Physical Therapy Marketing: Identifying and Contracting With the Best Payers

Physical Therapy Marketing: Identifying and Contracting With the Best Payers

Searching for the best insurance companies maybe hard to find, but it doesn’t mean that they do not exist. NItin Chhoda exposes simple techniques on how to identify and contract with the best payers so that your practice will have continuous income.

physical therapy marketing identificationA huge decision that will need to be made by the private practice managers and owners, that will affect physical therapy marketingis determining which insurance companies to work with.

The process of establishing relationships with insurance companies can be exhausting and time consuming.

The last thing that a business and physical therapy marketing manager wants to do is find out that the insurance companies they work with are bad payers. So how can you find the best payers?

Communication is Everything

When you start to look into insurance companies for your physical therapy marketing plan to work with, the first thing you will do is get in touch and find out how to negotiate a payment schedule and the rest of the details you’ll both need for the relationship to work.

Some insurance companies will essentially send your business through a completely automated physical therapy marketing system, lining you up with alongside everyone else who comes to them. You could never even have a conversation with a human before entering into a contract.

This kind of induction process is a red flag. If they don’t want to talk to you now, they are not going to want to talk to you when you are having trouble with a rejected or denied claim.

Build a Good Relationship

As a practice owner, you need to work your physical therapy marketing plan with companies that want to build a relationship with you. You want to have a conversation about their pricing allowances and you want them to hear your rates before agreeing to pay your claims.

It’s likely that you’ll run into a lot of insurance payers who are expecting and hoping to reject or deny as many claims as they can. If they are not even willing to communicate with your physical therapy services about how the process will work, you can bet that they will never pay a claim without a battle.

One of the ways that these companies make money is by wearing down the people who try to collect from them with a lack of communication and rejection after rejection.

Keep Tabs and Don’t be Shy

You may be able to avoid some of the worst offenders, but it’s likely that even some of the friendlier companies will treat you the same way as the bad ones. The best way to improve in your physical therapy marketing is to keep track of what has been happening.

Make sure that your physical therapy marketing strategies and medical billers know how to track the claims with each company and notify you if a particular company is bad at paying their bills. A particularly high rate of rejections and denials from one company out of a few may signal that it’s time to drop that company.

physical therapy marketing best payersDo Not Be Afraid to Take Risks

You don’t even have to do it all at once. Many practices are hesitant because they don’t want to drop patients just because their insurance company has some bad paying practices.

That’s probably a good physical therapy marketing  idea. But as you go, don’t be afraid to stop taking new patients with that insurance policy. If the insurance company doesn’t pay, you shouldn’t take the risk.

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

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

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.

physical therapy marketing goalsPlanning 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.

physical therapy marketing establishSo 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

Healthcare and Insurance in the United States

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 USAHealthcare 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.

healthcare and insuranceThis 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

CPT Codes — from the Medical Coder Perspective

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 codesCPT 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.

CPT codesMedical 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.

HIPAA : What Is It, Really?

HIPAA : What Is It, Really?

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 definitionHIPAA 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.

HIPAA

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 Software Best Choices

Physical Therapy Software Best Choices

Before buying a physical therapy software, make sure you know what your practice needs. Nitin Chhoda shares the one question every practitioner should ask first, before they can choose the best software that is right for their practice.

physical therapy softwarePhysical therapy software system affects your entire experience depending on what type of EMR you choose.

For some practices, price is a dominant factor. But cutting corners can backfire, and most cheap physical therapy software is going to cut some corners.

Before you decide what you can spend, think about what you need. If the EMR you choose doesn’t work for you, it probably won’t be worth any amount of money.

Look at Your Practice First

The first step towards choosing the right web-based physical therapy software is looking at what your practice will need. You’ve likely heard that EMRs for physical therapy software and services can increase efficiency and improve your bottom line. That’s only true if you’ve got some inefficiency that can be reduced with an EMR.

Ask yourself a few questions. Is your medical billing conducted on a regular and timely schedule? What is the percentage of rejected or denied claims you receive? Is your staff slightly overwhelmed with paperwork? How often do errors occur that upset your patients?

If you are having trouble in any of these areas, and most practices have more than one of these problems, it is very likely that physical therapy software can help. Scheduling, billing, and patient management are integrated in good PT documentation software. Does that sound like something that will reduce the number of steps each staff member has to take to do their job? Good.

Understanding the Benefits

physical therapy software best choiceAs soon as you know what you need, you can develop some goals. These goals for your practice should be independent of whether or not you get physical therapy software.

But if you design your goals around what will improve efficiency and your bottom line, then you will be ready to ask the most important question: will this physical therapy management solution help us to meet our goals?

If billing is your main concern because you get a lot of claim rejections and denials that need to be re-filed, then make sure that the billing system is integrated and comprehensive in the physical therapy software you are considering.

If one of your goals is to improve the professionalism in your office with a sophisticated system, make sure that the system actually provides improved consistency in billing, patient care, and communication.

Choose the Best Physical Therapy Software for Your Practice

Remember that EMR implementation can be taxing and frustrating for staff. Make sure that the physical therapy software company offers training and instruction for staff, both before, during, and after implementation.

Lastly, no matter what kind of physical therapy software you choose, make sure that it is intuitive to use. The most important thing about any physical therapy software is that it will be easy for your staff to use. You want the staff to become more efficient, right? Do not sacrifice intuitive interfaces and useful tools for a better price, because you will not get the results that you want if your staff can’t use the software.