• 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 …

  • Physical Therapy Billing for Beginners Image

    articleJul 26, 2019 | 7 min. read

    Physical Therapy Billing for Beginners

    Most physical therapists chose this profession to help people—not to become the world’s greatest biller. And yet, in order to stay in business long enough to truly make a difference for your patients, you’ve got to know how to make a profit—and that requires a solid understanding of PT billing. If you’re new to physical therapy, you might be feeling a little overwhelmed by the prospect, so below, we’ve provided some billing basics:  Codes ICD To properly …

  • 8 Workflow Tips to Save Time on Patient Documentation Image

    articleJul 25, 2019 | 13 min. read

    8 Workflow Tips to Save Time on Patient Documentation

    “I can’t wait to spend three hours documenting after work tonight!” said no physical therapist, ever . Yet, many of us take our documentation home each day. It happens so frequently, in fact, that some of us have just accepted it as part of being a PT. If you’re in outpatient care, you’ve got a million recerts, progress notes, pre-authorization forms, and Medicare-specific sheets to handle. If you’re in acute care, there’s the ever-changing battery of required …

  • MIPS 101 Image

    articleJul 24, 2019 | 3 min. read

    MIPS 101

    The Merit-based Incentive Payment System, or MIPS, is one tough cookie. It’s complicated and downright frustrating at times—but it’s something that rehab therapists need to be familiar with. If you’ve been looking for a no-nonsense, easy-to-follow MIPS explainer, then you’ve come to the right place! Just play the video to understand the basics behind this latest government program.  If you’ve finished the video and want a followup (or a recap) of the more complicated info we discussed, …

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