WebPT Blog - billing
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0 CommentsMay 21, 2013| Chuck Felder, PT, DPT, SCS, MBA
Today’s blog post comes from Chuck Felder, PT, DPT, SCS, MBA. For follow-up questions, please email Chuck at CFelder@HCSconsulting.com.1.) What?
In 2012, CMS began a process of reducing payment for therapy services based on multiple procedures performed during the same visit. This is termed the Multiple Procedure Payment Reduction (MPPR). Despite APTA’s and others best efforts to get this removed, CMS began a 20% reduction policy on the second and subsequent procedure each day. This is in effect for all therapy services provided on a single day. So, if the patient received OT on the same day as PT, CMS would pay the highest value procedure at 100% and reduce all subsequent procedures that day by 20% of the practice expense component. Overall, the average visit with around 3.7 units would have its payment reduced about 6%–7%. For the first quarter of 2013, CMS continued the 20% reduction policy. However, they’ve since switched to a 50% reduction.
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Mar 28, 2013| Ann Wendel
Today’s blog post comes from Ann Wendel, PT. Ann is the owner of PranaPT, a member of WebPT, and an active social media participant (@PranaPT). Thanks, Ann!
I am often asked how I document and bill for visits in my cash-based practice. I laugh every time a therapist comments, “You’re so lucky; you don’t have to worry about documentation or billing because you get paid up front!” While this is a funny (and false) belief, it proves that I need to explain how I run my practice in order to assist other therapists who want to adopt some cash-based services.The advantage of being cash-based is that I enter into a contract with the patient to provide physical therapy services in a manner that I have determined will help them reach their goals most efficiently. The thorn on the rose is that my documentation and billing practices must ultimately lead to the patient getting reimbursed from their insurance or they won’t be able to continue treatment with me.
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Mar 26, 2013| Heidi Jannenga PT
Today's blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.
Yesterday, I discussed the importance of not waiving patient fees. So what to do instead? Develop a system or procedure to collect all patient fees (including copays, deductibles, coinsurance, and payment for non-covered services and supplies) at the time of service. Here are steps based off an article from the APTA. 1.) Establish and enforce written policies and procedures for copay and other fee collection. Make sure you cover everything, including how the front desk will determine fees, what the is process for patient acknowledgement, and ways you’ll collect payment. To facilitate this collection, consider these:
- Get a credit or debit card transaction machine.
- Keep sufficient petty cash on hand to make change for those paying cash.
- Depending on your location, talk with a local bank about installing an ATM in the lobby of your building to encourage cash payments.
- Provide a mechanism for bill payment on your website.
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Mar 25, 2013| Heidi Jannenga PT
Today's blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.
Today, copays are the norm, and they’re only becoming more costly. To top it off, many insurance plans—especially those that individuals and small businesses purchase (including HSAs)—have very large deductibles that patients must meet before insurance will pay for anything. While it’s obvious that these increased copays and deductibles put a burden on patients, they also burden physical therapy practices. How? Many practices don’t have the procedures in place for effective fee collection from patients—especially not in person. Instead, many are willing to simply write off cash collections when the patient doesn’t pay. But with declining insurance reimbursements, successful over-the-counter collections are more important than everWhat are the implications of not collecting?
In an APTA Podcast, Nancy White says, “studies show that the chance of collecting from a patient drops almost 20% as soon as the patient leaves the office.” Anecdotally, I think its higher—especially after patient discharge. While some front offices may find it easier to simply mail a statement after the visit, there are usually hidden costs associated with this. In fact, according to Nancy White, there is data that indicates “it may cost between $5–$10 per patient to send and process each statement by mail.” Not to mention that when you mail statements rather than collect upfront, you’re decreasing your chances of receiving payment and there’s a self-made waiting period for any payments patients do send. -
Mar 21, 2013| Charlotte Bohnett
Billing is a crucial aspect of running your practice. However, you may be doing a disservice to your business by keeping your billing in-house. Now, before your say, “hogwash!” and list the perceived benefits, let me tell you that those benefits might actually be misconceptions. Let’s tackle ‘em.Misconception #1: You’ll have more control over your billing.
