In the words of American rock legend Tom Petty, “Good love is hard to find.” While I agree wholeheartedly with Mr. Petty’s wisdom, I think some rehab therapy practice owners might say good employees are even harder to find. And that certainly applies in the billing department. After all, your clinic’s billing operation is crucial to its financial well-being. One bad hire could mean the difference between your clinic achieving private practice rockstardom and hitting rock bottom. But how do you separate the billers with true staying power from the one-hit-wonders? It’s not an easy task, but you can start by ensuring any biller you hire:    

The PT’s Guide to Billing - Regular BannerThe PT’s Guide to Billing - Small Banner

Is an industry brainiac and news junkie.

Billing rules—especially those related to Medicare—change all the time. And if your biller doesn’t adjust his or her practices to align with those changes, your clinic could suffer some pretty serious cash flow issues. So, make sure you hire a biller who not only knows the ins and outs of billing-related policies in the rehab therapy industry, but also keeps an eye on the ever-evolving regulations that affect your practice’s bottom line.

You can get a sense for a candidate’s understanding of such rules during his or her interview. Try to work in questions about the regulations that impact your practice—for example, “How have you handled Medicare’s Multiple Procedure Payment Reduction (MPPR)? Have you run into any issues with it in past roles?” or “What kind of training have you done for ICD-10? How do you foresee this change affecting your workflow as a biller?”

Goes the extra mile to earn the extra dollar.

Most people are pretty diligent about chasing down their own hard-earned money if they spot any billing discrepancies. (I, for one, will go to great lengths to ensure I don’t pay full-menu price for any items I ordered on happy hour.) Your practice’s biller should approach claim investigations with the same passion I reserve for discounted guacamole. How can you make sure you’re hiring a grade-A dollar detective? Elizabeth W. Woodcock, MBA, FACMPE, CPC, offers the following suggestion in this Kareo article: “Black out the confidential information on an explanation of benefits from an insurance company that denied payment on the claim. Present it to candidates, asking them to walk you through how they’d handle it. If the candidate says he would write it off and call it a day, you know it’s time to conclude the interview.”

Has mad computer skills.

Even if your biller is a more proficient number-cruncher than the Human Calculator, no amount of mathematical brain power can make up for a lack of tech savviness. After all, this is 2015; software and technology play a major role in just about every industry—health care included. And if your biller is behind the computer curve, it could lead to claim issues and lost productivity—two major bottom-line killers in any rehab therapy practice. So, make sure your biller is skilled in whatever computer or Internet programs you rely on to do business. You’ll save yourself a lot of grief in the long-run.

Stays on the straight and narrow.

According to a survey cited in this blog post by Charlotte Bohnett, “83 percent of the 945 practices that responded had at some point been the victim of embezzlement.” Bohnett also shared the results of a separate study that showed “one out of every three business failures are the direct result of employee theft.” Neither statistic bodes well for rehab therapy practices that neglect to hire their billers with care. After all, these staff members are your practice’s direct link to payment, and for people looking to steal a quick buck, the closer they are to the cash, the easier it is to swipe a few dollars—or in this case, falsify documents or accounts, issue fake refunds, or divert clinic payments to personal accounts. So, while your biller certainly needs to have the chops for the job, he or she also must be uncompromisingly honest and ethical. How do you make sure of this? As Bohnett suggests, you should:

  • Screen all prospective employees.
  • Conduct pre-employment background/criminal history checks.
  • Collect and vet personal references.
  • Verify employment history and education, licenses, and certifications.

Remember, the process of hiring a great biller can take time, and to quote Tom Petty one more time, “The waiting is the hardest part.” But trust me, this is one process you definitely don’t want to rush, because if you bring the wrong biller on board, it won’t be long before you’re saying, “Don’t come around here no more.” (Sorry, I couldn’t resist.)

  • 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, …

  • The Physical Therapist's Guide to Contract Negotiation Image

    downloadSep 15, 2016

    The Physical Therapist's Guide to Contract Negotiation

    As a PT, you put your heart and soul into your work. So, it’s only fair that you get paid what you deserve. Unfortunately, payers don’t often see it that way, which means that in order to get what you want out of your private payer contracts, you’ve got to negotiate. And to do so successfully, you need to know how to play ball. Enter your email address below, and we’ll send your free guide.

  • 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 …

  • 9 Questions to Ask a Potential Billing Software Vendor Image

    articleMay 30, 2017 | 7 min. read

    9 Questions to Ask a Potential Billing Software Vendor

    The consumer landscape has changed drastically over the last two decades, and the healthcare space is no exception. Technology has driven much of that change. The rapid pace of innovation has created a technological smorgasbord, meaning consumers can sift through dozens of products until they find the perfect match. This proliferation of options has yielded a fresh set of challenges—including the overwhelming nature of so much choice. Salespeople might be counting on you to make a quick—and …

  • How the Affordable Care Act Impacts Patient Payment Collection Image

    articleMay 16, 2016 | 5 min. read

    How the Affordable Care Act Impacts Patient Payment Collection

    You take the good; you take the bad. You take ’em both, and you have healthcare reform. Like most government-led initiatives, healthcare reform in general—and the Affordable Care Act (ACA) in particular—has inspired a lot of passionate debate. And that’s because, while it has expanded health coverage to millions of previously uninsured people (woo-hoo!), it also has given way to some less-than-positive consequences. One such effect: the trend toward increased patient financial responsibility (whomp, whomp). Out-of-Pocket Overload …

  • Coding Faux Pas: 5 Common Rehab Therapy Billing Mistakes Image

    articleMay 9, 2017 | 7 min. read

    Coding Faux Pas: 5 Common Rehab Therapy Billing Mistakes

    As the old saying goes, “To err is human.” But when human error stands between you and timely reimbursements, it’s difficult to remain philosophical. From missing GP modifiers to miscalculated coding units, here are five common billing mistakes that keep rehab therapists from getting paid. 1. Omitted Modifiers Modifiers: Easily applied; even more easily overlooked. Therapy modifiers—including GP, GO, and GN—specify to the payer what kind of therapy service was provided (e.g., physical, occupational, or speech therapy). …

  • Down with Denials! 5 Claim Fixes to Make Sure Your PT Clinic Gets Paid Image

    webinarApr 19, 2017

    Down with Denials! 5 Claim Fixes to Make Sure Your PT Clinic Gets Paid

    One denied claim might not sound off your billing alarm bells—but in reality, it should. That’s because—as with faulty plumbing—one leak often indicates a much larger issue. And all too often, rehab therapy practices fail to act quickly enough—and soon find themselves wading in a flood of lost revenue. But there are simple, proven, and affordable ways to not only plug your billing holes, but also reinforce your whole system so you’re less likely to bust a …

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