Decisions

Clinical Practice Management

2200 W. Orangewood Ave, Ste 212, Orange, CA 92868-1980 | Phone: 714‐450‐4999 | Fax: 714‐974‐0055

Rounded Rectangular Callout: “Should I Outsource My Billing?”

Rounded Rectangular Callout: ...but the Savvy Provider Knows What it Takes to Achieve a Successful Practice

Rounded Rectangular Callout: Well, the amount of reimbursement received for Physical Therapy services has remained largely flat over the past several years...

Rounded Rectangular Callout: Also, in the last few years, the amount of required documentation has greatly increased in volume as well as in complexity! The increase in documentation requirements with a relatively flat level of reimbursement, has not kept pace with inflation. This has lowered the cost of reimbursement even further. These factors combined, have produced lower levels of professional productivity due to extensive documentation time and increased cost for additional office staff to support claims processing. The end result is working harder for less profit.

Rounded Rectangular Callout: Hmmm, so should you outsource? Well, let’s start by saying that the owner, the Therapist, cannot do it all! Nor can any one person be the whole ’billing department’. The amount that’s involved in running a Therapy business, even a small one, is great. From treating, to compliance issues, to accounting, to billing, to collecting, to training, to advertising, to hiring , to bookkeeping, you can NOT do it all!

Oval Callout: What You Don’t Know, Can Hurt You!

If you don’t know, or like, the billing aspect of your physical therapy business, and think it’s a headache, then you’re in the majority along with your fellow therapists. Most therapists want to treat patients and do not want to deal with the maze of medical billing, compliance issues, rules, laws, etc. They would rather pass it off on to someone else.

Rounded Rectangular Callout: The therapist must be careful in selecting that ‘someone else’. Those who hire the first reasonably thinking person who walks through their front door have learned the hard way and lost out on a lot of money. Some may have even found themselves out of compliance and the subject of an audit! Unfortunately, the typical practice that is not ‘on top of things’ collects only about 40% of what they could and should be collecting!

Rounded Rectangular Callout: Ok, I’ve decided to outsource my billing and revenue management. What do I look for in hiring an affordable, reputable Billing Revenue Management Company?

Home Offices:

Probably Not a Good Idea

These offices are usually ‘run’ by someone who has either worked in a billing office before and decided to work from home, or took a weekend course on “How to Make $40,000 /yr Working From Home”. Some billing concerns are home-based but have learned how to look like a large organization...how do you tell?

Characteristics:

· No set up fee

· Charges 4—10% of gross reimbursements

· They collect patient info and billing by fax, Fed-Ex, or PC Anywhere, U.S. mail

· Not very good about updating you on status of claims and collections

· Don’t keep you abreast of current compliance issues, laws, rules, and industry mandates

· Reports are not very good

Rounded Rectangular Callout: With a Home Office based billing concern, the potential to lose quite a bit of your revenue from un-appealed claims, lack of follow thru and lack of industry knowledge & compliance issues is high.

Professional Billing Companies: Probably a Good Idea

2200 W. Orangewood St., Ste 212, Orange, CA 92868

Professional medical billing companies usually work with many providers and have many accounts. They typically have more experience. However, you must be sure they have experience beyond just data entry, claims submissions and payment posting...How will you know and what Should you ask?

Rectangular Callout: Therapy billing is often misunderstood and taken for granted by most private practices. This results in thousands of dollars lost each month, if not more! Proper PT billing and CPT coding can make or break a practice. Those who are well versed in rehab billing, up on Compliance issues and politically savvy when it comes to healthcare issues, have a chance at being successful overall. Those who do not fully understand billing, compliance, and the ‘ins and outs’ of the political, legal, mandates, rules, and regulations of Rehabilitation Therapy, are in for a bumpy ride!

Rounded Rectangular Callout: By asking if they have a fully-staffed Collections Department you can be sure that your claims will be followed-up on and appealed. You will also want to know if they will keep you abreast of new laws, mandates and regulations. The good billing companies will have departments which inform their clients of the latest compliance, and other industry related news and issues.

· Can I contact your physical or occupational therapy billing clients for reference?

· Can you send me a sampling of the monthly reports you send to clients?

· How do you collect the billing and patient data?

· Will you teach code strategies for each payer type?

· Do you appeal denials? Can I see the letters that you use?

· What are your support hours?

What to Ask Before Hiring a Professional Billing Company:

In performing your due diligence by taking these few outlined steps, you should be able to contact, interview, and hire a professional billing company with confidence and the assurance you will have a long-lasting, profitable and reliable relationship with the professional billing company of your choice. Of course, we can, with confidence, highly recommend Clinical Practice Management as your professional billing company of choice!

714-450-4999

Rounded Rectangular Callout: Professional billing companies will usually handle your appeals, Collections from insurance companies and patients, as well as file letters of complaint to Insurance Commissioner. Revenue from a good billing company can be quite good and a good deal higher than if you handled your billing in-house. The ticket is to screen potential billing companies well.

CPM offers you all of the Professional Billing Company attributes and more!

· In-Depth Monthly Reports

· Your Own CPM Personalized Subweb site

· Keeps you abreast of all industry related information and issues

When you’re a member of CPMs team, you will get monthly reports that detail your practices’ Trends, Ledgers, Aging Status, and Collection Decisions.

Also! Once you join CPM, you will be given the password to your own Personalized Subweb site that has a plethora of Industry related info, links & resources, as well as your monthly Newsletter, Customized Clinic Forms, and Reports!