Physical therapy medical billing an intricate process
Physical therapy practices are different from regular medical services, and you need to remember this when you code and bill for the claims. It is not the same principle that applies everywhere for medical billing and coding for different treatment methods. To ensure your PT billing, an intricate process, ends well, you need to start with the front office. Get to know how to manage with PT billing.
Collecting all data at the front office is how it begins at every medical practitioner’s place. When it comes to physical therapy, your staff should take extra care to verify, if physical therapy services are paid by the insurance, and what sort of services are covered. Physical therapy services take more time than with a doctor. The services are patient specific, and can involve the practitioner staying close with the patient throughout the service. So, the check in and check out time plays a vital role here.
How to deal with the time:
In PT, the time is categorized into Pre time, Intra time and Post time. The preparation time, performing time, and the documentation time are what they mean, respectively. It is important for the providers to mention all these in their claims. Though the patients are visiting often as per their schedule, the providers still ask about their wellbeing and assess based on that. Many providers miss this out. This can mean getting under paid. Again, count all the duration you spent on the patient as intra time, even if it means discussing with the referring physician over phone. The same is applicable for documentation. Anything you mention as exercises referred for homework cannot be billed. So, if you ask your patients to do a bit of exercise in your office, it still is your time devoted, and get it billed.
However, do not go overboard by providing the in and out time in the claims. This is because, you give an opportunity to study and dissect your claims in details. The payers when find something not convincing can go about with audits. In and out time are not necessary.
One on one and group services:
Understand the difference between one on one and group services. One on one services need individual contact with the patient, though not constantly. Group services need constant attendance without having any individual contact. Billing for these rightly matters a lot.
Avoid payer audits:
Do not code exercises as therapeutic activities. The latter is expensive, and if you are coding as TherEx, then you add profit. When the insurance finds this, you might be penalized for coding everything as therapeutically activity. Frequent use of TherEx can lead to payer audits. Instead, NeuroRe-ed can be used. Dynamic movements that involve physical exercises still should be considered therapeutic activities and not exercises.
You are not flat paid every day, and don’t get the feeling that per diem, capped rates and fixed rates mean the same. There are variations. You are paid the capped maximum per day. However, to be eligible for this, you need to bill a fixed number of claims in a day.
Collect the copay and deductibles at the time of providing service. It can be when the patient enters or when he leaves. Do not waiver them, as the insurance will not pay for these services.