It’s the bottom of the ninth; the bases are loaded, and you’re up to bat. This one’s for the win. If you knock it out of the park, you may just get called up to the majors. And no matter how good you are, that’s a big leap. The same is true in rehab therapy private practice. Small practices already have a lot of balls in the air: marketing, keeping employees happy, and providing patients with an exceptional experience, just to name a few. As a practice grows, it becomes more and more challenging to meet those goals. But perhaps the toughest challenge facing growth-focused rehab therapy businesses is keeping their billing processes organized and efficient. If your RCM isn’t designed to scale, you can expect a lot of strikeouts in the form of claim denials, poor collection rates, and ultimately, lost revenue. That’s why it’s crucial to use the best physical therapy billing services, software, and workflows to ensure your clinic remains financially healthy as it grows onwards and upwards. As you set out to make your clinic a bigger, better version of itself, here are four strategies to help you scale your RCM:

WebPT + Billing Software - Regular BannerWebPT + Billing Software - Small Banner

1. Standardize your processes.

First things first: Consistency is crucial—especially for a large-scale practice. When everything is set to the same standard—from how you purchase supplies and equipment to which staffing agencies you hire from—it simplifies processes, mitigates financial waste, and even increases patient safety. The more staff you hire and patients you see, the more reason you have to standardize processes across your entire organization. (And if you have these standards in place before you make it to the big leagues, it’ll be a lot easier to get buy-in from your staff.) In terms of RCM, your processes for submitting claims, accepting payments, and sending bills should be written out in your practice policy manual and enforced across all locations.

This means your whole team needs to be familiar with any process changes you decide to roll out—which means you may need to conduct staff trainings as well as send out detailed communications whenever there are process updates or changes. This will save you a lot of headaches (and confusion) as you expand.

Simplify RCM by taking a holistic approach.

Additionally, standardizing your RCM tools by using a single RCM service vendor can help optimize your cash flow—and even increase your revenue yield. In this article from Becker’s Hospital Review, Steve Huddleston, president and chief client officer at nThrive, says, "Consider bringing on a single vendor that takes a holistic approach to the revenue cycle—incorporating solutions that span the entire process from patient access to payment resolution. This way, you'll eliminate the administrative burden associated with dealing with multiple vendors and will be assured that every component is optimized and plays well with the next, while minimizing silos." Even more optimal: Select a vendor whose RCM services are tailored to rehab therapy organizations.

2. Automate whenever possible.

As your business grows, your RCM process must grow with it, and automating any process means it’ll grow in tandem with your practice. At minimum, your billing platform should integrate with your EMR, so information and claims flow automatically and seamlessly. Ideally, your EMR will automatically alert you to important, billing-related information for each patient as he or she arrives for an appointment.

For example, if a patient has a regular copay due at each appointment, your integrated EMR and billing platform should notify you at the time of service. Not having this functionality can lead to billing hiccups for you and surprise bills for your patients—which can ultimately hurt your bottom line and your patients’ perception of your practice. You can also automate things like appointment reminders to ensure patients make it to their next visit, which, in turn, helps those patients stay on track with their goals—and keeps your revenue steady.

3. Track RCM trends.

As I mentioned in this WebPT Blog post, one of the biggest RCM mistakes practices can make is failing to identify trends in their RCM processes. Even if such trends seem negligible at first, as your practice grows, those patterns will have more impact. For example, if you start tracking your most common denial errors, you can find solutions to address the causes of those errors before they start seriously affecting your bottom line.

Additionally, keeping a close eye on your RCM metrics will tell you a lot about whether or not you’re even ready to expand. And to know that, you need to set up a cash flow budget. Here’s how, according to this article from Fundera:

  • “Collect the historical information on last year’s sales. Plug those numbers into the Sales section.
  • Collect the historical information on last year’s expenses. Plug those numbers into the Expenses section.
  • Make any adjustments to the budget numbers based on current plans for the coming year.
  • Pay close attention to the Cash Flow Surplus / Deficit line. Watch for red flags that indicate you’re headed for a cash flow problem.”

