physical therapy billing network

Welcome New Members to the bestPT Team in July

Five New members joined bestPT in July 2015.
Each new member benefits from and contributes to our network strength.
Let’s welcome bestPT’s newest members!

  1. Jackie Hellinger and Kim Burke of Big Sky Pediatric Therapy, Austin, TX.
  2. Gwenn Lillie of Bounce Physical Therapy, Liverpool, NY.
  3. Ann Short and Adriana Muzquiz of Kid’S Creek, Suwanee, GA.
physical therapy billing network

Welcome New Members to the bestPT Team in June

Five New members joined bestPT in June 2015.
Each new member benefits from and contributes to our network strength.
Let’s welcome bestPT’s newest members!

  1. Melissa Riddel and Kacey Heidemann of Big Sky Pediatric Therapy, Austin, TX.
  2. Megan Balkenbush of Bit-By-Bit, Fort Lauderdale, FL.
  3. C Taylor of Melwood Rehabilitation Center, Upper Marlboro, MD.
  4. Jennifer Bush of Tim Soder Physical Therapy, Las Vegas, NV.
physical therapy billing network

Welcome New Members to the bestPT Team in May

Five New members joined bestPT in May 2015.
Each new member benefits from and contributes to our network strength.
Let’s welcome bestPT’s newest members!

  1. Melanie Henderson of Big Sky Pediatric Therapy North Star, Round Rock, TX.
  2. Kayla Crosbie and Megan Van Winkle of Big Sky Pediatric Therapy, Austin, TX.
  3. Cristina Albistu of Bit-By-Bit, Fort Lauderdale, FL.
  4. Jamie Kelly of Mike Walsh Physical Therapy, Milford, DE.
physical therapy billing network

Welcome New Members to the bestPT Team in April

Six New members joined bestPT in April 2015.
Each new member benefits from and contributes to our network strength.
Let’s welcome bestPT’s newest members!

  1. Brenda Cabrera and Iris Ceballos of Axiom PT & OT Plus, Tuckahoe, NY.
  2. Anna Chmiel and Candace Cross of Big Sky Pediatric Therapy North Star, Round Rock, TX.
  3. Natalie Leonard of Big Sky Pediatric Therapy, Austin, TX.
  4. Ieasha Akins-Woods of Kid’S Creek, Suwanee, GA.
new members in bestPT billing software

Welcome New Members to the bestPT Team in March

13 New members joined bestPT in March 2015.
Each new member benefits from and contributes to our network strength.
Let’s welcome bestPT’s newest members!

  1. Courtney Kuehn, Joni Scaparra, and Madeline Ragan of Big Sky Pediatric Therapy, Austin, TX.
  2. Jeremiah Jorgensen of Center For Spine & Sport Rehab, Lincoln, NE.
  3. Emily Stanley of On The Move Pediatrics Therapy, Lexington, KY.
  4. Denise Tavares, Katy Bowers, Regina Yusupov, and Suresh Babu of Innovative PT & Fitness Center, Monmouth Junction, NJ.
  5. Kellie Abramovitz of Kalispell Rehab, Kalispell, MT.
  6. Rebecca Sabo and Victoria Mitchell of Kid’s Creek, Suwanee, GA.
  7. Shannon Rothwell of Midlothian Village Physical Therapy, Midlothian, VA.

Physical Therapy Billing Examples: 5 Little Mistakes That Cost A Physical Therapy Practice $634,837

5 Common Processing Mistakes You Can Check Right Now…

PHYSICAL THERAPY PRACTICE TO RETURN $634,837 UPON FAILING AN OIG AUDIT

In August 2014, the Office of Inspector General (OIG) released a report of the audit that had been conducted on an Illinois physical therapist. Their review sampled 100 random claims out of the 4,298 Medicare outpatient physical therapy services, totaling $645,966, that had been provided between January 1 and December 31, 2011.

