Physical Therapy Practice Management | Referrals and Patient Flow

“If I haven’t had a patient from this doctor in a while, I’ll hit him with a text message, “Hey do you want to go out and have dinner, haven’t seen you in a while.” Keep that relationship strong, that’s the key.”

– Mike Walsh, PT
Dover, Delaware

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Michael Walsh, PT: I know who’s sending me patients.
Jason Barnes: Is it important to know, in terms of physical therapy practice management?
Michael Walsh: Absolutely, my network of providers. I have a network of 17 doctors and p.a.’s and nurse practitioners sending me patients. I have the benefit of having all of their cell phone numbers on my phone and I can communicate with them. So if I have a question with a post-op and I think a knee is infected, I can call the doctor. If I have a post-op back patient, and I think the patient is being non compliant, I can call him, right then and there. If I haven’t had a patient from this doctor in a while, I’ll hit him with a text message, “Hey do you want to go out and have dinner, haven’t seen you in a while.” Keep that relationship strong, that’s the key. They all trust me, they all know I’m good but they all trust me, and I can call them. They give me their cell phone number.
Jason Barnes: How do you know who is your biggest referral source?
Michael Walsh: I can look at the system and roll my cursor over and see who is there. I just know ahead of time who is my first. I would say right now at this moment, Dr. Hamblin is probably up there, Dr. Spangler is there. You know right now I have such and such from this guy and I haven’t seen any from this guy, I need to go knock on his door and see how he’s doing. We need to go out for dinner and find out whats going on and go fishing, you know. Keep that relationship strong. Because if I’m not doing it somebody else is.

PT Clinic Control 5 | People, Process, and Technology

Physical Therapy Software | Practice Management  Work Smarter, Not Harder

By Chris Martin

A physical therapy practice owner must get used to thinking about his or her time in terms of revenues and costs, and a successful enterprise must generate more revenue than costs. The top three reasons for sub-optimal practice performance are problems in any of the components of the service: namely, process, people, and technology. When the physical therapy practice owner neglects any one of them or fails to operate all three of them correctly, the practice starts bleeding cash.

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Control is the key. The people component is about control, and it starts with the owner.

Control is also the most important part of technology – and it too starts with the owner. Control is always about your ability to make changes to your process, people, and technology so that you are on track to accomplishing your long term financial goals for the practice.

If your technology does not support your processes and your people, and if you are unable to customize it, to tweak it every time when you make a change to your processes or your staff, then your technology will impede you and prevent you from reaching your goals.

Next, practice owners’ time is the most expensive component of their practice. Obviously, when they spend that time seeing patients, they maximize their value; and when they write notes, they reduce their value.

The cost of visit physical therapy documentation is much higher than just the cost of the SOAP system because it takes YOUR time to document. You need to compute the cost of writing a SOAP note. Actually, you need to compute the cost of writing all your SOAP notes for the next ten years.

Process optimization puts it all together. This highly effective process results in a “working smarter not harder” atmosphere.

Physical Therapy Practice Management | Business Plan Checklist

physical therapy practice managementA physical therapy clinic, rehab company, or any smart business owner should always start with a business plan. It will help you stay focused on your end product through actions and results. Your business plan will help you decide who you will service, where you will do it, how it will be funded and what your overall vision will be.

The following article published by ’ My Own Business .org’ will give you a brief overview of a business plan and what items it may contain. For detailed information, contact your local Small Business Association.

’The primary value of your business plan will be to create a written outline that evaluates all aspects of the economic viability of your business venture. It will be valuable in number of ways.

Here are some reasons not to skip this valuable tool and road map:

  1. It will define and focus your objective, using appropriate information and analysis.
  2. You can use it as a selling tool with lenders, investors, landlords and banks.
  3. Your business plan can uncover omissions and/or weaknesses in your planning process.
  4. You can use the plan to solicit opinions and advice.

Here is a checklist to help you get started:

  1. Write out your basic business concept.
  2. Gather all the data you can on the feasibility and specifics of your business.
  3. Focus and refine your concept.
  4. Outline the specifics using a “what, where, why, how” approach.
  5. Put your plan into a compelling format
  6. Here are suggested topics you can tailor into your plan:
    • A Vision Statement: This will be a concise outline of your purpose and goal
    • The People: Focus on how your experiences will be applicable. Prepare a resume of yourself and each of your key people.
    • Your Business Profile: Describe exactly how you plan to go about your intended business. Stay focused on the specialized market you intend to serve.
    • Economic Assessment: Provide an assessment of the competition you can expect in your business.
    • Cash Flow Assessment: Include a one-year cash flow projection that will incorporate all your capital requirements.

