Physical Therapy Management: Clinical and Non-Clinical Staff

Physical Therapy Management: Clinical and Non-Clinical Staff

Nitin Chhoda discusses how good leadership, management and supervision of clinical and non-clinical staff can affect the total operation of a physical therapy business.

physical therapy management staffPhysical therapists hold many roles within their physical therapy management practice, from managing patient health and promoting physical therapy within the community, to managing clinical and non-clinical staff.

Therapists will be called upon to manage staff, disputes and performance inside and outside the clinic to ensure a superior level of customer service and profitability.

The three key ingredients for interacting with staff in an effective physical therapy management can be summed up as leadership, management and supervision.

Good Leadership

Physical therapy management employer-employee relationship is always an adversarial one, with each party’s goals in direct conflict. Therapists are focused on the profitability of their practice.

Employees are concerned with their families, homes, bills, social activities and a myriad of other topics. It’s not a bad thing – it just is. Despite all that, less supervision and great physical therapy management should be the goal of every physical therapist.

The first rule of staff management is that employees are not friends, nor are they family. A mutually friendly attitude should be cultivated in physical therapy management, but always remember that at the end of the day, employees are paid to do a job and do it well.

Management At Its Best

Camaraderie is desirable for the good of the practice, but viewing the relationship realistically will assist therapists in managing staff more efficiently for the future profitability of the clinic.

The less time spent on explaining tasks, disciplinary actions, accepting excuses and ensuring staff perform to expectations in your physical therapy management, the better. There will always be employees who lie, steal and provide inferior services.

Never tolerate unacceptable behavior and weed out those who refuse to conform. Firing staff is never pleasant, but it’s part of efficient physical therapy management and a necessary part of ensuring the quality of treatment and the reputation of any practice.


Incentive programs can be used to encourage clinicians to reach new heights in performance. Clinicians of physical therapy management require more hand holding and tracking, and therapists should condition them to receive small rewards based on performance.

If they see 81-90 patients in a 40-hour week, they get a $100 bonus. For those who treat 91-100 clients, they receive a $175 bonus. Anyone who sees 101 patients or more within a single week receives a $350 bonus for that week.physical therapy management peopleThe ultimate goal of any business is to make the maximum amount of money with the least number of expenditures.

Practice owners of physical therapy management are not in business to create jobs or operate in the red.

Every aspect, from labor and equipment to toilet paper, must justify the expense and pay for itself in one way or the other.

Every item and each employee must serve an essential function to obtain the best return on investment for the clinic owner.

Do Not Overlook

Practice owners shouldn’t overlook the convenience and cost savings of office and physical therapy management systems. They’re versatile, customizable, and can perform many tasks typically handled by employees.

Automation is essential in the 21st century to curb costs, attract new patients, market, and meet mandated requirements for electronic medical records (EMR).

An automated system provides therapists with the tools to manage every facet of their practices, from patient care, and billing to physical therapy management staffing for a more profitable clinic.

Healthcare and Insurance: Everything You Need To Know

Healthcare and Insurance: Everything You Need To Know

Whether you are healthy or not, having the right insurance for you is a must. Nitin Chhoda elaborates the importance of having the right insurance, and how it can help you prepare for future healthcare needs.

healthcare and insuranceThe terms healthcare and insurance have gotten a bit muddled in the minds of most Americans. So much of the public debate around healthcare is focused on health insurance.

But the reason that we need a better system of healthcare and insurance is because people aren’t getting the kind of healthcare they need to stay healthy.

It can be difficult to understand the healthcare practice management system if you never need to know how it works. But then one day you do need to understand, and maybe that’s because you’ve ended up in the hospital and are uninsured or underinsured.

The Truth About Healthcare and Insurance

The truth is that patients these days need better healthcare, and healthcare and insurance is the way that healthcare becomes affordable. If you had millions of dollars in the bank, you might not care about health insurance.

If something happened, if you were in a car accident or got sick with a serious disease like cancer, you could pay for your healthcare, even if that meant spending tens or hundreds of thousands of dollars for the best care. However, if you don’t have unlimited funds to spend on unforeseen expenses, healthcare and insurance is there to cover the big costs.

