paper involved scheduling and documentation. FyzicalCT’s digital plans quickly expanded to include an integrated software solution with all the components, including billing, collections and reporting. It did not take long to gain efficiencies and reduce errors. Scheduling, documentation, and billing were also faster and more accurate.

Despite significant improvements, managing billing in-house continued to be a daunting task. Keeping up with denials was time-consuming and frustrating. Then there was the operational overhead – space, computers and dedicated staff. Also, to avoid potential cash flow issues, at least one additional person had to be cross-trained in the event the clinic’s biller was on vacation or out sick. It was time to look outside for billing help.

FyzicalCT’s initial attempt at outsourcing was not as positive as anticipated. Technological requirements to work with the outsourcing company selected were steep. For example, continuous software updates were necessary to keep up with Medicare changes and other regulatory requirements. For FyzicalCT’s systems to be more compatible with the outsourcing company, the practice would have to upgrade its servers at both locations, at a cost of about $20,000. For a small business the expense was too much. A new outsourcing partner was needed.

After researching billing companies and cloud computing technology, FyzicalCT switched partners. The benefits associated with cloud computing allowed the practice to get rid of its servers and move everything to the cloud. This meant no more costly system or technology updates. Since making the move to a new outsourced billing partner and utilizing an integrated cloud solution, FyzicalCT has seen significant revenue cycle improvements and operational efficiencies.

  • Increased collected rate. By taking billing out of therapists’ hands and letting the system track treatments and handle coding, FyzicalCT’s average collection rate has increased by 25%.
  • Increased reimbursement. With expert billing staff overseeing the process, claims are coded correctly; denials are properly handled and reauthorizations streamlined, which leads to increased reimbursement.
  • Reduced operating expenses. The cloud-based billing service has reduced FyzicalCT’s capital costs and operating costs and has allowed the practice to turn space once used for billing into treatment areas.
  • Increased productivity. Documentation takes half the time so therapists can stay focused on what they’re trained to do – healing patients and delivering an excellent patient experience.

If you’re relying on your therapists for proper billing, then you are likely losing money. Outsourcing takes the subjectivity out of billing, which ensures every treatment is tracked so your clinic bills for everything that’s done. If you’re considering outsourcing to regain control over billing and collections, advance research is essential to find the right revenue cycle services billing partner. The following lessons learned are a great place to start.

Know your needs. One key to successfully outsourcing billing services is the ability to accurately assess a clinic’s challenges and needs, and convey them to the service provider. The vendor you select should work as a partner to understand your expectations and immediate requirements.

Experience matters. Because physical therapy billing is very discipline-specific, it’s difficult to find qualified staff. Outsourcing alleviates personnel issues such as finding and training expert billing and collection staff who are highly knowledgeable of the therapy space. Inquire about processes the vendor has in place to stay current on regulatory changes and commercial payer requirements. Ask about staff longevity and turnover.

One size does not fit all. There are significant differences between hospitals, outpatient departments and physical therapy clinics. It’s important to select a billing company that’s extremely well-versed in your particular area. For example, in the PT industry, processes are typically a little different. With each payer, documentation requirements, reimbursement and coding are unique.

Technology matters. Inquire about the technology requirements to work with the outsourcing company. If you have software in place, is it compatible? As we learned, continuous software update requirements can prove very costly.

Consider cloud-based technology. Because the technology is hosted and maintained by a third party, therapists save money by eliminating the need to purchase or replace server hardware and software. Cloud-based solutions also remove IT-related concerns, such as technology upgrades, security and regulatory requirements while reducing server-related expenses.

Pick a partner. Remember, you’re not just choosing a vendor, but a partner. Do your research and get to know the people with whom you’ll be working. In-person briefings whenever possible are a great start.

Ask to speak with current clients. This will give you a feel for the team. Inquire about how easy they are to work with, responsiveness, knowledge and professionalism. Lastly, because change can be scary, inquire about training (and any additional costs). Quality training is essential to ensure a smooth transition.

With the right billing services company in place, therapists can expect a significant increase in billing and improved collection times, resulting in increased revenue.

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About Author

David McMullan, PT

David McMullan is chief therapy officer for SourceMed, Birmingham, Ala.

Craig Zettergren, PT

Craig Zettergren is owner of FyzicalCT, part of Fyzical Therapy and Balance Centers.

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