Proximity does not equal effective control. Just because a biller is inside your clinic doesn’t mean you have the time to supervise them. You’re treating patients, and everyone else in your practice has responsibilities, too. Managing an in-house biller means you’re also managing your entire revenue cycle. That’s a whole lot of extra (and not fun) work—a burdensome amount that you can easily shove onto the back burner—meaning you can shirk that task.A professional off-site billing service actually offers you more control with less time-consuming responsibility. These services offer complete transparency and dedicated specialists (or account managers). Plus, the service should auto-generate at-a-glance reports for you, so keeping an eye on your revenue cycle is actually that—just an eye, not your entire self.
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“What Box Does my G-Code Go Into?”: Responding to Outdated Questions Related to Paper Billing Claims
Mar 20, 2013| Stacey AbelmanToday’s blog comes from WebPT’s Billing Onboarding & Operations Manager Stacey Abelman. Thanks Stacey!
Members often ask: where does my G-code go? Or what box does my NPI go into? Additionally, we—as the WebPT Billing Service—receive such requests as “I need my facility address changed in Box 32” or “I need to use my Tax ID instead of my SSN in box 24j.” But these “boxes” that Members sometimes refer to don't exist anymore in modern billing. In fact, they’ve become my personal four letter word. For a typical practice, 99% of claim submissions are electronic and sent in an ANSI 5010 837 format. If you are still printing paper claims for more than 1% of your payers, let’s be frank, you're outdated. And in this situation, trust me, you don't want to be outdated.
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Mar 19, 2013| Charlotte Bohnett
Today's blog post comes from WebPT Senior Writers Charlotte Bohnett and Erica Cohen.
Billing is one of the most important aspects of running a rehab therapy clinic, aside frompatient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic.The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time. With that in mind, we’re going to devote the next handful of posts to some billing best practices to help you get your life back.
Our first tip covered auditing your existing process; tip two discussed the need to shop around; tip three explained in-house versus outsourced billing; and tip four detailed the importance of integrated billing. Here’s tip five:
#5: Once you select a plan, establish a comprehensive patient registration process.
Regardless of the billing option that best suits your clinic, there are several things you should know before you treat a patient to ensure your claims are processed quickly and accurately.Here are ten questions you should be able to answer about each patient:
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Mar 18, 2013| Charlotte Bohnett
Today's blog post comes from WebPT Senior Writers Charlotte Bohnett and Erica Cohen.
Billing is one of the most important aspects of running a rehab therapy clinic, aside from patient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic.The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time? With that in mind, we’re going to devote the next handful of posts to some billing best practices to help you get your life back.
Our first tip covered auditing your existing process; tip two discussed the need to shop around; and tip three explained in-house versus outsourced billing. Here’s tip four:
#4: Ensure your billing integrates.
If you’re using an electronic medical record (EMR), it’s essential that your billing software and documentation software talk to each other. -
Mar 14, 2013| Charlotte Bohnett
Today's blog post comes from WebPT Senior Writers Charlotte Bohnett and Erica Cohen.
Billing is one of the most important aspects of running a rehab therapy clinic, aside from patient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic.The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time. With that in mind, we’re going to devote the next handful of post to some billing best practices to help you get your life back.
Our first tip covered auditing your existing process, and tip two discussed the need to shop around. Here’s tip three:
#3: Choose your method—in-house or outsource?
The next question to ask yourself is whether you should outsource your billing or keep your billing in house. Let’s first define each method of billing, then outline the benefits and drawbacks of each. -
Mar 13, 2013| Charlotte Bohnett
Today's blog post comes from WebPT Senior Writers Erica Cohen and Charlotte Bohnett.
Billing is one of the most important aspects of running a rehab therapy clinic, aside from patient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic.
The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time. With that in mind, we’re going to devote the next handful of posts to some billing best practices to help you get your life back.
Yesterday, our first tip covered auditing your existing process. Here’s tip two:
#2: Shop Around.
There’s little more complicated than medical billing. Throw in a rehab therapy specialty with therapy caps and timed codes, and there’s plenty of room to make mistakes. And mistakes mean more than lost or delayed reimbursements; they cost time. Time that you or your team could have spent focusing on patient care, family, or anything other than scouring over errored claims to identify and correct the fatal flaw.
That’s why experience is key. When you hand over your income source, it better be to someone who knows their stuff. And that’s always the case, whether it’s an internal employee or an outside company. Whoever has control of your claims must be well-versed in the nuances of physical therapy billing. Having specialized domain knowledge can both increase cash flow and decrease the amount of time it takes to process your claims.
What experiences do you have shopping around? Any tips to share?