What is Healthcare?

For a moment, let’s forget about healthcare and insurance altogether. Imagine that every time you got sick and needed to go to the doctor, you would just go and the doctor would charge you a fee for the visit, and you could afford to pay that fee.

You have a bad sore throat that won’t go away, you go to the doctor, suspecting strep throat, and the doctor charges $30 for the visit and gives you a prescription for antibiotics. Then you visit the pharmacy and pay $10 for your medication and you’re all better in a week. You don’t feel like you need a healthcare and insurance.

That is healthcare at it’s most simple approach. Of course, the situation gets more complicated if something serious happens.

You have pain in your back all the time and you visit the doctor. You have to go back a number of times for a number of different tests.

Each time it costs $30, plus the costs of the tests. Then your doctor orders an MRI. In the United States, an MRI costs hundreds of dollars. Healthcare and insurance seemed to be important at this time.

healthcare and insuranceOr if someone has back pain that is making their life difficult and full of pain, they do not have a choice about seeking out healthcare and insurance.

The alternative is to live with awful pain all the time, limiting what they do in fear of making it worse, and possibly taking pain medication which will do further damage in the long term, to the liver, kidneys, and other important organs.

Getting Healthcare and Insurance is Part of Life

So rather than risk that this patient will have to pay for all these medical tests and potentially ending up in surgery, which will cost $50,000 to $100,000, the alternative is to buy healthcare and insurance.

You may choose a high deductible and pay for all those inexpensive visits, but if something truly bad happens, you are financially protected from medical bankruptcy.

Health Coverage in the New Economy

Health Coverage in the New Economy

With many disputes our economy is facing today, increasing payments for healthcare services can be challenging. Nitin Chhoda explains why discussing with patients about their health coverage is important.  Making the patient feel prepared and ready will help improve the practice-patient relationship.

health coverageThe idea of the “new economy” has come from a change in the way the United States economy functions.

For a long time, most jobs were in manufacturing, the making of goods that were then sold on the market.

But today, more and more manufacturing jobs are moving overseas to countries where labor is much cheaper. The economy has been moving in a direction of being service-based rather than manufacturing-based.

The New Economy

The new economy is an economy where most jobs do not come from the buying or selling of products, but of services.

Healthcare is a service industry. Both healthcare and insurance are services rather than goods or products. The challenge in the U.S. right now is that service providers for health coverage cannot raise prices without becoming significantly overpriced for the majority of the population.

Health coverage right now is unaffordable to most Americans, and even health insurance is too expensive if you do not work in a traditional, full-time job. As a result, providers of health coverage, even with proper physical therapy documentation, must balance their practices in a new way.

Improving Efficiency for Better Economies of Scale

One way that health coverage can be better balanced in the new economy is to improve efficiency. Economy of scale is a term that describes how it is easier to make money from low prices if you have more clients, customers, or patients.

For example, if your practice pays rent, hires staff, and covers utilities every month, those costs stay the same month after month – these are the expenses. If you can only treat a certain number of patients, your income is capped.

But if you can find ways to improve efficiency so that you can take on more patients each month, you can increase income. Finding the balance is a challenge, and most practices rely on trial and error. For example, many practices of health coverage bill low prices to entice more patients. By increasing the number of patients, they increase their overall revenue, even if they lower prices.

Most people cannot afford health coverage, which means that they do not go to the doctor as often as they probably should to stay healthy. For a practice like a physical therapy practice, they may find that patients of health coverage limit the number of visits so they don’t have to pay the co-pay so many times. But that reduces the favorable outcomes and many patients do not recover or stay as strong as they should.

Encouraging Patients to Take Care of Themselveshealth coverage economy

There is no arguing that preventative care is not a bad thing. One way that a practice can improve their efficiency is to improve technology and find ways within the practice to be more time efficient.

Another way is to provide a service to patients that they do not get anywhere else. When the patient feels they are getting more for their money, they are more willing to pay.