Once you have your budget outlined, refer back to it on a regular basis. If you’re exceeding those numbers, that’s a pretty clear indication that it’s safe to expand operations.

4. Choose a software or service.

Software

RCM software is great for practices that handle their billing in-house—especially if it integrates with their EMR. With this option, owners have more direct oversight of the billing process. And as Justin Barnes, Partner and Chief Growth Officer with iHealth Innovations, mentions in this article from Becker’s Hospital Review, “Every CEO, CFO should know where they are financially and run their practice as a business.” That’s a whole lot easier to do when you handle all of your RCM processes in-house. Furthermore, the right billing platform will provide you with analytic reporting that helps you monitor those RCM trends I mentioned in the previous section. Just be sure your software’s pricing structure is supportive of clinic growth; some billing software providers charge based on the number of claims submitted, which essentially punishes growing practices.

As this WebPT Blog post explains, before committing to any billing software, be sure to ask the following questions:

  • Is it specific to physical therapy?
  • Does it integrate with your EMR?
  • What kind of reporting capabilities does it have?
  • Can it verify insurance eligibility?
  • Is it up to date with industry changes?
  • Will it grow with your practice?
  • How often do updates happen?
  • Does it offer free training?
  • Does tech support cost extra?

Compared to an RCM service, a billing software can be a much more cost-effective option for practices of any size, as long as the person using it—whether that’s a dedicated biller or a practice owner or manager—is well-informed on the ins and outs of rehab therapy billing.

Service

Conversely, many practices opt to outsource their billing to a third party. This can be pricey—as we explain here, most billing services “charge a percentage of collections (typically 6-12%), which means the more money you bring in, the more you pay out”—but if you don’t have access to an experienced, knowledgeable biller, the benefits may outweigh the costs. When we conducted our most recent State of Rehab Therapy industry survey, we found that smaller practices were far more likely to outsource their billing than larger practices. Of the respondents who said they outsourced their billing, more than 80% were from clinics with fewer than 20 providers. That’s probably because outsourcing not only takes some pressure off owners of practices with one or two other therapists (or practices where the owner is the only therapist), but also offers some peace of mind by providing a team of billing and coding experts who handle all things RCM (including payment collections) so therapists can focus on treating patients.

That said, having less direct oversight of your RCM process can mean you’re less aware of what’s happening on the billing end. Good communication with your billing team can keep you informed, but you’ll ultimately be beholden to their work schedule. On top of that, if a third party handles your billing, you’re probably one of many accounts being serviced by your billing specialist. On the other hand, keeping your billing in-house means having your biller’s undivided attention. (If you’re still wondering whether outsourced billing is the best option for your practice, take this quiz.)


When a clinic grows from one or two providers to a multi-location practice, it enters a whole new ballgame. So, if you’re ready to make that leap, be sure your RCM process is ready to step up to the plate. Got questions about RCM for large-scale practices? Let us know in the comment section below!

  • Founder Letter: 3 Ways Your Practice is Losing Money Image

    articleMay 5, 2016 | 7 min. read

    Founder Letter: 3 Ways Your Practice is Losing Money

    Much like the patients you treat, your practice can appear healthy on the outside despite significant internal issues. And when those issues are money-related, the consequences can be deadly. If your practice already is in the red, you know you’ve got some pretty serious cash flow problems. But even if you’re in the black every month, you may still be washing dollars down the drain. While there are myriad ways your practice might inadvertently be losing revenue, …

