Physical Therapy Archives | Page 4 of 6

Physical Therapy Marketing: Establishing Your Own Income Goals as a Private Practice Owner

by Nitin Chhoda PT, DPT | Sep 28, 2012 | Physical Therapy

It is very important to establish your own income goals, that way you will know if your business is thriving or not. Nitin Chhoda stresses the value of creating income goals and how it affects your physical therapy marketing plan.

Planning a physical therapy marketing strategy, as well as running and maintaining a private practice is most of the time a full time job.

Most private practice owners act as either a principal therapist or the primary manager.

With a host of responsibilities, from patient care and support to employee fulfillment and retention and physical therapy marketing, it can be challenging to find a balance. And the place where balance is often ignored is in regards to your income.

Know Your Income Goals

Most private practice owners do not bring in the income they had hoped they would, because any time there is a shortfall anywhere else within the practice, the owner is the first one to pick up the slack.

This is true of most small business owners. Because the business, and physical therapy marketing, is yours and your responsibility, you might be willing to make a lot of sacrifices, especially during those first few years that are so critical to the long-term success of the business.

Hopefully, you’ve already come up with a business plan, physical therapy marketing included, and you are at least on your way to becoming a money making physical therapy practice.

But if you are struggling, or if you’re still deciding how you’ll manage all your expenses, thinking about physical therapy marketing, physical therapy software, and retaining skilled staff members will be critical to increasing revenue. And with increased revenue, you can look forward to finally reaching your income goals.

How to Set an Income Goal

In any small business, it’s easy to leave yourself out of the income stream. Some people think that the opposite is true, that physical therapy marketing and small business owners give themselves the lion’s share of income, just because they can.

But it turns out that in many private physical therapy practices, the owner is not the one making the most money, especially at first. The owner is also the one who is shouldering the debt of the business, so even if they do pay themselves well, that income comes at a cost.

So how can you decide what a fair and reasonable income goal is for you as a private practice owner?

As with any financial planning, start with your expenses like physical therapy marketing plan.

Create a Great Plan

Some people prefer to start with their previous income level and have a goal of giving themselves a certain raise each year. But truly the most important financial planning advice is that your income level doesn’t matter unless you are comparing it to your expenses.

If you can figure out exactly how much it costs to live your life the way you want to live it, you have an easy income goal to reach for.

How much money do you want to be putting away for retirement, for your business or physical therapy marketing, and when will that retirement be? In some ways, these questions are very hard to answer on your own.

Financial planners have their profession for a reason. Setting particular financial goals including your physical therapy marketing and business can be complex, especially if you really take into account all of your expenses as well as all of your desires.

But this process really is just a math problem, and all math problems have a correct answer. It’s up to you to find that answer.

Healthcare and Insurance in the United States

by Nitin Chhoda PT, DPT | Sep 6, 2012 | Physical Therapy

Nitin Chhoda explains how insurance and healthcare in the United States differ from other countries. He discusses how healthcare is tied to insurance in order for Americans to afford proper healthcare.

Healthcare and Insurance in Other Places

In some countries, the price of healthcare itself is affordable to residents. For example, in Thailand the need for healthcare and insurance is negligible, especially if a patient is earning a first world level salary.

If you need to go to the doctor, you can afford to go. If you need surgery, it will cost you a lot of money, but it will not cost you even close to the amount you’d pay if you were in the United States.

Another example is the healthcare and insurance system in Norway. Rather than have health insurance, the government uses taxes to subsidize healthcare.

That means that when a Norwegian needs to go to the doctor, they pay an affordable rate, but the doctor also gets paid a good salary because an extra fee is added that is paid by the government. Even for expensive things, if you need healthcare you can get it and at the same time, everyone makes a really good salary.

Our Healthcare and Insurance System

In the United States, the system of a healthcare practice management is very different. The cost of healthcare and insurance is so high that it is unaffordable for most Americans. Especially if a serious accident happens or an illness is diagnosed, uninsured Americans will be responsible for paying all of the costs – hundreds of thousands of dollars.