Many practices with health coverage are now taking a more holistic approach and encouraging clinicians to help educate patients so they stay healthy. Then when the patient isn’t feeling well, they come back because they trust the clinicians and feel it is worthwhile to pay for health coverage plans at that practice.

Health Care Insurance : The Patient’s Perspective

Health Care Insurance : The Patient’s Perspective

Although patients know the importance of healthcare and insurance, most do not understand their coverage and benefits. Nitin Chhoda explains how patients misunderstand insurance, and why it is important to openly communicate with them in order to avoid financial struggle.

health care insurance patient's perspectiveThe nature of health care insurance of a healthcare practice management in the United States leaves most patients pretty confused about what they need and what they are entitled to.

For example, even patients who have health care insurance may not benefit from their insurance most of the time.

If a deductible is built into the insurance plan, the patient will end up paying for most of their doctor visits every year. The only time they benefit from having insurance is when a serious accident occurs or they are diagnosed with a serious illness.

A Patient’s Perspective

From the patient’s perspective, the health care insurance system is confusing and always more expensive than they expect. A co-pay that is required, perhaps $20 for a visit or 20% of the bill, might come as a surprise to a patient that doesn’t understand their policy.

Even worse is when the patient does not understand the deductible of his/her health care insurance. They may look at their policy, find out that a certain treatment is covered, and not realize that they must pay the entire cost because they haven’t met their deductible limit.

For Clinicians and Medical Practices, Misunderstandings Can Mean Lost Revenue

Let’s consider a patient who does not understand the deductible, but they want to go to a dermatologist to test an unusual mark on their skin. They wonder if it’s skin cancer or just a mole, so they figure out that this kind of test is covered by their health care insurance, as long as they get a referral.

First they go to a general practitioner who is covered by the particular health care insurance company. They pay for that visit, or perhaps just a co-pay, and get their referral.

health care insurance perspectiveBut then they have an appointment with a dermatologist and tests are done to determine what the skin growth is. This is all pretty expensive and the bill comes to $1000.

At first both the dermatologist’s office and the patient believe that the patient must only pay the co-pay of 20%, which is $200 because of his/her health care insurance.

If the patient has a $3000 deductible that they have not reached, a chain of events ensues, which causes expense, wasted time, and stress for the patient and the medical staff.

First, the medical billing staff will bill the health care insurance company for the amount they typically pay, in this case $800. But the claim will be rejected because the deductible has not been met. Then the medical office has to bill the patient that $800 – an amount the patient is not expecting to pay.

A Realization

From the patient’s perspective of health care insurance, this is a terrible realization. From the practice’s perspective, this has been a waste of time and now they do not know if they will be paid for services already rendered. It is quite possible that the patient cannot afford to pay that $800. Even the $200 was probably a bit of a bummer at least.

The truth is that the patient made the right choices in making a health care insurance.

If that skin growth was skin cancer, it should be tested and removed. If they leave it alone, they may get seriously ill and have to undergo much more expensive and intensive treatments. But they are discouraged from taking those first steps because it is so costly.

Insurance and Benefits: What the Average Citizen Should Know

Insurance and Benefits: What the Average Citizen Should Know

It’s not enough that a person should have insurance, it is equally as important they know what type of coverage they are buying. Nitin Chhoda explains the difference of premium, deductible, and co-payments types of insurances.

insurance and benefits averageIf you want to save money on health insurance in the United States, first you have to understand just what it is you are responsible for paying when you need healthcare.

Insurance and benefits and physical therapy documentation can be incredibly confusing, partially because insurance companies use certain terms to describe what you will be paying.

If the average citizen was better educated about insurance and benefits, they can make better decisions about healthcare and insurance. Healthcare providers are also better off when patients understand their responsibilities and what is covered by their insurance benefits package.

Below are the commonly misunderstood terms that related to payments that patients must make as part of their healthcare insurance and benefits responsibility.


The premium for health insurance is the monthly, quarterly, or annual payment that the patient makes to the health insurance company. By continuously paying the premium, a patient remains insured. If the patient stops paying the premium, or pays the premium late, insurance and benefits can be withdrawn.

