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Results Driven Physical Therapy Billing Company
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Overview of PT Billing Services
Physical therapy billing is nerve-racking, time-consuming, and tricky! There are several billing guidelines, coding standards, payer requirements, and regulations to follow, which often undergo annual updates. Hence, blunders while coding are hard to avoid. Unfortunately, these minor errors can lead to major consequences.
First, errors in billing charges will strain your practice's financial performance due to a high denial rate and A/R days. Second, it can tarnish your PT practice's reputation by landing you in legal battles or heavy financial penalties. Thus, partnering with a reputable physical therapy billing company is the SMART thing to do!
Common Challenges in Physical Therapy Billing
Physical therapy practices across the US often struggle to keep their revenue high in the face of the changing federal and state laws. The varying payer requirements and hundreds of diagnosis and procedure codes also add to the intricacies. Hence, on a daily basis, PT billing experts encounter several challenges.
Invalid Insurance Recipients
Not having a copy of the patient's insurance card or making a mistake while entering the plan details can cause claim denials, payment delays, and an unsteady cash flow.
Inappropriate Use of Modifiers
The CPT coding system has modifiers to address the specificity of PT services while billing. However, skipping them or using them inappropriately can lead to claim rejections or denials.
Lack of Code Linkage
The diagnostic codes must link with procedure codes to support the appropriateness and medical necessity of therapies. However, a lack of code linkage results in claim denials.
Upcoding or Undercoding
Overbilling or underbilling is another physical therapy billing error that may strain your practice’s revenue. It can lead to denials and result in financial penalties or legal actions.
Outsource Physical Therapy Billing to MediBillMD
We have designed our PT billing services after taking feedback from licensed physical therapists on their coding and billing nightmares. It helped us ensure our billing team is trained on the most pressing matters and is capable of addressing the billing issues.
When you outsource to MediBillMD - a reputable physical therapy billing company, you get complete peace of mind. Instead of losing control of your practice's financial aspects, you are empowered through our comprehensive performance reports. Our real-time insights on your practice’s financial health help you make informed revenue cycle decisions.
As your PT practice expands, so do your billing requirements. However, scaling up your operations becomes a piece of cake when you outsource physical therapy billing to us. How? Because we charge a percentage on your monthly collections.
The compliance regulations and insurance companies’ requirements constantly evolve, and failure to adhere to these changes may lead to payment delays, penalties, or denials. However, outsourcing physical therapy billing to us ensures the highest level of compliance.
Our physical therapy billing team has experience and expertise in the complexities and specific requirements of your specialty. Besides, we invest in regular training to ensure our team stays current with the changing standards and coding systems for clean claim submissions
Our physical therapy billing services are a cost-effective solution to all your billing requirements. You don't have to hire the best talent, train or retain them, and set up the costly infrastructure. We handle all this on our own.
We handle the intricate claim creation process, payer follow-up, denial management, and payment posting, ensuring a healthier revenue cycle. So, you can focus on providing quality physical care for a superior patient experience.
A range of payer requirements, federal rules, and state regulations can easily push PT practices to the edge. Not ANYMORE! At MediBillMD, we take pride in mastering the different payer guidelines and state laws of all 50 states to ensure accuracy and precision in PT billing services. So, whether you are up in Alaska or down south in Hawaii, tailored assistance is guaranteed.
MediBillMD Solutions to PT Billing & Coding Errors
In physical therapy billing, several factors are at play, and failure to address any can make you lose your rightful reimbursements. From misunderstanding the coding variations for group and individual sessions to not considering the 8-minute rule, each of these errors can cost you your revenue. Luckily, at MediBillMD, our billing specialists and certified coders have a keen eye. They proactively rectify these errors and ensure a healthier revenue cycle.
| Physical Therapy Billing & Coding Errors | MediBillMD Solution | |
|---|---|---|
| Not Knowing the Difference Between One-on-One vs. Group Session | Physical therapy has different CPT codes for individual and group sessions. Our PT billing team ensures the highest level of specificity while coding the therapy sessions to ensure accurate reimbursements. | |
| Not Considering the Complexities of Rendered Services | PT coding involves specific code sets for varying degrees of complexity, i.e., low, moderate, and high. Our physical therapy billing team includes certified professional coders (CPCs) who understand the intricate process and assign the most accurate codes and modifiers to improve your claim first-pass rate. | |
| Non-Compliance with Medicare’s 8-minute Rule | Our PT billing and coding team is well-versed in Medicare's 8-minute rule, which is crucial for billing timed physical therapy sessions. We take extra care while determining and coding the billable units. For instance, 8-22 minutes (1 unit), 23-37 minutes (2 units), etc. | |
| Non-Compliance with Changing Payer Requirements | The terms and conditions of Medicare, Medicaid, and third-party payers change with time. Therefore, our physical therapy medical billing team strives to stay current on various billing requirements and payer guidelines to ensure compliance and an optimized billing and payment cycle. | |
Lowest Prices Guaranteed
Physical therapy billing is complex, but many practices have second thoughts about outsourcing it, as they believe partnering with professionals will be expensive! But MediBillMD offers guaranteed AFFORDABILITY without compromising on QUALITY!
Get In Touch With Our Physical Therapy Billing Billing Experts
Are you looking for a reliable physical therapy billing company to streamline your workflow? Connect with our representative and get a dedicated account manager for your PT practice’s non-clinical needs.
FAQs
At MediBillMD, we don’t take a general approach to medical billing and coding. We have several specialized teams with coders and billers experienced in the specific requirements of 45+ specialties. Our tailored approach makes us the ultimate solutions provider, optimizing your physical therapy practice’s financial performance.
MediBillMD’s physical therapy billing services are cost-effective. You outsource them to us for 2-5% of your monthly collections.
Compliance with the different insurance payers’ policies and specific physical therapy billing requirements, using accurate codes, ensuring procedure specificity, and adequate documentation to support medical necessity are the most challenging aspects of PT billing.
A licensed physical therapist is authorized to bill for PT services. It may include services performed under their direct supervision or services that the physical therapist assistants (PTAs) may carry out.
No, a chiropractor cannot bill for PT services. Both specialists can only bill under their assigned CPT codes. Trying to bill outside of it may flag their activities as fraudulent or manipulative.
Using accurate CPT codes against rendered PT services, maintaining adequate documentation, following the 8-minute rule, adding modifiers when needed, ensuring correct patient information, and following up on claims are a few best practices to successfully bill Medicare.
No, a physical therapist cannot bill for occupational therapy services because both are distinct specialties. Besides, there are various coding sets available for each specialty. If one tries to bill from the other specialty, it may result in penalties or legal issues.
Typically, a physician cannot directly bill for physical therapy services. However, there are a few exceptions. For instance, if a physician personally performs the PT services, or a nurse practitioner (NP) or physician assistant (PA) conducts the PT services, they can bill for it using the specific CPT codes.