Physical Therapy Billing |Turning Visits into Cash

Physical Therapy practice management cash_paying_Patient“If you can’t get paid for the work you do, you can’t pay your staff, can’t pay your rent, and you can’t provide good quality service.” – David Alben, Clinic Director, Axiom Physical Therapy and Occupational Therapy Tuckahoe, New York

Axiom PT & OT sees 850 monthly visits and has six full time PTs, two OTs, and six administrative staff. David Alben tells Jason Barnes how bestPT helps Axiom meet all of their objectives.

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David Alben: You know, trying to get your arms around the receivable is a huge problem. I run a healthcare consulting practice, and I see this time and time again. Which claims have been paid, which claims haven’t been paid? Who owes you the money, how long have they owed you the money? The whole issue between insurance approved amount, usual customary charges, all of those things are confusing.
Jason Barnes:Why do insurance companies make it so hard to get paid?
David Alben: I think that insurance companies have placed barriers to payment because it’s in their business interest to do that.

Intentional billing complexity

I don’t have a problem with that as long as everybody understands the rules going in. Each of the individual payers has their own twists and turns and hoops they make you jump through to get paid. So what works for insurance company X is not going to work for insurance company Y.

Insurance companies profit on the float

We are in the business of getting paid to provide excellent physical therapy and occupational therapy. It’s a reality of running a healthcare company these days. If you can’t get paid for the work you do, you can’t pay your staff, can’t pay your rent, and you can’t provide good quality service.
Jason Barnes: Why did you select bestPT?
David Alben: You know over the years, in various different businesses, we have gone from manual systems, literally paper claims, to home grown systems, to other commercially available systems. And many of them have good and bad points.

All-in-One Solution for Practice Management

It has really been hard to find one system that galvanizes of the different components of running a physical therapy practice, the front end stuff, collecting the demographics, having a schedule that is easy to use and understand, and then the whole back end procedures of turning those visits in to cash!

Physical Therapy Practice Management | How to Grow Your Small Business

physical therapy practice managementWhen you are just starting out as physical therapy practice owner, staff training should be one of your top priorities. Having a skilled, well-versed staff will ensure a) they are intimate with your company products, services, and mission, b) they can contribute to the growth and expansion of the business, and c) know how to properly handle problems and conflicts that may affect the business.

Patient retention should always be a top priority. Getting new patients will be irrelevant if you can’t keep your current ones. Not to mention, it is cheaper to keep current patients than try to attract new ones. Follow through on your commitments and keep the lines of communication with your patients open to build relationships.

Focus your marketing dollars where you will get the most bang for your buck. From direct mail marketing to podcasts to Google AdWords, there is an advertising solution for every business budget. Finding the right one may be a bit tricky, but research your options, find out pricing, and calculate your ROI.

Protect your small business assets and implement an online backup solution. Online backup is the most simple, convenient, and affordable way to protect valuable business records and intellectual property. And many services provide unlimited backup for a low monthly fee. Not having important documents backed up could mean the end of your business should something (or someone) damage your network.

Have a professional website designed made for your business. These days, the internet has become an integral part of business and virtually everyone uses the internet to research and check references. Your website will be a direct reflection of your business, so you want to make sure you have something that is professional, user-friendly, and eye-catching. Furthermore, if you are hoping to garner new customers from your website, you will need an effective internet marketing campaign in place to create a robust and noticeable presence online.

Source: Ezine Articles, By Holly Matheson, Small business section

PT Clinic Control 3 | Costs-Benefit Analysis of Documentation

Best practices for physical therapy billing

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Chris Martin: So, are you saying that the cost of visit documentation is much higher than just the cost of the SOAP system [as part of the physical therapy billing process] because it takes YOUR time to document?

Dave Macolino: Precisely. The practice owner’s time is the most expensive component of their practice and they should be maximizing that value. Obviously, when they spend that time seeing patients, they maximize their value and time writing notes, reduces it.

Chris Martin: So, how do you compute the cost of writing a SOAP note? More importantly, how do you compute the cost of writing all your SOAP notes for the next ten years?

Dave Macolino: A successful enterprise must generate more revenue than costs and a practice owner must get used to thinking about his or her time in terms of revenue and cost.

So, the first question is: what is the cost of your time?

The answer depends on your productivity. Suppose your practice can handle 4 patient visits per hour and it requires you personally to supervise them for 15 minutes each. If an average visit pays $80, then your hour is worth $320. So, in this case, your optimal performance is $320 per hour.