The audit found that 99 of the 100 claims in their random sample contained more than one deficiency. Therefore the government extrapolated the failure rate from the sample and applied it to the entire paid claim population.  They are now seeking a refund of $634,837. In other words, the government does not seek a refund for the 100 claims survey but rather for all the claims submitted assuming that they have the same error rate.

Moreover, these sample claims were subjected to a very high level of scrutiny.  The report details the deficiencies as follows:

  • 97 claims did not meet Medicare’s plan of care requirements (Goals not measurable, invalid or missing Therapist’s Signature, and incomplete or no Plan of Care)
  • 95 claims did not meet Medicare’s treatment note requirements (Missing specific Skilled Intervention, unsupported number of Units Billed, Invalid Therapist’s Signature, and Billed Code not in Plan of Care)
  • 49 claims had progress reports that were untimely or not contained in the medical record (Progress Reports not made at least once every 10 Treatments, and No Progress Reports)
  • 44 claims had therapy services that were not medically necessary (Goals in Plans of Care were unmeasurable, Invalid or Missing Certification of Plan of Care, Did not meet Medicare’s Physician Certification requirements, Documentation failed to support Medical Necessity, and PT was repetitive/no evidence that Skilled Therapy Services were needed)
  • 39 claims did not meet the Medicare physician certification standard (Plan of Care not signed by Physician, Physician Certification not dated, and Untimely Physician Certification)

To review the full OIG report go to http://oig.hhs.gov/oas/reports/region5/51300010.pdf.

To improve your chances of surviving an OIG audit, make sure to clearly establish medical necessity, prove that skilled therapy services are performed, and that those services are both reasonable and necessary. Studying physical therapy billing examples, expert guidance, and periodic self-audits in tandem with an automated professionally built and ONC-certified documentation system will help you achieve this goal effectively and efficiently.

 

Three Key Compliance Skills for Physical Therapy Practice Management in a BestPT Training Webinar

Industry leaders unveil tested strategies to increase office compliance and save health care practices time and money in this short webinar.

PTcompliance

 

BestPT’s new short webinar reveals three effective methods to increase compliance in the office, thus saving physical therapy practice managers time and money. The webinar is available online and can be watched or listened to at any time – request access below.

“Ninety healthcare providers were charged with compliance violations reaching $260 million in billing in May 2014. A growing number of practices are subjected to audits and penalties.” says Reuven Lirov, Chief Practice Growth Officer at Vericle. Physical therapy practice owners too struggle to maintain compliant practices against a tangled web of regulations from insurance companies, the government, Medicare, and Medicaid.

According to Lirov, mistakes and oversights in the office are a regular occurrence in most healthcare practices. “Physical therapy practice managers face severe problems posed by compliance issues such as the increased risk of audit failure, growing compliance complexity, and lack of time to learn and implement new procedures based upon new rules.” says Lirov.

Lack of compliance is a serious issue that can lead to substantial loss of revenue and fines. For example, a practice might see 100 patients a day, or approximately 25,000 patients a year. Suppose just 0.4% of those visits (100 visits) are undocumented. Each of those unbilled visits would be marked as a “fail” in the audit, with a resulting penalty of $10,000 per line item — or $1 million in audit penalties.

“Better compliance liberates physical therapy practice owners from worrying about fines and audits, and lets them get back to treating patients. “ says Lirov. “Physical therapy EMR software helps practice owners stay compliant and grow. Our average clients have seen substantial growth in their practices including an average revenue growth of 186%, patient growth of 141%, and patient lifespan increase of 86%.”