  • 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 …

  • The Case for Care Cost Transparency in Your Practice Image

    articleApr 26, 2017 | 6 min. read

    The Case for Care Cost Transparency in Your Practice

    Back in the day, the notion of healthcare providers discussing the cost of treatment with insured patients was relatively unheard of. After all—aside from a nominal patient copay—insurance usually footed the bill. That’s not the case today. As Fair Health President Robin Gelburd writes in this Physicians Practice article , the insurance industry has evolved to place greater financial responsibility on patients—hello, high-deductible health plans (HDHPs). As a result, patients want to know the cost of the …

  • 5 Essential Billing Benchmarks for Your PT Practice Image

    articleJul 1, 2019 | 7 min. read

    5 Essential Billing Benchmarks for Your PT Practice

    You set goals—and track outcomes data —for your patients, right? And you tweak plans of care as you go to ensure patients are moving in the right direction, optimizing your approach to bring them closer to the results they want. Otherwise, you’d be treating blind, hoping that your patients were progressing, but not really knowing for sure. The same holds true for your practice’s billing health. If you're not benchmarking , setting goals, and monitoring your practice’s …

  • Collection Objection: Overcoming Patient Excuses for Why They Can’t Pay Image

    articleApr 19, 2017 | 5 min. read

    Collection Objection: Overcoming Patient Excuses for Why They Can’t Pay

    If collecting patient payment at the point of service was important before, then it’s mission-critical now—especially as reimbursements continue to shrink. That’s because—as we’ve mentioned here , here , and here —only 21% of patient balances that aren’t collected at the point of service are ever recovered. That’s a lot of cash you’re leaving on the table if your patient collection strategy is not on point. So, in addition to implementing a solid payment policy, successful providers …

  • 8 Reasons You Should Attend Ascend 2019 Image

    articleJun 26, 2019 | 4 min. read

    8 Reasons You Should Attend Ascend 2019

    Great news! Ascend— the ultimate business summit for rehab therapists —is back. Last year, the fifth-annual event hit our hometown of Phoenix, Arizona, for two incredibly educational (and incredibly fun) days. This year—September 19–21, to be exact—Ascend is heading to the Land of 10,000 Lakes (that’s Minnesota, don’tcha know!) for another round of rehab therapy’s can’t-miss business conference. Seriously—you’ve gotta be there. Here’s why: 1.) You’ll earn CEUs. In addition to upping their business acumen, physical and …

  • 8 Reasons You Should Attend Ascend 2017 Image

    articleJun 15, 2017 | 5 min. read

    8 Reasons You Should Attend Ascend 2017

      Great news! Ascend— the ultimate business summit for rehab therapists —is back. Last year, the third-annual event hit Fort Worth, Texas, for two incredibly educational (and incredibly fun) days. This year—September 29 and 30, to be exact—Ascend is heading to our nation’s capital. As we all know, DC is full of movers, shakers, and changemakers, and Ascend will keep that tradition alive—minus the political drama. This two-day conference is a can’t-miss affair. Here’s why: 1.) You’ll …

  • How to (Ethically) Boost Billing Productivity in PT Private Practice Image

    articleJul 16, 2019 | 5 min. read

    How to (Ethically) Boost Billing Productivity in PT Private Practice

    You’ve got a business to keep afloat, staff to pay , and patients to serve—so, of course you want to make the most out of every unit charged. But boosting billing productivity doesn't necessarily mean squeezing every possible charge out of each date of service—especially when those charges aren’t warranted. With that in mind, here are seven workflow and strategy best practices to ensure you’re billing at your best (adapted from this resource as well as our …

  • Death to Denials: 4 Strategies for First-Pass Claim Payment Image

    articleMay 1, 2017 | 4 min. read

    Death to Denials: 4 Strategies for First-Pass Claim Payment

    Claim denials are the worst. You provide your patients with exceptional therapeutic intervention—and bill their insurance companies to recoup payment for those services—only to find out that the payer has no intention of actually doing any paying. Womp, womp. While you could—and should—implement a process to correct and rebill denied claims, wouldn’t it be even better to stop them from happening in the first place? After all, it costs providers an average of $25 to rework a …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.