Physical Therapists and Billing: How to Manage When You’re Always on the Go | Carepatron

What is physical therapy billing and how does it work?

Patient information collection

The first step involves collecting all necessary patient information, including personal details, insurance coverage, and medical history. This information is crucial for verifying eligibility and benefits under the patient’s insurance plan, including personal information, insurance coverage, and medical history.

Service documentation

During each treatment session, the physical therapist must document every service provided. This documentation should include the type of treatment, the duration of the session, and any specific interventions performed. The documentation must be detailed and accurately reflect the medical necessity of treatments, directly supporting the billing process.

Coding

Once the services are documented, the appropriate Current Procedural Terminology (CPT) codes are assigned to each service. CPT codes are standardized codes used to describe medical, surgical, and diagnostic services and are essential for insurance claims as they tell the insurer what specific services were provided.

Claim submission

After coding, a claim is generated and submitted to the patient's insurance company, detailing each treatment session. This universal claim form includes the patient’s information, the services provided (with respective CPT codes), and the charges for each service. Claims can be submitted electronically or on paper, though electronic submissions are generally faster and more efficient.

Claim adjudication

Upon receiving the claim, the insurance company reviews it to determine its liability. This process, called adjudication, involves checking the claim for errors, verifying coverage, and ensuring that the services billed are covered under the patient’s plan.

Payment and reconciliation

If the claim is approved, the insurer processes payment according to the terms of the patient’s health plan. The physical therapy practice receives this payment either through direct deposit or a mailed check. Any discrepancies between billed amounts and payments received must be reconciled. If a claim is denied, the physical therapist’s office may need to correct it, resubmit it, or appeal the decision.

Patient billing

After the insurance portion is settled, any remaining balance that is the patient’s financial responsibility, such as copays or deductibles, is billed to the patient.

According to the American Physical Therapy Association, physical therapy and billing procedures can be complex due to the need for accurate coding and compliance with insurance regulations. Many practices use specialized billing software or hire billing professionals to manage this process effectively.

Medical billing services: Effectively managing billing services on the go

Effectively managing medical billing services on the go is essential for healthcare professionals who must ensure accurate and timely billing service calls, even when they are away from the office. Here are some strategies and tools that can help achieve this:

Mobile billing applications

Using mobile apps designed for medical billing allows healthcare providers to enter charges, check claims status, and access patient billing information from anywhere. These apps often include features for scanning documents and capturing charges in real time, which can reduce delays and errors.

Cloud-based billing platforms

Cloud-based systems enable billing staff to access the billing software from any device with an internet connection. This flexibility ensures that billing operations can continue uninterrupted, regardless of location. These platforms often come with high-level security features to protect sensitive patient data.

Automated reminders and alerts

Setting up automated reminders for upcoming deadlines, such as claim submission dates or patient payment due dates, can help keep billing tasks on track. Alerts can also notify staff of any issues with claims, such as denial to receive reimbursement or requests for additional information, ensuring quick resolution.

Integration with electronic health records (EHR)

Integrating the billing system with EHRs can streamline billing by automatically transferring diagnostic and treatment information into billing codes. This reduces the need for manual data entry and decreases the likelihood of coding errors.

Training and support

Ensuring all billing staff are skilled in service and are trained to use mobile and cloud-based billing solutions effectively is crucial. Ongoing support and access to help desks can resolve any issues, minimizing downtime.

Outsourcing mobile-friendly services

For practices that prefer not to manage their own billing, outsourcing to a company offering comprehensive, mobile-friendly billing solutions can be an effective alternative. These services manage all aspects of billing, from claim submission to follow-up, and provide access to their systems via mobile and web apps.

Secure data access and compliance

When managing billing on the go, it’s essential to maintain compliance with health care regulations such as HIPAA in the U.S. Using secure connections, such as VPNs, and ensuring that all mobile devices are equipped with strong security measures can protect patient data.