For employer insurance plans, often the employer pays the premiums for employees. This is not always the case, but even when the employer does pay, they tend to reduce the salary for the position based on the cost of adding another employee to their insurance plan.


The deductable is usually referred to as a cash amount, and it is the cash amount that the patient is responsible for paying. Most plans for insurance and benefits will include a deductable, and as the deductable rises for a different plan, the monthly premiums go down.

For employer plans, you may not have a choice unless you are choosing between an HMO and a PPO. The word deductable is used in insurance and benefits as the amount of money you have to pay before you can start benefiting from your policy.

For example, if your deductable amount is $500, no matter what you go to the doctor for, the first $500 in bills are yours to pay. If you want to have a higher deductable, you can get a cheaper insurance and benefits plan. But you’ll be paying the amount before you can collect benefits.

insurance and benefits of patientsIf you rarely go to the doctor, a high deductable can save you money. If you need medical care suddenly and it will cost thousands of dollars, you only pay the deductable and the rest is covered by your insurance company.


A co-payment, or co-pay, is also a cash amount. Some insurance and benefits plans are zero deductable plans and instead they require that you pay a percentage or flat fee for each visit to the doctor.

Even some plans with deductibles include co-pays for standard visits to the doctor for general check-ups.

Knowing the details of your insurance and benefits is different from understanding the insurance and benefits you are entitled to.

Most people who are healthy never even think about their co-pay or deductible until they need to go to the doctor and they find out that the amount is not yet billable to the insurance company. Often, this realization comes at great cost to the patient and the healthcare facility.

Insurance and Benefits and How They Relate To Good Health

Insurance and Benefits and How They Relate To Good Health

The future of healthcare and insurance is still uncertain.  Nitin Chhoda imparts how major changes are needed to be made in order to help policy holders maximize the use of their insurance policies.

insurance and benefitsWithout a good understanding of health insurance and benefits and physical therapy billing process, many patients make big mistakes that end up costing them money.

These are mistakes that also cost their healthcare providers time and money in the form of billing, rejected claims management, and late payment of fees.

Because so many people don’t understand that even with insurance and benefits they will still have to pay for some healthcare, the system can be very inefficient.

Some People Do Not Understand Their Insurance

But what about the cost to the health of people who have insurance and benefits but do not understand how the system works? Some people who do not understand will have certain healthcare procedures done without realizing that they will have to pay.

When they find out that they actually have a deductible of insurance and benefits which they are responsible for, they are shocked and disappointed to be suddenly in medical debt.

And even for patients who do understand the system, making these decisions is dangerous to health.

For a patient who has a problem with their skin and is wondering if they might have a melanoma, the correct and safe thing to do is go to the doctor right away. When skin cancer is caught early it is much easier and cheaper to treat and treatment is more likely to be effective without having to use paid insurance and benefits.

If a patient knows that they will have to pay up to a $3000 deductible, they may be nervous about going to the doctor for financial reasons. What good is an insurance and benefits plan if you still have to pay for medical care that you can’t afford?

What Patients Should Know Before Selecting Insurance and Benefits

insurance and benefits relationsThe best way to avoid a bad situation is to educate patients before they choose their insurance and benefits plan.

That way, patients can choose a plan with a deductible that they can afford and that makes sense for their health history.

Of course, for people working in the healthcare industry, it is usually too late by the time they see patients.

In many practices today, the induction process for new patients includes a somewhat sobering educational experience.

Rather than waiting until the billing process starts and services have already been provided, the reception staff or nurses will actually find out exactly what is covered by a patient’s insurance and benefits plan, and they will find out if the deductible has been reached yet.

Financial Future

This may take more time at the beginning, but in the long run it saves time and money for the practice. As a patient, if a practice wants to figure out how much financial responsibility you have, it is best to indulge them so you also know what you will be responsible for paying.

By working together, patients and medical practices can determine what the best course of medical treatment will be based on both the financial resources and insurance and benefits that the patient has.