• The Roaring 2020s: Why We’re Entering Rehab Therapy’s Greatest Era Image

    articleAug 27, 2019 | 5 min. read

    The Roaring 2020s: Why We’re Entering Rehab Therapy’s Greatest Era

    High out-of-pocket costs. Inefficient care paths. Market Consolidation. Unfair payer and government policy. I could probably draw out this list for several paragraphs, but you get the idea—there’s a lot that we, as rehab therapists, are up against. And most of it is seemingly out of our control. If you pay attention to politics—and with the next election cycle already taking over national news headlines, it’s kind of hard not to—then you know that debate over healthcare …

  • From Claim to Cash: How the Billing Process Works in PT Private Practice Image

    articleAug 23, 2019 | 5 min. read

    From Claim to Cash: How the Billing Process Works in PT Private Practice

    I’m a big fan of those “how it’s made” videos. It’s way too easy for me to get sucked into a YouTube black hole and spend hours learning about the art of building a guitar from scratch or how my dream car is pieced together . As I fell down the YouTube rabbit hole again the other night, it got me thinking: how are physical therapy reimbursements dispersed? What happens after a claim leaves the billing software? …

  • 4 Common Reasons for PT Claim Denials (and What to Do About Them) Image

    articleAug 21, 2019 | 8 min. read

    4 Common Reasons for PT Claim Denials (and What to Do About Them)

    No one wants to deal with denials, but unfortunately, they happen. In some cases—for some PT practices—they happen a lot. And they can be a major drain on clinic resources and cash flow. The best method for dealing with denials—including medical necessity denials—is to prevent them from happening in the first place. With that in mind, here are four common reasons for PT claim denials—and what you can do to avoid them (or, at the very least, …

  • Building from the Ground Up: Billing Checklist for New PTs Image

    articleAug 20, 2019 | 7 min. read

    Building from the Ground Up: Billing Checklist for New PTs

    You might say that when you’re building a table, the most important tool to have on hand would be a saw. Another person might say it’d be a sander—and another might argue that you can’t do anything without a tape measure. I’d personally say that, while you definitely need all those tools, the most important tool to have on hand is a calm, clear-headed frame of mind. (Seriously, don’t use dangerous equipment if you’re not 100% present …

  • 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 …

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