Last year, the Florida state legislature passed the 2012 Personal Injury Protection (PIP) Insurance reform, which included an exclusionary clause requiring physical therapy providers to gain licensure and accreditation as a healthcare clinic before they could receive reimbursement for providing PIP-related services. As a result, Florida-based physical therapist Amado Mendoza saw a significant reduction in the number of referrals his clinic, A&M Therapy, received. “Referrals are the lifeblood of outpatient PT clinics,” Mendoza said. “And such a decrease in referrals [negatively] impacts our small businesses.” Additionally, Mendoza pointed out that approximately 20% of his clinic’s gross revenue comes from automobile insurance cases, and “that loss is hard to surmount.” There was also the issue of the cost to license, which, including fees and lost productivity, Mendoza estimated to be about $10,000.
Several small clinics in Florida went out of business. Mendoza, however, put up a fight—on behalf of therapists and patients in his state and across the country. “I believe that no entity should dictate which patient populations licensed practitioners can treat and receive payment for,” Mendoza said. “This type of limitation has no grounding in science or cost containment.” Mendoza had his own evidence-based outcomes to justify his position that physical therapists are completely qualified, as is, to provide care for patients suffering from automobile injuries as well as legal proof. And he felt that it was his obligation to ensure that all patients—regardless of the source of their injury—have access to physical therapy services from small-business physical therapists. After all, if this type of legislation could pass in Florida, it could pass anywhere, and if it could impact automobile injury patients, it could impact any patient group. Furthermore, without being able to demonstrate across-the-board value to insurance carriers and traditional referral sources, physical therapists’ goal of achieving nationwide direct access would be in jeopardy.
With the support of the Florida Physical Therapy Association, the physical therapy community, and many orthopedists, neurosurgeons, and chiropractors, Mendoza won. In an overwhelming victory, the General Counsel of the Florida Office of Insurance Regulation recently announced that “an individual licensed physical therapist may, upon receipt of a referral from one of the providers listed…in statute, treat and bill PIP carriers for services under their individual license.” However, A&M Therapy and other small PT clinics in Florida are still working to overcome the damage their clinics sustained as a result of this legislation passing in the first place. According to Mendoza, many attorneys still don’t know that Florida physical therapists can once again receive reimbursement for treating automobile accident patients, so those attorneys haven’t yet resumed referrals. But Mendoza believes that with better marketing and communication efforts from the physical therapy community as a whole, this will right itself in 2014.
So, how does Mendoza feel about his win? “I hope that the small success I was able to attain for the profession will inspire others to carry on the fight for our [continued] existence as valued members of the caregiving industry.”
Thank you, Amado Mendoza, for standing up for what you believe in and making the healthcare environment a friendlier place for physical therapists in the process.
About Amado Mendoza, PT, and A&M Therapy
Mendoza graduated as a physical therapist from the University of Manitoba, Canada, in 1992. He was greatly influenced and inspired by Canadian practitioners Dr. David Magee, A.J. Fernando, and Dr. Cal Botterill as well as US-based Dr. Stanley Paris. In his early career, Mendoza realized that he could make a significant impact in his patients’ lives by applying both Eastern and Western philosophies of care. He used this approach as well as an emphasis on customer satisfaction and service delivery when he opened his own clinic, A&M Therapy, in November of 2006. More than anything, Mendoza believes in providing the utmost in patient care in an outcomes-oriented and cost-effective manner.
In terms of marketing, Mendoza has three pieces of advice for other small physical therapy practices:
1. Get to know your referral sources well.
He suggests finding out what they like, being personable to everyone in the office, and providing consistent follow up.
2. Provide excellent customer service, positive outcomes, and patient education.
After all, the patients you serve will be the best sources of goodwill for your clinic.
3. Get involved with your community.
Support educational facilities, charities, and fundraising activities and donate time to local school athletic teams. Not only does this serve the community, but it also helps increase awareness of your clinic and the benefits of physical therapy.