• Growing Pains: How to Manage Transitions and Chaos as Your Practice Expands Image

    articleAug 16, 2019 | 7 min. read

    Growing Pains: How to Manage Transitions and Chaos as Your Practice Expands

    This post comes from Ascend 2019 speaker Amy Lafko, the owner of Cairn Consulting Solutions. Want to see Amy speak about rehab therapy business and leadership strategy during a live interactive session? Register for Ascend here . Curious about the rest of the speaker lineup? Check it out here . A few years ago, I was working as a director of rehab. My team of 35 had been in a really good groove. That’s when the merger …

  • 10 Signs You Need a New Physical Therapy Billing System Image

    articleAug 14, 2019 | 6 min. read

    10 Signs You Need a New Physical Therapy Billing System

    Are you happy with your billing system? Would you recommend it to a friend? Those might be tough questions to answer truthfully, especially if you’re the one who chose your practice's billing software or service. Still, if your billing—or revenue cycle management (RCM)—system isn’t living up to expectations, then your practice may be due for a change. I know—change can be tedious, overwhelming, and disruptive. So, how do you know it’s truly worth ditching your current system …

  • The 2020 Proposed Rule: Bite-Sized Edition Image

    articleAug 13, 2019 | 6 min. read

    The 2020 Proposed Rule: Bite-Sized Edition

    Too much of anything is bad for you—even if it’s something you like. Too much sun will give you some gnarly burns. Too much exercise can damage your muscles or cause stress fractures. Even too much Chipotle can make you sick (much to my eternal disappointment). All humans need to avoid consuming too much of one thing—and reading through CMS’s annual policy changes is, inarguably, way too much . So, we’re gonna keep this explanation of the …

  • Stamp of Approval: How to Obtain Prior Authorization for PT Services Image

    articleAug 12, 2019 | 8 min. read

    Stamp of Approval: How to Obtain Prior Authorization for PT Services

    If you contract with third-party payers , then you’re most likely already familiar with the term [cue ominous thunder sounds] “prior authorization (a.k.a. preauthorization)”. And if you’re not yet, just wait. This Verywell article —written for patients—explains that when an insurance company requires prior authorization, healthcare providers must obtain approval from said insurance company before providing patient services, treatment, or equipment. Otherwise, the insurance company won’t pay for it—and either the provider or the patient will be …

  • 3 Times When You Absolutely Must Issue a Patient Refund Image

    articleAug 8, 2019 | 4 min. read

    3 Times When You Absolutely Must Issue a Patient Refund

    When we talk about the billing side of rehab therapy , we’re usually referring to getting money—not giving it back. However, failure to refund patients when necessary can result in some dire financial consequences—including heavy fines and other penalties. The government is pretty clear about its stance on this: according to guidance from the Office of the Inspector General (OIG), “Billing companies should institute procedures to provide for timely and accurate reporting to both the provider and …

  • Founder Letter: The Cost-Shifting Conundrum: How to Combat High Patient Copays Image

    articleAug 6, 2019 | 9 min. read

    Founder Letter: The Cost-Shifting Conundrum: How to Combat High Patient Copays

    In our 2019 State of Rehab Therapy survey , 80% of respondents cited payer requirements as the top reason their organizations require physician referrals as a condition of treatment (even in states with unrestricted direct access ). Additionally, high copays and coinsurances were by far the top-ranked regulatory issue in terms of impact to the physical therapy industry and profession. In other words, as it stands, the insurance industry (and its propensity to shift costs onto patients …

  • 5 Reasons to Outsource Your PT Clinic's RCM Image

    articleAug 5, 2019 | 5 min. read

    5 Reasons to Outsource Your PT Clinic's RCM

    If you’re at a place where your clinic’s billing is the bane of your (or your staff’s) existence, it may be time to get some help. Not every practice needs to outsource its billing—let’s make that perfectly clear. If you have an expert biller (or a few) on staff—and you’re not experiencing any major billing frustrations—then outsourcing is probably not the right move for your clinic. But, for the clinics that are overloaded, overwhelmed, or completely burnt …

  • Credentialing vs. Contracting: Everything Rehab Therapists Need to Know Image

    articleAug 2, 2019 | 6 min. read

    Credentialing vs. Contracting: Everything Rehab Therapists Need to Know

    There’s a lot of confusion about the difference between credentialing and contracting —as well as what PTs, OTs, and SLPs must do to complete each process. In fact, questions about the insurance credentialing process are some of the most common inquiries we get from new clinics. So, I decided to do a little digging. And with some help from clinical-biller-turned-WebPTer Asia Giuffrida, our Therabill Onboarding Team Lead, I’ve compiled everything rehab therapists need to know about credentialing …

  • The Difference Between Medicare and Medicaid Billing and Reimbursement Image

    articleJul 31, 2019 | 8 min. read

    The Difference Between Medicare and Medicaid Billing and Reimbursement

    At first glance, Medicare and Medicaid might seem like twins, or a dynamic duo, or two peas in a pod—basically, inseparable. They’re both government healthcare programs; they were both created at the same time ; they’re both confusing and usually don’t boast the best reimbursement rates ; and they even sound alike (they both start with “Medi-,” right?). In reality, though, these two programs are very, very different. For starters, Medicare is a federally run program, which …

  • The Rehab Therapist's Guide to Using CMS-1500 Claim Forms Image

    articleJul 29, 2019 | 17 min. read

    The Rehab Therapist's Guide to Using CMS-1500 Claim Forms

    Healthcare billing can get even the best billers tangled up in knots—and it’s no wonder why. Between tracking and adhering to shifting payer guidelines, managing patient claims, verifying insurance , and defending against denials , billers are pulled and twisted in a million different directions. That’s why it’s so important to have a strong billing foundation; a concrete understanding of your billing basics will help you pivot and twirl and handle the whirlwind of the billing office …

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