• The Dish on Patient Discounts: Can You Charge Different Rates for the Same Service? Image

    articleSep 11, 2019 | 7 min. read

    The Dish on Patient Discounts: Can You Charge Different Rates for the Same Service?

    Let’s start with the bad news. (Spoiler alert!) Patient discounts aren’t anywhere near as straightforward as we’d all like them to be. Getting a hard-and-fast rule from every commercial payer and state government—or even from CMS —can be harder than keeping up with the gossip in a highschool cafeteria. So, naturally, the discounting situation is less “he said, she said” and more “they said, they said, they said, and they said.” It’s hard to know what you …

  • FAQ: Physical Therapy Billing Live Q&A Image

    articleAug 30, 2019 | 51 min. read

    FAQ: Physical Therapy Billing Live Q&A

    Earlier this week, Heidi Jannenga, PT, DPT, ATC—WebPT’s Co-Founder and Chief Clinical Officer—and John Wallace, WebPT’s Chief Business Development Officer of Revenue Cycle Management, paired up to answer rehab therapists’ most burning billing questions during a live Q&A-style webinar . And, boy, did we get a lot of great ones. So many, in fact, that we couldn’t possibly get to them all live, so we created this massive post-webinar post (our biggest yet) with the most commonly …

  • Compliance Quest: 7 Medicare Muck-Ups and How to Fix Them Image

    webinarAug 30, 2019

    Compliance Quest: 7 Medicare Muck-Ups and How to Fix Them

    Legends tell of a great beast who lurks in the depths of CMS’s darkest dungeon. Many adventurers have set out to conquer this mighty leviathan, only to find themselves outmatched, outnumbered, and eventually, defeated. But now, the time has come for a hero to emerge and subdue this prodigious beast once and for all. That beast is Medicare. And the hero? That’s you. With the right knowledge and skillset, you and your party (er, clinic staff) can …

  • EDI, ERA, and EFT Overview for Rehab Therapists Image

    articleAug 27, 2019 | 4 min. read

    EDI, ERA, and EFT Overview for Rehab Therapists

    What would health care be without its love for initialism? And healthcare billing is no exception, which is why we decided to shed some light on three common ones: EDI, ERA, and EFT. If you’re in the rehab therapy billing world, you’ve probably heard these terms bandied about. But because they directly impact your practice’s ability to make money, it’s imperative that you’re crystal clear about electronic data interchange, electronic funds transfer, and electronic remittance advice definitions. …

  • 4 Common Reasons for PT Claim Denials (and What to Do About Them) Image

    articleAug 21, 2019 | 8 min. read

    4 Common Reasons for PT Claim Denials (and What to Do About Them)

    No one wants to deal with denials, but unfortunately, they happen. In some cases—for some PT practices—they happen a lot. And they can be a major drain on clinic resources and cash flow. The best method for dealing with denials—including medical necessity denials—is to prevent them from happening in the first place. With that in mind, here are four common reasons for PT claim denials—and what you can do to avoid them (or, at the very least, …

  • 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 …

  • 3 Times When You Absolutely Must Issue a Patient Refund Image

    articleAug 8, 2019 | 4 min. read

    3 Times When You Absolutely Must Issue a Patient Refund

    When we talk about the billing side of rehab therapy , we’re usually referring to getting money—not giving it back. However, failure to refund patients when necessary can result in some dire financial consequences—including heavy fines and other penalties. The government is pretty clear about its stance on this: according to guidance from the Office of the Inspector General (OIG), “Billing companies should institute procedures to provide for timely and accurate reporting to both the provider and …

  • Founder Letter: The Cost-Shifting Conundrum: How to Combat High Patient Copays Image

    articleAug 6, 2019 | 9 min. read

    Founder Letter: The Cost-Shifting Conundrum: How to Combat High Patient Copays

    In our 2019 State of Rehab Therapy survey , 80% of respondents cited payer requirements as the top reason their organizations require physician referrals as a condition of treatment (even in states with unrestricted direct access ). Additionally, high copays and coinsurances were by far the top-ranked regulatory issue in terms of impact to the physical therapy industry and profession. In other words, as it stands, the insurance industry (and its propensity to shift costs onto patients …

  • Credentialing vs. Contracting: Everything Rehab Therapists Need to Know Image

    articleAug 2, 2019 | 6 min. read

    Credentialing vs. Contracting: Everything Rehab Therapists Need to Know

    There’s a lot of confusion about the difference between credentialing and contracting —as well as what PTs, OTs, and SLPs must do to complete each process. In fact, questions about the insurance credentialing process are some of the most common inquiries we get from new clinics. So, I decided to do a little digging. And with some help from clinical-biller-turned-WebPTer Asia Giuffrida, our Therabill Onboarding Team Lead, I’ve compiled everything rehab therapists need to know about credentialing …

  • The Difference Between Medicare and Medicaid Billing and Reimbursement Image

    articleJul 31, 2019 | 8 min. read

    The Difference Between Medicare and Medicaid Billing and Reimbursement

    At first glance, Medicare and Medicaid might seem like twins, or a dynamic duo, or two peas in a pod—basically, inseparable. They’re both government healthcare programs; they were both created at the same time ; they’re both confusing and usually don’t boast the best reimbursement rates ; and they even sound alike (they both start with “Medi-,” right?). In reality, though, these two programs are very, very different. For starters, Medicare is a federally run program, which …

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