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How Does Billing Work in Physical Therapy

Quality physical therapy services without a streamlined billing system could affect your day-to-day operations. You need quality services and a comprehensive billing system to ensure your physical therapy practice runs as smoothly as possible. Physical therapy billing services should consider the patient’s condition and treatment codes, and shorten your revenue cycle.

You can eliminate the stress of manual billing and claims reimbursements by using an automated billing system. It can increase your profitability and potentially improve your cash flow fluidity, boosting your operations and practice. Learn how the billing system works in physical therapy.

Physical Therapy Billing

Your billing system should accommodate insurance and out-of-pocket payments. Some insurances only cater to prescribed physical therapy (PT) after an injury. Other insurance companies expect you to sort your bill for different reasons. Reasons like preventing an injury could force you to settle your bill.

An automated system should capture these differences when submitting claims. It helps you follow up with the patient to settle the difference. The system should calculate your bill using different codes that define your condition and the type of treatment given. Then, submit the claims to the insurer for reimbursement.

There are two types of medical codes used in the field, namely:

  • The International Classification of Diseases (ICD) codes. These codes change every 10 to 15 years.
  • The Current Procedural Terminology (CPT) code system. This code is updated every 3 to 5 years.

Physical therapists and doctors use these codes to record and submit your visit details. They use it to charge for services and submit claims. If the insurers identify a code they don’t cover, they won’t cover the bill. Since the codes change periodically, having an automated system that changes this data promptly eases the work during the transition. Here’s the billing process in a physical therapy practice:

Patient Verification

You must verify the patient’s demographics and information to know whether the insurance covers the treatment. An automated insurance verification tool helps you hasten the process and maintain the accuracy of the results. It eliminates the long search and manual verification of information through calls or emails. This saves you time and frees staff to work on other tasks.

Having transparent pricing policies eases your patient filtering, making your practice more efficient. You won’t have to look into each patient’s details to confirm if they can afford your services.

Once the patient knows your pricing and insurance status, they’ll decide how to sort the bills. They can pay out-of-pocket, or see if insurance will cover the costs.

Billing and Recording

Once you authorize and verify the patient, the medical experts diagnose and suggest a treatment plan for the patient. You must key in the details for accurate charging and billing.

Each physical therapy practice and health facility has a book with both codes. This book helps to accurately transform your PT’s visit into the medical codes. Get a billing software that allows you to code and submit accurate billing details, saving time and streamlining your claims process.

Claim Submission

The right billing solution with high accuracy allows you to submit your claims in a timely manner. Electronic billing systems integrate your workflow with the billing process to send out the claims periodically.

The system takes the translated coded documents and feeds them the claims sheet ready for submission. Timely submission of accurate claims results in timely payments improving your practice’s business status.

Reimbursement

Once the insurer approves your submitted claims, they remit your payments. If the insurer doesn’t cover the entire bill, you can let the patient know the reimbursement status. Follow up with them to clear the pending charges.

You can even provide an online payment portal to help them settle their bill easily. Accommodate those who want to make their manual payments in your billing system.

If any of your claims get rejected, be prompt in refiling and resubmitting the claim. Make sure to submit your claims on time to keep your revenue cycle short and profitable.

Improving Your Physical Therapy Billing Services

A physical therapist’s task in their practice is to provide quality services and help patients. Streamlining your physical therapy billing services through an automated system allows you to file your claims easily. It will enable you to get your reimbursements in a timely manner. Outsource these services to improve your profitability and ease your practice workload.

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