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Physical Therapy Software | New Network Members in February 2014

Physical Therapy Software_new-network-members

Ten new members across six practices joined bestPT in February. Each member benefits from the size of bestPT’s network as we use the shared knowledge in the battle against the payers. This proverbial strength in numbers helps you build your dream practice using our physical therapy practice management software, billing, and profitability coaching services.

Let’s welcome bestPT’s newest members:

  1. Angela Craig of Bassett Physical Therapy, Stanleytown, VA.
  2. Holly Mouton and Debbie Allen of Big Sky Pediatric Therapy North Star Llc, Round Rock, TX.
  3. Kaitlyn Wise and Manda Brittsan of Bit-By-Bit, Inc., Fort Lauderdale, FL.
  4. Denny Wongosari, Samantha Wright and Danielle Jenna of Isu Physical Therapy & Sports Rehabilitation Clinic, Terre Haute, IN.
  5. Paul Deforrest of Pts Dover, Dover, DE.
  6. Aura Rivas of Tim Soder Physical Therapy, Llc, Las Vegas, NV.

Medical Billing Book Review: If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently

Fred Lee, the author of If Disney Ran Your Hospital: 9.5 Things you would do differently, has great story-telling talent and a unique combination of first-hand experience working at hospitals and Disney. This book compares the workflows and cultures at both and teaches us how to design modern hospital patient interactions for success. It turns out that his lessons are directly applicable to my physical therapy billing software business.

Whenever a medical billing service owner comes to me for “billing software” they usually mean software to manage what they had. I, on the other had, want to understand how their service is designed and delivered and what the practice owner (their customer) and the patient (their customer’s customer) would expect. It seems to me that if the billing service is sub-par, outdated, or not profitable, we should consider redesigning it before automating it. I believe that the worst you can do to a poorly delivered service is to scale it up and exacerbate an already negative customer experience by delivering it faster to more customers. This often does not sit well with billing service owners who see my expertise limited to selling my software and see my questions about their business approach and growth, compliance, and convenience as needlessly intrusive.

You would think that a billing service owner has a much more difficult customer than Disney; the risk of client loss is higher; the medical billing environment is much more complex with many more non-standard situations. At Disney, the customers start our happy and excited instead of upset and underpaid. They stand in lines but not worried about their insurance claims, patient referrals, or compliance. They take a ride that’s duplicated a million times while every new payer is a unique experience. Meanwhile practice operations, technology, and legal costs are growing. Disney looks like a picnic compared to the nightmare the billing and practice managers face every day in a hostile payer environment over which we have very little of the kind of control we would have at Disney.

This book is practical and profound. Instantly useful.

Physical Therapy Profitability | Staff Compensation Strategies – Part I

physical therapist billing strategyBy Yuval Lirov, PhD, Dave Macolino, and Kevin McGovern, DPT

“It’s ten minutes past eleven at night…Where is Peter?” Alicia asked herself as she woke up from dozing in front of the TV with their daughter, Jessica. She was pleased to hear the sounds of an unlocking door and Peter walking in. He looked exhausted but was happy to carry Jessica to bed. After all, it was a Saturday and he should have had the day off.

Alicia was proud or her husband. He worked tirelessly without counting hours, evenings and weekends, so that he could accomplish his goal of owning his own physical therapy practice and give Alicia the freedom to dedicate herself to raising their two children and continue pursuing her MBA.

Peter opened his physical therapy practice two years ago and built his business from the ground up. Referrals were growing rapidly and he was now seeing 100 patient visits per week. He recently hired a PTA in addition to his administrative staff to help him with his growing case load. His passion was treating patients but his current priority was building his practice and achieve physical therapy profitability. Peter was telling Alicia that in a year or two, he could pull in more than $600,000 a year, perhaps making $6,000,000 over ten years.

