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Physical therapy invoice template for Education

hey guys thanks for watching Tony Merritt out of here so I'm going to talk to you about creating a Medicare patient responsibility calculator in Google sheets I'm going to show you how you can integrate a basically an invoice I would not use it as a super bill it's an invoice payment tracker this is for somebody kind of starting out fresh out of the gates you don't want to invest a lot of time a lot of money a lot of effort into a full-fledged system for accounting for your patients so this is going to be a cheap easy kind of quick one to go to so I'm going to show you my screen let's do this together okay so this is just a rough look at what I've got and we're going to go through this part by part so it's kind of a long training but basically what I did here was I created a list of my most common CPT codes now what we want to do we want to get the allowed amount the Medicare allowed amounts I'll tell you so if you go to your state's fiscal intermediary I'm using the one in Ohio CGS most of the websites look pretty similar but as you scroll down here on the Left there's an option for fee schedules if you come out here this will take you out to the actual cms.gov website and so if you go to the fee schedule here 20:17 is what we're gonna look at I can use a list of CPT I don't want I want my local Mac and we'll talk about that and so here I need an eval code I need an exercise code a manual therapy code a neuro read [Applause] and a therapeutic activity you're going to choose all modifiers and you're going to choose your local Mac for me it's Ohio so I'm gonna jump into Ohio and hit submit while that's loading here they are if I come in here and that's kind of interesting so this is the CGS that's our fiscal intermediary when I come down here I choose Ohio I choose 2017 nine seven one six two I choose an evaluation could I hit display and what's interesting as the participating provider allowed amount shows seventy eight ninety four but here it shows seventy nine sixty and I can tell you that we get paid based on this fee schedule not the other so using this let's create kind of our list and what I want to do is I pull that out you know what I'm not sure if that's going to show so I'm gonna keep it in here so I'm just gonna go ninety seven sixty and jump back here in ninety seven sixty therapeutic exercise next one is manual therapy and just so you can see these fields under this eighty percent column this has a formula so that it's calculating 80 percent of the allowed amount and then on my 20 percent column I've got a formula calculating twenty percent of the allowed amount if you need help with formulas just let me know they're they're pretty basic Excel spreadsheet type formulas and then we've got one last one therapeutic activity okay so here are our calculations this is the Medicare allowed enough this is 80 percent which is what Medicare pays after the Medicare deductible in mimic this is 20 percent the 20 percent is either paid by the patient if there is no secondary paid by the secondary in full or paid by the secondary after the secondary deductibles been met or if there's a coinsurance it's not unusual here in Ohio that secondary plans will have a 20 percent coinsurance in which case try to stick with me Medicare establishes a dollar amount an allowed amount and Medicare pays 80% of that allowed amount then the 20 percent goes to the secondary the secondary pays 80 percent of that remaining 20 percent and the patients responsible for a net total of 4 percent of the total allowed amount I'm not going to spend the time to get into it that detailed but the best part of it the one thing that we don't have yet that I'll try and set up in a separate video but is this MPP are and what that is essentially it's the reduction in reimbursement for multiple procedures and so that's worth its own kind of topic but just to give you a rough idea not including the MPP are let's just say for example this is a situation where I've got a patient who comes to me first first of the year neither the Medicare deductible nor the secondary deductible has been met in which case I treat that patient and I provide one unit of exercise one unit of therapeutic I'm sorry when about one exercise one man and so what we end up with here because the deductible has not been met let's see here I'm going to pause this and set up my formula one more time okay so the patient responsibility is 100% so before I pause the video that was set at zero because no deductibles have been met patients responsible for a hundred percent of the allowed amount which in this case comes out to a hundred and forty dollars and fifty nine cents and so how do I charge the patient let's say we said this was data service New Year's Day super motivated patient became a New Year's Day here is where I can put my CPT code nine seven one six two and if you want you know physical therapy evaluation quantity one unit price this is the full Medicare allowed amount because no deductible has been met seventy nine point six total amount new seventy nine point six and then basically what I've got is I take because we got two more dates of service nine seven one one Oh therapeutic exercise quantity we did in this example of one unit allowed amount 3169 and then our last one here I just have a one for Oh manual therapy one unit twenty nine thirty so at this point the patient knows one hundred and forty dollars and fifty nine cents now you know if we want to and we can have this conversation separately but one of the complaints is that insurance does not pay physical therapists enough to cover our