That also means that if you spend your time on other activities that earms you less than $320 per hour, you’re losing money.

The amount of money you’re losing depends on the time you spend not generating $320 per hour. So, if you can only write 2 notes per hour then each note basically costs you $160. If you are writing 200 notes a month, then you lose the time equivalent of $32,000 a month! Extrapolate this forward to 10 years, and you get to $3,840,000 or very close to $4 million dollars in lost productivity and earnings!

Chris Martin: OK, I got it. It costs millions of dollars if I use a slow documentation system. So what should I do now? It all seems so confusing…

Dave Macolino: It’s not so much a slow documentation system as it is a system that has a flow of information and is set up with consistent phrases and measurements that are often used in the daily notes.

This computation is just an example of how you should think about your costs of any activity. Once you identify all your activities and attach cost to each one of them, you can focus on those activities that matter the most and eliminate or optimize those that don’t.

You can also set very clear requirements for the kinds of processes and systems you need to have in your office to help you spend as much time generating $320 per hour and very few hours that generate less or even worse, cost you as high as $320 per hour.

Think about it this way. If you personally spend 1 hour a week on practice administration and 3 hours a week on say billing, then over the next 10 years, you will spend the equivalent of $640,000.

So now you can add up all of your costs (add office rent, equipment, staff costs) and start thinking about what processes and systems do you need that reduce these costs?

Since documentation, administration, and billing are the largest components of your cost, then you need to design processes and install a system in your office that address these costs first.

Physical Therapy | Should I start a new business or buy an existing one?

Are you interested in buying an existing Physical Therapy practice or do you have what it takes to start a rehab company of your own? Only you can decide! This article from the Small Business Association can help.

Don’t let insurance reimbursement stop you from fulfilling your dreams of owning your own business. BestPTcan take all the insurance reimbursement worries away. You can start up your new practice or sign up an existing practice to take advantage of our Outsource Billing Service and our Automated Practice System. article to follow:

Buying a Business

Many find the idea of running a small business appealing, but lose their motivation after dealing with business plans, investors, and legal issues associated with new start-ups. For those disheartened by such risky undertakings, buying an existing business is often a simpler and safer alternative.


The main reason to buy an existing business is the drastic reduction in startup costs of time, money, and energy. In addition, cash flow may start immediately thanks to existing inventory and receivables. Other benefits include preexisting customer goodwill and easier financing opportunities, if the business has a positive track record.


The biggest block to buying a small business outright is the initial purchasing cost. As the business concept, customer base, brands, and other fundamental work have already been done, the financial costs of acquiring an existing business is usually greater then starting one from nothing. Other possible disadvantages include hidden problems associated with the business and receivables that are valued at the time of purchase, but later turn out to be noncollectable. Good research is the key to avoiding these problems.

Article source:

Tips for Aspiring Physical Therapy Entrepreneurs

If you opt to launch your own practice in physical therapy (PT) or occupational therapy (OT), you’ll need a brain for business and a knack for marketing yourself. Don’t take the plunge without evaluating whether your potential business has what it takes to stay afloat.

Here are six tips for aspiring therapy entrepreneurs.

Ask Yourself the Hard Questions

Not everyone is cut out for entrepreneurship. Physical therapist James Glinn Sr. recommends asking yourself two key questions: Do you have a passion to own a business? Do you have a work ethic beyond the 9-to-5 mentality? You must answer yes to both questions to succeed with your own practice, says Glinn, who is coauthor of Private Practice Physical Therapy: The How-To Manualand owner of FutureRehab, a healthcare consulting company in Bakersfield, California, that specializes in practice management.

Private practitioners may also have to deal with fluctuating income, especially during their first months on their own. They must possess “the ability to take risks,” says occupational therapist Jane Koomar, PhD, executive director and owner of Occupational Therapy Associates — Watertown, PC, in Watertown, Massachusetts, and author of Plan for Success: A Business Workbook for the Occupational Therapist in Private Practice.

Examine the Marketplace

The demand for physical and occupational therapists is strong, but you should still use business smarts when determining the type and location of your venture. Glinn recommends performing a market survey to evaluate the need for your type of services in a specific area. Too many physical therapists focus on popular niches like sports or manual therapy in areas that are already saturated with qualified practitioners.

According to Glinn, the market may be poor for new practices in idyllic locations like San Diego, but outstanding in outlying and semirural areas. “The more desirable an area, the more competition you will have,” he says.

