How Rehab Therapy Clinics Can Strengthen Their Revenue Foundations

For rehab therapy clinics struggling with their billing or revenue cycle issues, there isn’t always one big, glaring problem staring you right in the face. Often, billing and RCM operations that can’t get clean claims out the door on time or can’t get paid on time and in full are dealing with a few smaller but no less pernicious problems that eventually add up to a serious issue for the practice.  

Many practices are dealing with tighter financial margins in this payer climate; they can’t afford to miss out on the revenue they earned, especially if it’s within their control.   More dependable revenue starts with a better billing operation—and that starts with an eye for details and a drive for consistency across every area of your practice. 

Start at the front desk.

Billing may happen in the back office, but the relative success (or lack thereof) of your billing operations depends heavily upon what happens in your front office. As we explain in this blog, 67% of billing mistakes start at the front desk—meaning that early errors with things like eligibility verification, benefits review, and authorizations make an impact throughout the entire revenue cycle. All those denials that result from incomplete or incorrect information coming from your intake process? That’s rework that could have been avoided with stronger front office processes. And a growing list of past-due copays can be the result of inconsistent collections at checkout.  

Creating a stronger, more efficient front desk begins with:

• Verifying eligibility and benefits consistently before visits
• Identifying authorization requirements early
• Setting clear financial expectations with patients

When you’re not starting off with admin errors—or at least minimizing them as much as possible—you’re setting up the rest of your team for success 

Emphasize better documentation.

Documentation is another of the cornerstones of better billing—specifically, strong documentation that clearly supports the treatment provided. Defensible documentation is one of our oldest tenets here at WebPT, and with good reason: you’re only going to get paid for your exceptional care if you can effectively communicate what you did with a patient, and why.  

Fortunately, AI has come around to help make it that much easier for providers to better document and code for the treatment they provide. For example, WebPT’s AI documentation tool takes a conversation between a provider and a patient and turns it into a compliant note, while also highlighting coding that aligns with the activity described and potential issues within the note. 

Of course, any note still requires a clinician’s expert eye and trained judgment, but saving the time they would have spent typing frees them up to spend that extra time reviewing their notes to make sure everything’s correct. 

Make clean claims the standard.

Your clean claims submission rate is a pretty good barometer of the overall health of your revenue cycle. If you’re not submitting clean claims, it’s a clear sign that you’re making missteps earlier in the operation. 

It’s not enough to give lip service to filing clean claims; making them a reality requires emphasizing details with the staff—not just collecting them up front, but double-checking for things like misspelled names, incorrect demographic information, missing coding or modifiers, or incorrect insurance information. It’s also worth double-checking a patient’s benefit eligibility when possible, or at least making sure that your staff is on top of benefit expiration cycles.  

When clean claims become the norm, first-pass acceptance improves, days in A/R stabilize, and teams spend less time chasing preventable issues.

Build visibility into your billing.

One common issue in revenue operations—particularly in smaller practices—is that leaders lack a big-picture, holistic view of their practice’s performance. It makes sense; it’s hard just to stay on top of everything needed to get claims out the door and payments posted, let alone trying to track and measure every step of the process. And even then, many leaders don’t have a firm grasp on which numbers track and what weight to give them, making meaningful measurement difficult.   

Tempting as it may be to avoid numbers, if you want to build a successful billing operation, you have to measure performance to understand strengths and weaknesses. You don’t necessarily have to track every single billing metric out there, but it’s essential that you have a grasp on some of the key ones, like:

• Daily Sales Outstanding, or DSO; 
• Percentage of Receivables Over 120 Days; 
• Net Collection Rate; 
• Denial Rate; and

• Underpayments and write-offs.

Having a dashboard of essential and easily digestible metrics gives you what you need to feel confident about your revenue.

Find technology that supports your team. 

Anxiety around AI as a replacement for human workers is very real, so it would be understandable for rehab therapy staff to express concern about greater adoption in the practice. What should hopefully put minds at ease is that for all the advances we’ve seen in AI over the past few years, it’s not capable of replacing what people can do — especially in a connecting-driven field like rehab therapy.

With that preamble out of the way, why not use technology for what it is actually good at, which is supporting staff in their day-to-day work? Adopting AI into your front office and billing workflows gives you a tool that can handle the monotonous tasks of checking benefit eligibility and authorizations, or reviewing documentation and coding to avoid denials. 

With technology working in the background on the time-consuming tasks, your team is able to use their critical reasoning to solve problems and their people skills to help patients. 

Strong revenue is about growth. 

Most rehab therapy practice owners aren’t business people by trade; they’re clinicians who wanted to do good in their community and forge their own path, and started their own business to try and achieve those ends. They almost certainly didn’t do it for the money, because there’s not exactly a fortune to be found in this economic environment, as anyone reading this knows too well. Because of that, some owners might not be thinking about revenue in the same way they consider care.

Building a strong revenue base for your practice is about supporting your goals. Helping patients heal, taking care of the clinicians and staff on your team—none of that is possible without the resources to keep your doors open, or even to grow, if that’s your aim. Looking after your practice revenue is the best way to position your clinic to make an impact for years to come.