costs I can tell you in my practice the typical treatment would be one evaluation for a first-time visit usually to exercise one manual or two manual one exercise whichever depending on the the patient's condition the allowed amount for that is a hundred and seventy two dollars and twenty eight cents that's above most cash based physical therapists billing rate at one hundred and fifty dollars so you know Medicare is an outstanding payer and with that Medicare pays typically within about 10 to 14 days of claim submission so let's just update this let's say two units and we said it was sixty three thirty feet okay oops sorry I forgot that that was already calculating 3169 okay so here we go there's our charges for today that's what the patient owes again another video topic would be do you collect this at the time of service before treatment after treatment you collect at the end of the week you allow insurance the process there's a lot of things for you to decide as the practice owner but now let's say patient comes back and it's treatment number two they come back in on the third and so let's just for the heck of it say Medicare deductible has been met secondary deductible has been met and the secondary has a 20% coinsurance so when you do the calculations it tells you that the patients responsible now for four percent of the allowed amount so if I come in here now it's a follow-up visit in this case let's say I do three exercise one manual the patient's responsibility is four percent so here I can pull this down I can pull this down come out here we set three exercise one manual and what we're looking at is the four percent rate now which is a dollar twenty seven and then we're looking at a dollar seventeen and looks like just because of a little bit of rounding where this calculator gave us three dollars and eighty cents this calculator is giving us three dollars and eighty one I would buy us on the higher side and refund the patient if I over collect so now the new total is one seventy seven point two six obviously you have your logo field your company name you know rendering provider yada yada if you want to use something like this as an e as a super value may you just need to add a little more information but I'd much rather use office allied to generate my super bills but now let's say I want to print this out and give it to the patient the easiest way to do it in Google Docs is to click I'm holding the left click button down I'm gonna drag down and across to here I just realized that this oops sorry about that [Music] this needs equal that here are where you may choose to put some discounts you know if you're offering a 10% cash pay discount or whatever it may be you have to be kind of careful with Medicare and offering discounts so I left all that blank but basically what you do is again click drag down and across let go right there I go to print right now it's showing me the whole sheet but if I choose selected cells all of a sudden now it just is showing me my invoice and from here obviously I can print it let's say the patient makes a payment on the third so I usually come in here patient payment check number and then I can come out here and I can say so because these charges are in the positive a payment is going to be in the negative and so let's say this patient pays negative 177 twenty-six amount do is zero and now I want to make this a receipt I do the same thing highlight it click the print button and come over here is selected cells and so you can see that the balance is doing zero patient payment is right there you've got each line I certainly maybe if if your if anyone's interested we can make a more comprehensive a invoice receipt that shows what the insurance paid what the secondary page any contract adjustment but most patients are going to be more than satisfied with the receipt like this and so if you need anything else just let me know I'm going to make this video and here I will make this spreadsheet available to anyone who asks just in the comments below say send me spreadsheet and I'll send you a link to the Google Drive where you can download it actually one more point so I would use this as my master template and then what happens now is you create duplicates of it so let's say I come in here I right-click I say duplicate then I come here and I go to rename and let's just make up patients name this is Joe Smith right and so here is where we have you know Joe Smith and we have all of Joe Smith's information and then the next time I come in here I duplicate it I come in here I rename and now I have Jane Doe you know and then I get another Medicare patient I come in here I duplicate it I rename it I say Jones and Bobbie and now what I would do is I would keep these in alphabetical order so that let me see my image get rid of that there you go so that as you're searching over time you've got them in alphabetical order and you could have a hundred of these tabs everyone has their own invoice everyone has you know whatever their patient responsibility calculation is everybody has their info and then whatever else you need you know like maybe you this patient wants you to collect weekly maybe another patient wants to pay daily this is just a really handy functional tool to keep track of this stuff so let me know what you need I'm happy I'm going to keep putting content out like this I think it's important I think we could all learn and benefit from it in my next video I'll talk about the Medicare you know what our actual collections are from a Medicare visit a four-unit Medicare visit because I bet it's not too far off from what you're getting now so you guys just let me know what you thanks for watching