Because the prices are so high and nobody can afford to pay for surgery in the U.S., instead we buy healthcare and insurance, just in case something bad happens.

Healthcare and insurance work similarly to car insurance. Most of the time you pay your monthly premium, or you pay it up front for the year or the quarterly price each quarter.

Your plan may include co-pays, which are the amounts that you pay when you go to the doctor for certain types of visits. It may also include a deductible, which is the amount you pay each year before you start to redeem your healthcare and insurance.

But if you get into a car accident, your insurance is meant to pay for the amount that you cannot pay. The damage to the other car, medical costs of people in the cars, and damage to your car and your medical expenses can all be covered by car insurance, depending on your policy.

The same is true of healthcare and insurance. If you are diagnosed with cancer, your insurance policy should cover the high costs of treatment.

Healthy or Not

If you are healthy, you don’t use your insurance for healthcare. But once something happens, you cannot get healthcare and insurance because no insurance company will accept you as a client if you are going to be expensive.

This is why healthcare and insurance are so intimately tied together in the U.S. Without insurance, you cannot afford healthcare when you need it.

Sadly, these days healthcare and insurance companies are largely unregulated and can charge incredible premiums for insurance.

That means that even if people want healthcare and insurance, they can’t afford to get it.

If you stop paying your insurance bills, you are no longer covered. That means that healthcare and insurance are unaffordable. In that situation, Americans do not have many options besides medical bankruptcy.

CPT Codes — from the Medical Coder Perspective

by Nitin Chhoda PT, DPT | Aug 3, 2012 | Physical Therapy

Nitin Chhoda explains how medical billing and coding can be simplified with an integrated electronic medical records and billing system. The importance of communicating with patients and elaborating costs and financial responsibilities is also discussed.

CPT codes are pretty complex to use if you are unfamiliar with the process.

However, because they are so widely used, there have been many improvements in the way that medical coders and billers can access the codes they need.

Especially in an increasingly electronic age, CPT codes are only getting easier to use. Coding speed and accuracy can be increased with special physical therapy software that allows you to search for the right CPT codes quickly.

The most common reasons that insurance claims are rejected or denied have to do with incorrect coding or policy non-compliance. And every claim that has to be re-done makes the medical coding in your office slower and more costly.

With the Internet and software prices going down, these problems are being reduced for medical coding professionals and for the clinics that they work for. The high-end EMR solutions also include coding databases and can help improve efficiency and accuracy.

In order to draw more clients to use EMRs, software developers are learning to provide just what clinics and clinicians need from a complete electronic system.

Not Just CPT Codes – All Medical Coding

And of course, CPT codes are just one aspect of the job of a medical coder. CPT codes for Medicare are the same as certain HCPCS codes. Not every clinic will use all CPT codes, but only a certain sub-set. CPT codes list are only good if they are combined with the appropriate ICD codes when submitted with claims.

These kinds of important requirements keep medical coding staff very busy, which is one reason why many practices prefer to hire certified medical coders.

Communication with Patients

Another important way that CPT codes are used is in communication with patients. After a claim is filed and the insurance company responds with the amount they are covering, if there is any leftover amount it is up to the medical biller to bill the patient.

Patients usually find the medical billing paperwork to be confusing and overwhelming, especially patients who have recently undergone a medical procedure or have been diagnosed with a serious disease or condition.

Medical billing staff have to be able to communicate why certain CPT codes are used, why the insurance company did not cover the entire cost, and what the patient is responsible for paying.

Determining Future Costs

It can also be helpful if patients get an explanation about what future costs to expect due to discrepancies between the amount the insurance company will cover and the amount the patient has to pay.

CPT codes dictate how much a patient will be charged as well as how much the insurance company will pay.

The hope is that with a reasonable agreement between the health care provider and the insurance company, the patient will not be responsible for partial payments all the time. CPT codes can be used to ensure that pricing is consistent with the expected reimbursements from insurance companies as well as programs like Medicare and Medicaid.