Gain Some Business Savvy

You don’t need an MBA for your practice to succeed, but you do need to understand how to operate a business. You’ll need to know the difference between a sole proprietorship and a corporation, Glinn says. You’ll also need to learn tax laws, coding and reimbursement methods.

Koomar notes that some small private practices are private-pay only; they do not accept insurance. Practitioners give receipts to patients, who try to get reimbursed. If you do decide to accept insurance, be prepared to ask for help with your billing. If you can’t afford to hire your own billing coordinator, Koomar recommends using an outside billing agency to collect what you’re owed. “You have a better chance of getting reimbursed if you’ve got individuals or groups of individuals working on your behalf who have knowledge of how third-party reimbursement is working in your area,” Koomar says.

Sell Yourself

When building your practice, one of your top priorities should be developing strong relationships with referral sources. While lawyers, dentists and other professionals can expect long-term relationships with clients, PTs and OTs tend to have patients for shorter periods. “From a business perspective, your referral sources are just as much your clients as your patients,” Koomar says. “You want to nurture and care for them in the same way you do your patients.”

Your referral sources may include physicians, other PTs and OTs, mental health professionals, social workers, teachers and many others. Koomar recommends ongoing communication to maintain strong relationships with referral sources. Koomar’s company sends referral sources regular newsletters and letters. Referral sources also get free passes to educational workshops and talks Koomar’s company sponsors.

Put Your Patients First

It goes without saying that private practices live or die based on the care and attention you lavish on your patients. Don’t forget that small gestures can have a big impact in a private-practice setting, Glinn says. For example, you should go out of your way to create a pleasant clinic atmosphere and make your hours convenient for patients, Glinn says.

Seek Help

Both the American Physical Therapy Association and the American Occupational Therapy Association have private-practice sections that offer help and mentoring to new entrepreneurs. The US Small Business Administration also offers advice on topics ranging from financing to marketing on its Web site.

Article source by Megan Malugani

Monster Contributing Writer

BestPT can help you start up your new Physical Therapy practice right with our unique outsourced billing service and automated practice system. Don’t spend your time fighting the insurance companies put your hands back in the clinic!

Top 10 Physical Therapy And Rehabilitation Golden Opportunities!

Physical Therapists and private practice rehabilitation owners continuously struggle with ways of marketing their services to the community where they provide services. We advertise, develop web sites and create elaborate marketing materials. In this marketing campaign, we often overlook our most valuable resources; ourselves and our staff.

Every day, in every thing we do, we are presented with opportunities to market our Physical Therapy service, skills and knowledge. Simple opportunities present themselves when attending local sporting events, going to a doctor visit with your child, or even offering words of advice to a local community group. When presented with these opportunities, it is important to remember to take a moment to make a connection with the other person and use the strategies listed below to make a lasting, positive impression. Making a good first impression is a singular opportunity! An opportunity which can change the profitability and success of your Physical Therapy and Rehabilitation practice.


1. Provide written schedule of appointments-A written schedule of appointments will improve the customers’ attendance by decreasing opportunities for cancellations due to not remembering the date/time of the appointment, location or phone number to call and reschedule.

2. Discuss what to strive for/goals-establishing goals with the client in cooperation with the Physical Therapist clarifies what therapy can and can not do for the client. A clear level of communication and expectations are established.

3. Provide written information-Home exercise programs, internet and written references provide ongoing learning at the client’s own pace and contributes to the client’s increased level of responsibility for their own success.

4. Start and end your session on time-Respect your client’s time and they will respect your time in return.

5. Send reports in a timely manner-Documenting treatment and delivering this information to the team of care providers effectively and efficiently helps to manage the timeliness of treatment protocols.

6. Discuss other therapies and their benefits-An informed client who makes their own choices will participate in the therapy plan of care with an increased level of commitment and success.

7. Serve as a referral source for family/client-The Physical Therapist is the coach. We must help the client access and successfully utilize the resources in their community in an appropriate manner to compliment, support and eventually be a replacement for the physical therapy program once they have achieved their rehabilitation goals.

8. Look for opportunities to promote yourself, coworkers and services-You are your own greatest advocate! Share conferences you have recently attended, materials you have read, and provide access to information your coworkers and team-mates are learning!

9. Provide business cards to contacts-Business cards do more than share vital statistics about credentials and contact information. They are a tangible reminders of your interaction which represent you and your company.

10. Send thank you note in appreciation for the visit-Common courtesy and appreciation are hallmarks in treating our clients with respect.

