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Physical therapy invoice template for Purchasing

so let's go over how to create a patient reimbursement form or a super Bill what a lot of people call it in a cash-based physical therapy practice so this is my template of what I use and you can get all of my templates this fillable PDF and everything in the Business Essentials course along with all the other documentation you need that but today let's focus on the patient's reimbursement form so again in the old days when you used to submit a claim it used to be on a 1590 form okay so I pretty much just labeled this a modified 1590 form just so when the insurance company gets it they know that template so I just labeled it as a modified 1590 form sometimes they're going to still request you to maybe fill out one online but at least the patient has this and the insurance company is going to be known of what this layout is again it's monotonous but this is what the insurance company wants and we try to do our best to get our patients reimbursed so I have this statement here and then I have the patient's name here so if you go down to the next section it'll go over all the patient information um that is on the old forms that I converted just to this you know I don't know why they want half the stuff but um at least I fill out all of this for them one that they can fill out their insurance info this is all their information regarding um the insurance info that they need and then from there we'll go down to the provider so this is all of my companies the address the facility type the code um you do want to include the code and it's going to vary different verses of brick and mortar versus a mobile practice versus other places but make sure that you have your information down your tax ID or your EIN number the business National provider number the treating therapist and the PT license so this is everything that they want again broke it down into three sections patient info insurance info and the provider information okay and then we go back to the services provided so um this is the updated version of the video in 2023 right now things change every year like this time we're putting GP codes on on everything just because I know a lot of insurance companies are adapting to Medicare so we just added the GP codes versus the old video doesn't have GP codes on there just little things that we're getting feedback from patients of what the insurance company wants we'll just change the template update it so the patient has the best chance of getting reimbursed or just applied towards the deductible so I have three spaces up on the top of the services provided for the ICD-10 codes they're going to know the date of the service you're going to have your CPT code this is for more of a treatment package so it's more of a complex case and our charges and then I keep it simple if you follow any of my comp content I follow the kiss principle keep it simple stupid we do pretty much a combination of fair X or manual therapy that's all that we pretty much do here I want to keep this simple and efficient as possible and try to do what's best for the patients so they can get reimbursed so I'll go in here and fill out all the dates on these and again this is a fillable template like if it's okay 4 26 23 I haven't built that these templates that you could just go through and press Tab and then you go down 427 23 and it's already labeled it looks something like that um again this is based off of my fee schedule and how we charge patients so your fee schedule may may be different we go through we fill out the dates make sure that's formed completed and then we have the ICD-10 codes put in here the total matches the total amount and then we have a signature line here and then we save it at a as a PDF and it gets emailed to every patient at discharge whenever they want this we don't do it each individual session we just wait until the end and give them a master reimbursement form One Time One Shot One everything's done at one instant so we're not constantly doing this and updating it doing over and over again we will do it for bigger packages we'll do it at a halfway point sometimes most of the time we wait until the patient's done and discharge and then we give them one super super bill or a reimbursement form so this is the template of what I follow I I pretty much designed this myself it's a modified 1590 form you have your patient info your insurance info your provider info and then the services provided based off of your fee schedule this is what I do and then we save it as a PDF and send it to them so if you have any questions about reimbursement forms and any other questions about this stuff just put a comment in the comment box below and thanks for listening and hope you learned something thanks