As a physical therapist, what do you first think when you hear “personal injury?” Is it:
- “I want to help my patients regain function and heal from their trauma.”
- “Ugh! Paperwork, headaches, and delayed payments—I’d rather not.
- “I wouldn’t touch that with a ten-foot pole.”
No matter which sentiment you most identify with, most PTs can agree that personal injury (PI) and physical therapy have historically been a mixed bag. Some reasonable points for pause include:
- Unfamiliarity with the PI payer system;
- Not enough time to dedicate toward learning the PI payer system; and
- Reservations about getting involved in a long, drawn-out personal injury claims process and having little to know insight into when you might get paid for your services.
And while these are understandable hangups, the reality is that learning this payer system—and more specifically, understanding the value you can provide to these patients as a musculoskeletal professional—has quite a few upsides.
So, to help us explore this payer system further, we interviewed Rick Lybbert, PT, OCS, CEO and President of Mountain Land Physical Therapy and Rehabilitation, a comprehensive rehabilitation services company that offers physical therapy for personal injury (among a slew of other specialties).
Getting Familiar with the Unfamiliar
Like many PTs and practices, the Mountain Land team faced their fair share of uncertainties when it came to personal injury cases. But, about eight years ago, that all changed.
“We opened our minds,” says Lybbert. “Although we were unfamiliar with the ins and outs of the PI payer system, we thought: ‘Isn’t it our responsibility to get familiar with this system—just as we did with Medicare and private payers?’”
To Lybbert’s point, the majority of the medical world is familiar with the Medicare system—even though it’s cumbersome, ever-changing, and difficult to understand at times. But, providers accept its idiosyncrasies because that’s the way it’s always been. In other words, it’s what’s familiar. However, ignoring the PI payer system not only inhibits PTs reaching patients that could really use their help, it also leaves room for misinformation to run rampant.
“There are a lot of inaccurate stories within this space—like patients trying to cheat the system— that are jeopardizing the health of those who suffered from a personal injury,” Lybbert explained. “It’s not beyond comprehension that these folks may be seriously injured, and can really benefit from musculoskeletal care. Therefore, it was important for us to figure out how we could effectively care for these individuals.”
Rather than skirting the obstacles presented by the PI system, Lybbert and his team made the decision to set aside the “unknown” in pursuit of the ultimate goal: “To care for these folks who desperately need our services.”
Aligning Goals with Patient Needs
To help navigate the legalities involved with the PI payer space—while honoring what best serves the patient—Lybbert and his team set up meetings with many local personal injury attorneys as possible. They approached these interactions with transparency, and stuck to the important questions like:
- What creates value to you?
- What constitutes a win in your mind?
- What is your understanding of the big picture when it comes to PI?
In addition to asking these questions, Mountain Land also shared their goals with the attorneys they spoke with, emphasizing that, “We’re here to take care of these patients and give them the proper care they need—no more, no less,” Lybbert added.
As a result, Lybbert and his team were able to establish solid and trusting relationships with a number of local attorneys—which in turn spurred a newfound appreciation for the legal profession as a whole.
“These attorneys are really in it to help their clients. They see themselves as advocates for the little guy,” Lybbert says. “Their job is to meet their clients’ budget and see that they get compensated. It’s all part of the payer system.”
Strengthening PT’s Value Prop in New Ways
An unexpected plus side to these relationships is establishing new and viable referral sources among the attorneys they’ve grown close with. Mountain Land receives a considerable amount of referrals from the attorneys in their network. This is a testament to the team’s ability to prove physical therapy’s value overall—and get folks from outside the healthcare paradigm on board realize their worth.
Additionally, having gained such in-depth knowledge of the PI payer system, Lybbert and his team are being sought out by other healthcare professionals who are also trying to make headway in the PI space.
“Having us work with these attorneys brings greater value to the overall case and has helped substantiate our team as an authority in this field,” Lybbert said. “As such, we’ve started to create networks with other medical providers who now also understand PI better than years past. And now we’re able to make the appropriate referrals to doctors and surgeons—making patient care all that better, overall.”
Expanding Clinical Reach for the Win
If you make good with lawyers, insurance carriers, and other medical providers, will your PI niche be next to perfect? Hopefully. But if you’re more of a realist, it’s important to realize that it will take time and effort—and to expect bumps to occur along the way.
“It can be difficult; some patients are angry, feel victimized, and have a lot of other troubles stemming from an accident,” Lybbert says. “This may require an even greater skill set for therapists to deal with—both the mental and physical aspects of these cases.”
Despite the challenges PI can pose to PTs initially, the payoff of completing the necessary steps accomplishes a number of rewards—the topmost of which is improved patient care for those who need it most.
“It’s been refreshing to work at the top of our license—to do exactly what the patients need,” Lybbert says. “And, we’re seeing more and more of this in the areas in which we operate. More medical providers are recognizing the importance of taking care of this population—and the mutual value in doing so—all connecting to PT’s 90% issue.”
Fundamentally, PI can open doors for your practice and expand clinical reach—just like it has for Mountain Land.
The moral of the story is this: Don’t let the unfamiliarity of the PI payer system stand in your way of broadening your services to help patients who could benefit from your care the most. Before you put a plan in motion, though, be sure you’ve done your due diligence. Get familiar with the lien laws that exist in each state and the PI payer system. Additionally, we strongly recommend that you seek out expert opinions of PI attorneys in your area (which can be a natural way to begin building relationships with them).
In the meantime, if you have any questions about personal injury in physical therapy, slot them in below. Or, reach out to us directly.