Physical Therapists and Rehabilitation practice owners can use the Top 10 Daily Golden Opportunities to market their services and skills. They take very little time or financial resources to implement. If you consistently capitalize on everyday opportunities, you may find the “small” impressions you make today will take root and grow into big returns in the future.

Gerilyn M. Gault, BSPT, is co-owner of the rehabilitation company and Account Specialist for bestPT. Gerilyn is an advanced neurological clinician with years of experience in professional staffing, private practice, contract and fiscal management.

Fair OT Coverage Under Medicare: LCDs FAQ

rehab, PT, physical therapy, software, billing, notes, SOAP notes, EMR, rehab-software, rehab-billing, rehab-notes, rehab SOAP notes, rehab-EMR, PT-software, PT-billing, PT-notes, PT SOAP notes, PT-EMR, Physical Therapy software, Physical Therapy billing, Physical Therapy notes, Physical Therapy SOAP notes, Physical Therapy EMR How to Advocate for Fair OT Coverage Under Medicare: LCDs FAQ

Regional Medicare Local Coverage Determinations (LCDs) are undergoing some changes. Under the Medicare Program, Medicare contracts with regional corporate entities that process and pay claims for services provided in their regions which may range from one state to multiple states to parts of states. These entities, usually insurance companies, have in the past been called “carriers” or “fiscal intermediaries” but due to recent legislative changes are moving to be called Medicare Administrative Contractors (MACs). This article presents key issues about LCD changes already underway, and opportunities for advocacy.

What is an LCD?

LCDs are coverage and payment policies that have been used by current carriers and fiscal intermediaries but will also be used in the regions covered by the new MACs to interpret national Medicare policy issued by the Centers for Medicare and Medicaid Services (CMS). LCD coverage policies may be based on discipline (e.g., an LCD might be titled “occupational therapy” or “physical medicine and rehabilitation”) or type of service (e.g., wound care services; dysphagia services and so forth).

What is Changing?

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) enabled CMS to make significant changes to the Medicare fee-for-service program’s administrative structure. The key feature is that the MACs will gradually be identified over the next several years to replace the old carriers and fiscal intermediaries. Under the law’s provision for Medicare Contracting Reform, CMS will integrate the administration of Medicare Parts A and B into one regional entity-a MAC. All Part A and B fee-for-service claims will be processed through these new entities. As part of the reform, CMS is conducting open competitions to replace contractors but it will take time. Affected regions are being phased in from 2005-2011.

What is Affecting Occupational Therapy Now?

The MACs are currently being selected and as part of the reform process, LCDs are under review. As MAC contracts are awarded to local Medicare contractors, these contractors are re-examining existing LCDs that govern Physical Medicine and Rehabilitation policies in their coverage region and are consolidating and revising the LCDs, typically through a stakeholder notice and comment process.

What Should Occupational Therapy Practitioners Do About the Changes?

The changing contracting process is one reason for the recent explosion of open LCDs and requests from new MACs for therapists to provide comments on an LCD. LCDs are required to allow for some public comment. It is imperative that practitioners follow the changes in the process and entities that affect their Medicare billing by watching the Web sites of current and new entities.

While some LCDs recognize the full scope of occupational therapy practice, LCDs frequently present inappropriate or erroneous information on the occupational therapy scope of practice and that of other therapy disciplines. Further, these inappropriate LCDs may lead to AOTA members receiving widespread Medicare denials of claims for services that occupational therapists are educated and licensed to provide. There have always been efforts made by therapists and sometimes state associations to affect and change LCDs; AOTA also weighs in with comments on many LCDs. With the many changes now happening, it is important that all in the field watch what entities are doing to protect occupational therapy practice, payment, and scope of practice. The best source of information is the Web site of your current fiscal intermediary or contractor. Changes to MACs will be posted there.

What Materials Are Available to Help Me Be an Advocate on LCDs?

AOTA wants to provide members with the following tools and resources to respond to requests for comments on LCDs:

  • LCD Advocacy Packet: This packet provides the materials and resources necessary to enable state associations and individual practitioners to monitor and advocate for OT services under Medicare, critical fact sheets, AOTA official documents, and sample LCD comment letters are included.
  • Medicare Benefit Policy Manual – Presents frequently used citations. (See Chapter 15)
Chapter / Section / Subsection / Title
15/220 – Coverage of Outpatient Rehabilitation Therapy Services (Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services) Under Medical Insurance
15/220.2 – Reasonable and Necessary Outpatient Rehabilitation Therapy Services
15/220.3 – Documentation Requirements for Therapy Services
15/230 – Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology

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