Physical Therapy Billing Compliance | Can you reduce your audit risk?

Shannon could have thought of better ways to spend those $30,000 with her husband, Mike, and their two small daughters, Heather and Laurie. Like taking that vacation to Europe as they had always wanted. Or buying a new family car so Mike would not have to drive the old, rusty van anymore.

It seemed like failing that audit last month caused a wound that just would not heal. After paying her fine, she also had to return the money she had already received for her failed claims, pushing her further down the proverbial rabbit hole. Unsure what the future would bring for her physical therapy practice, she held on to the hope that she could emerge from this audit nightmare with a better way to stay compliant. She just did not know yet how to go about it.

“Have you been worried about compliance since you got audited last year?” Shannon asked her friend Ariana, whose physical therapy practice was thriving after last year’s brush with disaster. “I am trying to figure out how I can improve my compliance so that I can avoid another failed audit.”

Ariana smiled and said:”Yes, of course, but I have learned that we really can’t avoid an audit. So I decided to cut down my error rate to reduce my audit risk. PTs can absolutely not afford to have any unsigned notes, unbilled visits, missed re-exams, or denied claims as number one rule. So you have to find a way to track these meticulously.”

“Ok, but it seems impossible to even remember all the different insurance protocols for each patient,” countered Shannon. “It is so confusing to keep track of all the requirements, and just when you think you get it, they change everything again.”

“That’s true,” Ariana admitted. “I also realized that many of those so-called compliance experts give advice that is really difficult to implement, not to mention that they all tell you something different.”

“So how can we get it right then?” Shannon asked. “I can’t gamble with the future of my practice and need a bulletproof process to stay compliant.”

How do you manage your: 
Unsigned notes
Unbilled visits
Missed re-exams
Claim errors