According to Dr. Amy Vant, DPT, BestPT has built in safeguards that help maintain a more compliant office and simplify physical therapy practice management. “As therapists, we are continually looking out for the best interests of our patients. We don’t really have the time to review our daily notes, evaluations, and billing documents to ensure that we have checked all of the right boxes and marked all of the right codes. We need a double-checker because we certainly don’t have time to do it. With Best PT, I have found that everything I need in an evaluation or daily note is available and the system even cues me to testing items that I may have forgotten.” says Vant in her article about physical therapy EMR onboarding experience.Physical Therapy EMR Compliance

Physical therapy practice managers face severe problems posed by compliance issues such as the increased risk of audit failure, growing compliance complexity, and lack of time to learn and implement new procedures based upon new rules

Continuously increasing compliance requirements and lack of time do not excuse physical therapy practice owner during a practice audit. A short thirty minute webinar teaches the three most important practice management skills to save a physical therapy practice and avoid audit failure penalties. The webinar includes a demonstration of bestPT physical therapy practice management software. It contains automated features to discover the most frequent documentation errors that lead to compliance issues, such as undocumented visits, unsigned notes, and late billing. The software is also browser-based, so it can be changed as the law changes without inconveniencing the practice owner. Click here to sign up for the free webinar and find out more information.

About bestPT and Billing Dynamix, LLC
bestPT by Billing Dynamix, LLC is a comprehensive cloud-based Practice Management system that includes intuitive EMR, effective billing, scheduling, and powerful yet simple workflow management. Save documentation time and keep legible and compliant documents. Automate claims and leverage over 2.5 million coding rules spanning 2,500 practice-years of experience. Reduce administrative overhead and foster staff teamwork. bestPT is the ONLY PT clinic solution that reduces administrative time by 70% compared to industry averages,  GUARANTEED. Complete practice management consulting and a rich array of integrated products and services round out bestPT product and service packages. Register for a private Demo+, and review our industry-leading guarantee at https://bestptbilling.com

 

new members in bestPT billing software

Welcome New Members to the bestPT Team

9 New members joined bestPT in Feb. 2015.
Each new member benefits from and contributes to our network strength.
Let’s welcome bestPT newest members!

  1. Nereyda Bueno of Arizona Physical Therapy, Tucson AZ. http://www.azptgo.com/
  2. Brithny Dolcius and Crystal Alcantara of Advanced Physical Therapy And Sports Rehab Lynn MA, http://www.aptsr.com/
  3. Jasmin Gerez of Axiom PT & OT Plus, Tuckahoe, NY. http://axiomptandotplus.com/
  4. Kc Gipe of Kalispell Rehab, Kalispell, MT. http://www.kalispellrehab.com/
  5. Victoria Morgano, Allison Juris, and Caitlyn Bird of On The Move Pediatrics Therapy, Lexington, KY. http://www.onthemovepeds.com/
  6. Krista Marie Alvarez of Prime Therapy And Pain Center Riverside, CA. http://www.primetherapy1.com/

CPT Codes For Physical Therapy 2012-2014 | Pop Quiz, February 2015

Pop Quiz:
Which two CPT codes combined were more than 50% of all claims from 2012-2014?

Answer: 97110 and 97140.

In the BESTPT billing network, what CPT codes were used during 2012, 2013, and 2014?

We saw some minor variations that can be attributed to Medicare regulation and reimbursement strategies. We saw more use of 97140 (Manual Therapy) from 2012-2014,  and less use of 97530 (Therapeutic Activities) for that same time period.

The average CPT collections per unit was $24.47 in 2012, $23.60 in 2013, and $23.82 in 2014. This is an average reduction of 3.5% from 2012 to 2013 and a modest 0.9% increase from 2013 to 2014.

CPT code pay per unit 2012-2014

CPT Codes Pay Per Unit 2012-2014

Read the full CPT story. Download the CPT Analysis eBook

 

I got so busy, my right hand didn’t know what my left hand was doing.

TodoPT_New

Have you ever been so busy that your right hand didn’t know what your left hand was doing?  It works for this cartoon, but I think this is talking more about a PT practice owner who can’t keep up with what his staff is doing.  If you used the bestPT billing software and a task manager, then a PT practice owner could actually see what everyone’s hands are doing. Have a laugh with “It’s a Stretch,” our weekly physical therapy cartoon. And be sure to let us know what you think in the Comments section. Share it with friends, colleagues and co-workers.