By leveraging these tools and strategies for effective revenue cycle management, medical professionals can manage their billing tasks efficiently and securely, even when they are away from the office. This mobility enhances operational flexibility and helps in the revenue cycle, maintaining cash flow and reducing administrative burdens.

Tips to optimize your practice’s physical therapy billing process

As we’re sure you know, the billing process for physical therapists can be exhausting. Fortunately, there are strategies your business can employ to reduce the amount of time you spend on administrative tasks and ensure your whole professional physical therapy billing process is as hassle-free as possible:

Patient information

Collecting patient information before their first appointment is an easy and sure way to save time in the office. Set up an online patient form accompanying the booking process so that when the patient arrives for their appointment, all relevant payment information is already in your system. 

Dealing with rejected claims

Unfortunately, rejected claims are common and can significantly delay payments. Clearing house rejections return to the sender with a message detailing the error within the electronic claim forms, making it easy for staff to fix the mistake and resubmit the claim. If you habitually fix and resubmit cleaning house rejected claims on the day you receive them, you will be reimbursed much faster.

Billing dashboard

Setting up a billing dashboard allows you to track the progress of each of your claims’ progress and understand when you can expect to receive payment. One of the most important things to track on your billing dashboard is that there are no response claims. If you know that claims have not responded in 14 days, your staff can contact the insurance carrier or carriers regularly to ensure timely payment.

Physical therapists who don’t track no-response claims risk losing significant money. Your billing dashboard should also track new patients, the number of visits, check-ins, check-outs, and low authorizations.

Reduce your lag time

Lag time (the time between the date of service and the first billed date) is one factor in the billing process over which the physical therapist in your practice has complete control. Ideally, physical therapists should submit their claims on a particular date, the same appointment day. While submitting claims can be time-consuming, you should be incentivized by the payments you are facilitating.

Encourage co-pays

If patients pay their copayments at their appointment, this eliminates half of the complicated billing process. Various methods can be used to encourage timely copayments, including setting up an online payment method via a patient portal. 

Billing software

Utilizing medical billing software is one of the most accessible and secure methods to optimize your physical therapy services and billing process. With healthcare software, you can maintain consistency and reduce the time spent chasing up unpaid invoices and tracking claims progress.

Improving the patient experience for physical therapists

Improving the patient experience in physical therapy settings is crucial for patient satisfaction and successful outcomes. One practical approach is to enhance communication in group therapy by educating patients about their treatment plans, expected outcomes, and the progress they are making. This transparency helps to build trust and empowers patients to take an active role in their recovery.

Physical therapists can also improve the patient experience by optimizing the physical space of their clinics. The environment of the physical therapy clinic should be welcoming and comfortable, with private treatment areas to ensure patient confidentiality and comfort. Accessibility is critical, including adequate parking, wheelchair access, and easy navigation within the clinic.

Technology can significantly enhance the patient experience in physical therapy. Digital tools, such as online appointment scheduling and electronic health records, cover essential services and streamline therapeutic exercise administrative processes. Additionally, apps that track rehabilitation exercises and provide virtual coaching can offer continuous support outside of regular sessions.

Finally, soliciting and acting upon patient feedback is essential for continuously improving therapy services. Regular surveys and suggestion boxes can provide valuable insights into patient needs and preferences. By addressing concerns and adapting therapeutic services, physical therapists can create a more patient-centered care environment.

Take home message

Physical therapy billing, particularly for manual therapy techniques, is complicated and requires much repetitive work. Using healthcare software can streamline the billing process for your manual therapy business, minimizing the number of errors in your claims and reducing lag time. Carepatron is a healthcare platform perfect for physical therapy businesses that integrate medical billing and coding software with various other telehealth features.

With Carepatron, you can better keep track of the progress of your claims, which improves your organization and minimizes the number of rejected and denied claims. By choosing to implement medical billing software into your maintenance therapy business, you are guaranteed to save a significant amount of time that can instead be spent doing what you do best: delivering quality physical therapy care to patients!

One app for any Physical Therapist: Try Carepatron for free today!