CPT Codes: What's In It?

by Nitin Chhoda PT, DPT | Aug 2, 2012 | Physical Therapy

CPT codes and ICD codes are the terms used when discussing medical situations, and are used by the insurance and medical billing companies as guides. Nitin Chhoda describes the categories and roles of these codes as they relate to the physical therapy business.

CPT stands for Current Procedural Teminology. The CPT codes have been set and maintained by the American Medical Association and they are updated every year in October.

One of the easiest ways to understand the CPT codes is to compare them to ICD codes. While ICD-10 codes identify the diagnosis of a patient, CPT codes identify the services rendered.

CPT codes are used by clinicians, medical billing and coding professionals, and patients, as well as accreditation organizations, as a standardized communication tool for talking about medical services.

In fact, the reason that CPT codes are so useful is that everyone uses them when referencing medical services. The most prominent uses are in medical coding and billing, when a clinic needs to bill an insurance provider or government program. Medicare and Medicaid are both billed using CPT codes list along with ICD-10 codes.

Categories and Sections

CPT codes come in three categories, Category I, II, and III. Category I is split into six sections: Codes for Evaluation and Management, such as home services, hospital observation services, or emergency dept services; Codes for Anesthesia, such as obstetric, head, or neck; Codes for Surgery, such as nervous system, digestive system, or general; Codes for Radiology, such as nuclear medicine, diagnostic ultrasound, or mammography; Codes for Pathology & Laboratory, such as drug testing, immunology, or transfusion medicine; and Codes for Medicine, such as dialysis, allergy & clinical immunology, acupuncture, and ophthalmology.

Categories II and III are a little different. Category II are CPT codes that measure performance and are entirely optional. Category III are CPT codes for emerging technology use.

Not Optional

CPT codes are required by health insurance companies, as well as Medicare and Medicaid, in order for medical or physical therapy billing to be successful.

Additionally, HIPAA requires that CPT codes are used as part of a national data standardization and collection effort.

However, the copyright for CPT codes is help by the American Medical Association (AMA). That means that anyone who uses the CPT codes must pay license fees. This usually falls on the shoulders of health care services providers.

Insurance companies and government programs also use CPT codes as a reference for the amount of reimbursement that the clinician or clinic is paid for services. Insurance companies will negotiate with health care service providers in order to determine the precise amount, but once the amount for a service is set, all both parties need to know is which CPT code to use and the payment can be made in the agreed upon amount.

Updates and Improvements

But paying for access to CPT codes isn’t all bad. The AMA maintains the system and ensures that updates are made every year. The resulting system provides all users with a way to share information quickly and in a standardized way. The AMA has workshops to get informed feedback in order to make the system easier to use. The uniformity that CPT codes provide benefits everyone who works in medicine.

HIPAA : What Is It, Really?

by Nitin Chhoda PT, DPT | Jul 1, 2012 | Physical Therapy

The Health Insurance Portability and Accountability Act (HIPAA) was designed to protect the staff and patients alike. The guidelines and intentions for the creation of this act are explained in this article, along with their implications for your practice.

HIPAA or the Health Insurance Portability and Accountability Act has been around since it was enacted in 1996. All healthcare practice management must be familiar and compliant to this law.

Like most legislation, HIPAA is complex and can be difficult to understand. However, the basic ideas behind HIPAA are very interesting and can be explained relatively simply once you parse out the legal language. HIPAA is divided into two Titles.

Title I: Health Care Access, Portability, and Renewability

The legal ramifications of Title I of HIPAA favor individual staff members and attempts to protect people from insurance company policies that are unethical or dangerous.

For example, if you start working at a new job and are switching from your old group plan to a new group plan through your new employer, HIPAA prohibits your new health insurance company from denying you coverage of a pre-existing condition.

Many health insurance companies will do anything to avoid paying for healthcare for their clients. If a potential new client has a pre-existing condition that will cost the insurance company money, they can refuse to pay for benefits relating to the condition for 12 months after the client has enrolled in the plan.

