Choose in-house or outsourced billingBilling is one of the most important aspects of running a rehab therapy clinic, aside from patient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic.

The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time. With that in mind, we’re going to devote the next handful of post to some billing best practices to help you get your life back.

Our first tip covered auditing your existing process, and tip two discussed the need to shop around. Here’s tip three:

#3: Choose your method—in-house or outsource?

The next question to ask yourself is whether you should outsource your billing or keep your billing in house. Let’s first define each method of billing, then outline the benefits and drawbacks of each.

In-House Billing
In-house billing means that you have a key staff member (or several) in charge of billing your claims from your office. If you plan on implementing this method, you should hire a designated billing professional. Having an employee handle billing as a side job often results in a giant headache and more importantly, delayed collections, which for many clinics can mean the difference between success and failure.

In-house billing also requires that you choose a software platform to administer. Keep in mind, though, that no billing software is created equal. Do your homework:

  • Research software
  • Make a list of the providers you like
  • Complete an interactive demo with each

During the demos, make sure all of your key stakeholders are present. It’s important that the software you choose is intuitive, easy-to-use, and includes all of the features you need to properly manage your billing.

Outsourced Billing
In-house billing requires time, labor, and internal expertise. So, if that doesn’t seem like your cup of tea, you may want to consider outsourcing, which essentially means that another company will handle all of your claims processing while you sit back and collect your payments—when it’s done right, that is.

Outsourced billing usually costs a percentage of your total collections (industry average is between six and twelve percent) but each service will have a different price point, different therapy-specific experience, and different service levels (for instance, included claims follow-up or statements might be a higher price-point). But there’s more than just cost to consider. Outsourced billing can definitely impact your clinic’s revenue.

When a front office employee or PT assistant calls off, clinics typically pull the in-house biller to help out, which can result in decreased attention spent on claims. Additionally, in-house employees all take vacations so there may be significant gaps in your claim processing. With outsourced billing, these aren’t issues for your clinic. Sure, there’s a cost, but because outsourced billers are entirely and constantly focused on your reimbursements, clinics can expect their bottom lines to increase dramatically.

Here’s an ROI example: If your clinic collects $100,000 each month and your billing service charges 6.5%, you might assume that you would bring in only $93,500. However, if your outsourced billing service can increase your revenue by 20%, your collections would increase to $120,000, and you would actually net $112,200.

As you evaluate outsourced options, get to know your key contact person for each service and find out what tools they provide for you to keep track of your claims. Many companies feature administrative dashboards so you can monitor your account, obtain details regarding your claims, and respond to any action items.

What experiences do you have with in-house or outsourced billing? Any tips to share?

Make sure to check out Part 2 and Part 4

Cashing In on Private Pay: The PTs Guide to Going Out-of-Network - Regular BannerCashing In on Private Pay: The PTs Guide to Going Out-of-Network - Small Banner
  • articleMar 18, 2013 | 3 min. read

    Get Your Life Back: Billing Best Practices for Rehab Therapists, Part 4

    Billing is one of the most important aspects of running a rehab therapy clinic, aside from patient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic. The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time? With that in mind, we’re going to devote the next …

  • Clear Course for Cash: 5 Simple Ways to Optimize Your PT Billing Workflow Image

    webinarJul 6, 2015

    Clear Course for Cash: 5 Simple Ways to Optimize Your PT Billing Workflow

    Is your current billing workflow flooding your clinic with claim delays, rejections, and/or underpayments? Don’t try to bail yourself out with a sieve. Instead, stop taking on water entirely by patching the holes in your billing processes. But how, you ask? Never fear; we have the answers you need to shore up your ship—for good. Tune in to this month’s webinar, where hosts Heidi Jannenga and Charlotte Bohnett will show you how to set your billing workflow …

  • Creating the Perfect PT Billing Workflow Image

    articleJul 14, 2015 | 7 min. read

    Creating the Perfect PT Billing Workflow

    In an ideal world, patients would know their benefits like the back of their hands, we’d have a global payer list, and every claim would be accepted on the first try. But the world is not a perfect place, and there’s only so much you can control. Still, you can do your darndest to get close to the perfect billing workflow. Perfect—or near-perfect—billing begins way before you even create the claim. So, let’s start at the very …

  • The 411 on UB-04: What PTs Need to Know Image

    articleApr 29, 2015 | 4 min. read

    The 411 on UB-04: What PTs Need to Know

    Developed by the Centers for Medicare and Medicaid Services (CMS) and implemented in 2007 , the UB-04 form—also known as CMS-1450—is the standard claim form providers use to bill CMS. But plenty of other government and commercial insurance carriers use it, too. As CMS explains , UB-04 can be “used by an institutional provider to bill a Medicare fiscal intermediary (FI) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for …

  • Undoing Denials: Managing Claim Rejections and Appeals in PT Billing Image

    articleOct 20, 2016 | 7 min. read

    Undoing Denials: Managing Claim Rejections and Appeals in PT Billing

    When the stakes aren’t high, people are more forgiving of flubs. If you have a bad hand, a missed stroke, or a poor toss, you may cry, “Mulligan!”—and get a do-over. But, what happens when the stakes are high—like when you’re billing for physical therapy services, and you suffer a denied claim? Do you get a mulligan? The short answer: yes. The long answer: I wouldn’t necessarily call appealing a denied claim a “do-over,” but the important …

  • Mad Maximizing Reimbursements: Revenue Road Image

    articleApr 23, 2015 | 3 min. read

    Mad Maximizing Reimbursements: Revenue Road

    We might not live in a post-apocalyptic world like the characters in the latest Mad Max film , but it certainly feels familiar in the world of physical therapy, where private practices fight to survive against ever-shrinking profit margins and federal legislation that threatens to erode bottom lines. Our weapon of choice in this furious battle? Increased efficiency. Here’s the strategy: Technology Processing Paper claims process in six to eight weeks, while electronic claims process in about …

  • articleMar 13, 2013 | 2 min. read

    Get Your Life Back: Billing Best Practices for Rehab Therapists, Part 2

    Billing is one of the most important aspects of running a rehab therapy clinic, aside from  patient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic. The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time. With that in mind, we’re going to devote the …

  • 4 Keys to Keeping a Steady Cash Flow Image

    articleMay 18, 2016 | 5 min. read

    4 Keys to Keeping a Steady Cash Flow

    As a private practice clinic owner, you’re probably familiar with the cold sweat-inducing struggle to keep a steady cash flow. Claims management muck-ups, inefficient processes, staff issues, and lack of insight into your clinic’s financial health can leave you feeling like you’re riding a revenue rollercoaster. So, whether you’re trying to maximize reimbursements , combat employee theft , or optimize patient payments , these four keys to maintaining a steady cash flow will help you even out …

  • 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, …

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