What to Look for in a PT Biller

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:    

Article continues after ad.

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.)

Stay on top of the latest rehab therapy tips, trends, and best practices.

4 min. read

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