Resource Center | PtEverywhere

Top Three strategies to make PT billing a snap in 2023

Written by PtEverywhere | Mar 6, 2023 1:00:00 PM

One of the biggest obstacles is having seamless physical therapy billing. Complexities include working with insurers, understanding medical codes, and staying compliant. Sigh - you got in this business to help people, not to be a medical billing specialist! So how can you modify your PT billing without wanting to break every bone in your body? 

Leveraging the right tools and practices can help avoid clinic disruptions and strengthen patient-to-provider relationships (a win-win!). Here are three strategies to navigate the nuances of PT billing without being a finance expert.

Learn to take charge of PT billing by:

1. Be Green and Support Paperless PT Billing

 Ready for a mind-blowing but true stat? 75% of providers primarily use paper and manual processes for collections, Which begs the question, WHY. Going digital reduces the time-consuming busy-work that comes with manual billing for physical therapy. 

PT electronic payments simplify a tedious task while maintaining the ICD-10 and CPT code accuracy. Running a PT clinic is hard enough, so ditch the paper, crumble it, and throw it in the recycle bin. 

How does Physical Therapy Practice Management software help?

An online dashboard detailing your practice’s payment model can keep your clinic organized efficiently and accurately. Additionally, it's incredibly impactful for specialists (like PT) since they can access information about a patient's Electronic Medical Record to make informed decisions based on the data. 

An excellent PT practice management platform should extend beyond a patient's chart. 

Look out for these tools when cruising for solutions:

  • Payment automation that keeps you far from administration cabinets
  • Revenue Cycle Management abilities that make handling insurance claims a breeze
  • Making sending Superbills easy as one-two-three! 

Digital billing is the calculation you need to avoid more paperwork clutter.

Finding a comprehensive platform keeps paperless billing simple and accurate. 

2. HIPAA PT Billing is Just What the Doctor Ordered 

HIPAA classifies two types of groups that must meet their regulatory requirements:

Covered Entities - HIPAA defines these organizations as providing healthcare through medical practices, insurance plans, and Healthcare Clearinghouses that collect patient information. For example, if you’re a Physical Therapist, you would be identified as a Covered Entity.  

Business Associate - HIPAA defines these organizations as third-party associates that covered entities may use to help collect or maintain their patient’s healthcare. An example of this would be patient management solutions - like us!   

Be BFFs with HIPAA medical billing terminology

Medical billing for physical therapy in U.S. healthcare utilizes codes that identify which treatment a patient receives. HIPAA regulates these codes to ensure patient data remains secure and protected through billing physical therapy transactions. 

Here are the medical codes that HIPAA affects:

  • ICD-10 - A mandate that applies to all parties covered by HIPAA, not just providers who bill Medicare or Medicaid. As of January 1, 2012, all HIPAA-covered entities must comply with Version 5010. In addition, this revision now includes the regulation of payment and billing done electronically to be HIPAA compliant. 
  • HCPCS - Developed by the Centers of Medicare and Medicaid Services, it represents the medical transactions to Medicare, Medicaid, and other third-party payers. In some instances, HCPCS codes are mandatory to be HIPAA compliant. 
  • CPT - Created by the American Medical Association, it’s the medical industry's most extensive and widely used set of codes. CPT is a crucial component of the reimbursement process between patients and their healthcare plan. HIPAA formalized the use of these claims as a requirement with the Administrative Simplification update.
As a PT, your patients trust you with their care and information. Working with a partner who can securely transmit electronic transactions can make this intimidating process more approachable. 

3. Activate Physical Therapy Billing for Telehealth 

Offering virtual appointments through your practice expands your business growth and allows you to see more patients throughout the day.   
Research shows how beneficial telehealth is for the patient and provider. For example, 92% of PT patients treated virtually were satisfied with its effectiveness! 

Remote repairs with the help of Medicare

Over 18% of the U.S. population is on Medicare (A low-cost U.S. healthcare plan offered to Americans 65 and older), and the aging population is increasing.  About 36.1% of PT patients are over 65 years old and most likely seeking Medicare coverage.

Currently, Medicare covers telehealth for some physical therapy.  Virtual PT appointments will most likely fall under Medicare Part B, which covers doctor visits, preventive services, and outpatient care. Understanding Medicare Telemedicine billing can help you extend your PT practice remotely.

Let’s look at the types of services Medicare Telemedicine covers:

  • Medicare telehealth visits - Virtual appointments between a PT provider and their patient. Provider requirements include having reliable audio and video software for clear communication. Billing for these virtual appointments is comparable to in-person clinic appointments.    
  • E-visits - Electronic Exchanges are virtual care done exclusively through a patient portal. This communication involves brief chats with the providers, rescheduling appointments, and building your patient profile on the portal. To remind you, physical therapy billing happens after establishing a relationship between the patient and the provider.  
  • Virtual check-ins - A brief interaction (5-10 min) between a healthcare provider and the patient. These check-ins can happen through multiple communication channels, such as a phone, SMS messaging, video, or emails. As with E-visits, PT billing occurs after establishing a relationship between the patient and the provider.  

PT telehealth is a great way to provide a better patient experience. A remote option like telehealth can give your patients much-needed convenience and flexibility. Now that Medicare covers telehealth medicine, following the best billing practices is imperative to get reimbursed for your services without delay. 

Tip: With PtEverywhere's all-in-one platform, you can provide or manage e-visits, virtual check-ins, and telehealth appointments for your patients. 

Don’t Make Physical Therapy Billing Taxing in 2024

Considering the many codes, compliances, and administration procedures, Physical therapy billing can initially seem overwhelming (and a bit of a headache!). Make 2024 the year you find a pain reliever for all your PT billing woes and eliminate barriers to more efficient clinical billing.
Designed by physical therapists for physical therapists, PtEverywhere streamlines payment collection, insurance billing, and membership packages, all from its all-in-one physical therapy medical billing software. 

To learn more about PT billing for 2024, book a demo or check out our media center for more therapy tips and tricks! 
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