However, if you had health insurance that was providing you with care before the transfer, you can reduce those 12 months because of HIPAA.

Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform

Title II is the part of HIPAA compliance that most people are familiar with. Title II pertains to privacy and security of health information, including medical records and health records. The five rules set forth in HIPAA Title II cover everything from the physical security of hard copies of medical records to the safe transmission of electronic health records.

Title II also protects the privacy of patient information by regulating how insurance companies, employer sponsored health plans, and healthcare providers can and cannot share your private information.

Title II is broken into five rules.

The Privacy Rule protects you from businesses that might want to sell your medical information to other interested parties, i.e.: an insurance company selling private patient medical records to a pharmaceutical company that may then be able to target you with advertisements of their products.

The Transactions and Code Sets Rule attempts to standardize health care transactions. To accomplish this, a number of forms were developed to simplify the process of transferring health records and filing claims.

Some problems have arisen due to the complexity of the process and implementation has not been smooth. As a result, an update has changed some of the original procedures.

The Final Rule on Security Standards details how specific safeguards must be put into place to protect patient information. HIPAA’s Privacy Rule says that information must be protected, and the Security Rule talks about how it is protected.

The Unique Identifier Rule made all health care providers adopt a unique ID number. And the fifth rule, the Enforcement Rule, is meant to deter those violating HIPAA by putting financial penalties in place.

Physical Therapy Management Improved Because of EMR

by Nitin Chhoda PT, DPT | Jun 21, 2012 | Physical Therapy

The best way to increase efficiency and productivity within your current physical therapy management and practice is to use the latest software called EMR.

Nitin Chhoda shows how the right EMR can improve staff’s professionalism and systematize billing, as well as have a positive impact on staff to patient relationships.

Physical therapy management and handling patients come in two forms. The first revolves around the interpersonal relationship you have with patients.

This form of physical therapy management is critical to managing the expectations of patients as well as getting the best results from treatment plans.

The second form of patient management is the paperwork side of things. With an EMR for physical therapy management and services, you can improve efficiency in the way you record patient visits, referrals, insurance information, and billing.

Gaining Trust and Demonstrating Professionalism

One way that physical therapy management software can help with patient management is by giving your office a feel of professionalism and modern documentation techniques.

For example, every new patient that enters your office should feel that things are well organized. Trust is an important part of the clinician to patient relationship, and one way patients will come to trust you is through the tidiness and efficiency of the way your practice works.

This kind of judgment starts right away, and will continue into every facet of their experience with your staff and practice. Physical therapy management and documentation software can standardize the paperwork that patients deal with. EMR systems are designed to make communication straightforward for everyone within the practice and with patients.

Billing Expectations

Another way that EMR for physical therapy management and services will improve patient management is through your billing system. EMRs should include an excellent billing system that allows you to bill regularly and quickly. Physical therapy EMRs will include the necessary filing options for health insurance reimbursements, as well.

Patient management often strays into the physical therapy management or meeting patients’ expectations, and the best way to manage expectations is to communicate clearly and preemptively.

In other words, if your patient believes that their insurance policy will cover all expenses, but the policy only covers 80%, you can avoid an uncomfortable situation by communicating those details before you send any bills.

Physical therapy management and billing can be extremely complex from the perspective of the patient. If you can communicate with them about billing and if your EMR has automated calculators for insurance and patient responsibilities, you’ll be able to maintain a good relationship with your patients.

Planning Together

Patient and physical therapy management services can ensure that your patients stay with your practice and that they are an active participant in their own recovery or health plan.

Many patients will arrive with a sense of dread or apprehension about their physical therapy sessions.

The best way to ensure that they are ready to do the work is to plan together with them so they know what to expect.

Once a plan is set, an EMR system will help you to maintain consistency within that plan. Electronic medical records are quick and easy to access, and updates are quick and easy to make.

Every visit with a patient can be productive if both you and the patient feel confident about knowing what happened last time and what to expect for the current appointment. Physical therapy management and EMRs provide consistency and efficiency for patient management.