Streamline Your Physiotherapy Bill Format for Businesses

Physiotherapy bill format for businesses

what's up guys Tony maritato here so I had a couple related questions come in through Facebook Messenger one was regarding the transition from an existing billing company to a new billing company the other one was looking to hire a biller to come in and do their billing so first I wanted to touch on the transition now this is one of those areas that I think is the hardest thing we switched uh we switched billers twice and then we went in-house when we first started our practice just to give you a little context if you don't know me I'm a physical therapist Private Practice owner we started our practice back in 2001 2002 we had no idea about billing we were all cash based at the time once we contracted with Medicare and started to contract with other payers we hired a billing company we thought that they knew what they were doing when it came to physical therapy billing but they were not experienced in PT billing and so it resulted in a lot of denials a lot of delays all sorts of mistakes so then we switched to a second billing company same problem once we hit the third billing company they did an amazing job but they were never able to recover almost sixty thousand dollars in claims that either had gone past the timely filing limit or were just unrecognizable at that point like nobody knew where they were what was going on and remember this was like before emrs and and lots of technology that we have today but I can tell you that I remember when we were then switching from an amazing in-house biller um or excuse me an amazing outsourced biller bringing it in house that was a challenge because what we had to figure out was if they were receiving a percentage of revenue for claims that they submitted where are we going to make the break how are we going to say okay on Friday this claim and all previous claims are yours but on Monday this claim and all future claims are mine how are we going to switch the EDI enrollment so that we can start submitting our own claims to Medicare and other third-party payers when they still need access to be able to download eobs and post payments electronically for claims that they were working on it was a really really challenging transition now what we did which a lot of people don't have this opportunity we had two locations that were up and running that the other billing company was handling we opened a third location and I started from scratch doing my own billing for the Third location so by the time that I was up and running probably six months into doing my own billing for the Third location I had optimized my systems I know know exactly what was going on and I was actually able to kind of hold on to claims that wouldn't exceed the timely filing limit while the contract biller the auditorious biller was able to finalize 30 60 90 days worth of AR before we made a clean break and I said okay now I'm switching over all of the EDI enrollments I'm switching everything else over you've had 90 days to finish collecting now we're going to do it ourselves but we had enough bankroll we had enough collections from the other Clinic we we could do that at that time a lot of other private practices cannot do this so this is one of those situations where I would tell you don't stick with a failing billing company but figure out yours your your plan to split before you actually are in that situation understand are you just going to make a clean break are you gonna buy your AR and accounts receivable from them since they would you had agreed to pay them the percentage they would have collected that percentage they were willing to continue to do the work is there a genuine breach of contract like just because somebody is making more mistakes than you like doesn't mean that they necessarily need to um or that they necessarily would qualify as a breach of contract and you can just outright fire them and not pay them the money that's due to them I know in a lot of cases I find it's easier to just negotiate if they were going to get five percent you negotiate a three percent payout you take all the accounts receivable in-house and you just pick up from there but it is a sticky situation now going to the other question that came in how do I find a building company I can Outsource my billing and collections to this particular individual was doing primarily Medicare and Medicaid no other plans no non-federal plans or Medicare Advantage plans and my question was do you do you really think that you should be Outsourcing is there any chance you can find somebody in your local network in your family in your circle of friends who's looking for a part-time work who could maybe do something like this because the reality is Medicare especially Medicare is absolutely like it should be less than a tenth of a percent of error rate in a typical calendar year for medic care claims you might forget an occasional 59 modifier the ncci edits have become so easy nowadays there's hardly ever a problem with edits um maybe you forget a KX modifier and you just need to reopen the claim and add it back on like there's a couple Logistics that do come into play but once you create a system once you make a mistake you make the first mistake you resolve that first mistake you create a system to avoid that mistake ever happening again you should never have a problem now that you know if if I was doing billing for just Medicare potentially Medicaid depending on your state and depending on if you're just doing state-run Medicaid or Medicaid managed Medicaid plans that does get a little bit more tricky but I I would tell you that you know most billing companies are not going to accept a small sole owner operator they're they're just too much work for too little pay you know if you're doing a hundred thousand a year in in Revenue a billing company is going to make seven thousand dollars there is no chance that billing company can afford to make seven thousand dollars gross off of your account and even if you went to two 200 000 they're gonna make fourteen thousand if you go to three hundred thousand for a sole single owner operator 300 000 is a pretty high number it's doable totally doable but it's a high number and the billing company is still only going to generate twenty one thousand dollars a year on your account and if you're having enough problems with your account and Company is going to have a bunch of headaches and they're not going to want to deal with you so it really is one of those situations that for you to find a billing company at that level it's probably going to be someone who's desperate and they're probably not going to do that great of a job you know because they are going to be losing money accepting your account you I would encourage you to strongly consider figuring out a way to bring the billing in-house to do it yourself especially if it's just Medicare and and the occasional Medicaid referral I I think it's in your best interest but guys these are the kind of questions I love to get because it gives me a chance to see what you guys are thinking about what you guys are struggling with if you have questions like this absolutely post it in the YouTube comments below and I'll catch you on the next video