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Physical Therapy Billing: How to Reduce (and Contest) Payment Denials
Since payments from insurance companies provide vital cashflow, it’s essential to have a system in place to minimize denials. Once a denial does happen, a system must be in place to contest those denials.
Nitin Chhoda explains how to minimize denials and also contest them successfully. This is one of the most essential elements of a successful, cash-rich practice.
One thing is certain, no matter how hard you work to perfect your physical therapy billing practices, you will still be faced with denials and rejections from insurance companies.
Every physical therapy private practice experiences a high rate of denials and rejections and unless the entire system changes dramatically, this is going to continue to be part of the deal.
Find the Solutions
Rather than getting frustrated with denials, it’s time to think about minimizing them and finding ways to contest them successfully. When we think about problems and attempt to find solutions, the place to start is in the practice.
Minimizing denials is the job of physical therapy billing professionals, and in many cases they simply need the structure and the space to do just that.
Reporting for Physical Therapy Billing Improvements
The best way to avoid making mistakes is to start with the mistakes that have been made in the past. The reporting capabilities of physical therapy documentation software can make the process of physical therapy billing much more accountable.
Rejected or denied claims can be tracked with reasons and time stamps, and by using reporting functions physical therapy management can determine just what goes wrong and how much time it is costing the practice in re-submittal of claims.
The back to basics approach of reinventing physical therapy billing is critical to finding solutions. Any system that has grown and changed as much as health care billing and insurance payments, is going to have inefficiencies built right into the process.
To get rid of those inefficiencies, the whole system may need to be torn down and re-built.
Start at the Beginning to Avoid Mistakes
A physical therapy EMR is going to allow for reporting and documentation that has previously been nearly impossible to extract and use. This is great news for physical therapy management.
But for physical therapy billing staff, it’s going to be a tough adjustment. Rather than focusing on the mistakes of individual billers, changing over to an EMR can help turn the process of re-education into a whole-office re-education.
Training the physical therapists to document their patient visits a little differently will be made easier if the entire staff is learning to document differently and use the information differently.
The burden of making adjustments of physical therapy billing to reduce the chances of claim denials and rejections will be shifted to the whole staff, rather than focused on billers who only have control over one portion of the process.
Responsibility is Key
At the same time, physical therapy billing staff are responsible for a certain portion of mistakes, and finding and eliminating those kinds of mistakes is going to be a big part of reducing denials. If you find that insurance companies are blanket denying claims, and it’s not the fault of billers, you can address the problem differently.
It may turn out that billing staff are actually spending time contesting denials because an insurance company is not worth working with. But you’ll never know that unless you have a system for recording the processes of physical therapy billing, documentation, and claims denials.