“Pete, Jessica was really upset that you missed her soccer game again. All of the other Dads were there.” Alicia said disapprovingly. Peter worked every evening and weekend over the past 3 months. “I don’t understand why you spend every night and weekend in the office,” she said. “Isn’t your staff supposed to be doing most of this work while you are treating? Do they stay late to help you?” she asked.

“I really don’t need this extra stress right now,” he replied. “I can’t pay them overtime to help, and I really can’t sit there and watch what they’re doing all day.”

“You know, Peter,” pressed on Alicia, “It’s clear to me that you’re not managing your staff properly.”

Peter felt like he was punched in the stomach. He wasn’t going to challenge Alicia. For the past two years, she managed to take care of Jessica while pursuing her MBA. Peter started getting a headache.

“You are heads down all day treating patients and not paying attention to what is going on with your staff.” she added. “Last month, you had to replace both your front office person and two months ago, you replaced your biller.”

“You’re paying your administrative staff $12 and hour and you just hired a PTA for $45,000 a year but you’re doing most of the work anyway.” Alicia continued, getting more agitated. “You have to be losing money because of the turnover and salaries and on top of that, you’re never home anymore. If you are going to see 100 patients a week and then spend every night and weekend doing business administration, why have staff at all?” Alicia asked.

“Good question, I don’t know” Peter reluctantly replied.

“Katherine called the other day.” Alicia said.

** to be continued :  Physical Therapy Profitability | Staff Compensation Strategies – Part II

Physical Therapy Billing | Practice Growth

physical therapy billing | practice-growthAn Interview with Shaun Kirk, President of Measurable Solutions
BestPT Physical Therapy practice management software partnered with Measurable Solutions to help clients grow their practices, manage staff and improve overall efficiency and net profits. Dave Macolino reached out to Shaun Kirk, President and Co–Founder of Measurable Solutions. Shaun wanted to know more about our products and services and presented his methodology. We were pleased to discover how Measurable Solutions is a perfect fit for BestPT Physical Therapy Billing Software. Read the press release of the partnership here. 

Dave: What is “Measurable Solutions?” 

Shaun: Measurable Solutions is a management training company. We train private practice owners to better manage their practice, increase their referrals and ultimately their overall net profit. 

Dave: Shaun, you’re a physical therapist, is that right?

Shaun: That’s right. 

Dave: How does being a physical therapist give your company an advantage when working with private practitioners? 

Shaun: We understand this profession. When I first started out as a private practitioner I was a complete failure. I thought that if I kept adding initials after my name my practice would grow. It did not. I realized that the problems I experienced in private practice were not related to treating “Bob Smith’s” back condition. The problems I had were related to getting more new patients, hiring or firing staff, getting paid, billing correctly and more. Clinical skills were not my problem, my lack of administrative skills were definitely creating all my problems. I had to dig myself out of it. I was able to grow my practice by 9–fold and ultimately worked 18 hours a week in my practice. Measurable Solutions takes the knowledge that I gained in growing my practice and we use that knowledge to help other practice owners. 

Dave: You’ve got a line you said when we first met that made me laugh. It’s something like, “When the going gets tough, the owner treats patients.” What do you mean by that? 

Shaun: People are like water. They tend to run in the path of least resistance. The easiest thing to do when all else fails is to go with what you know. What most private practitioners know is how to treat patients. 

It’s like a captain of a ship who is a passionate well–trained chef. He knows how to cook 5–star meals and prefers to do so as his ship runs aground. A practice owner who is also a clinician MUST man the helm of his or her ship if one intends to right that ship. 

Dave: That makes sense. It’s tough to handle office problems when you are treating patient morning to night. Let me ask you, when you begin working with a practice owner to make him or her into a better “captain”, is there a particular format you follow?

Shaun: Sure. We first help the owner drive patients to his or her door. The first part of our Executive Training Program has this as its primary focus. The second step of our Executive Training Program is designed to show you how you can get other staff to get their statistics up. The third step of our Executive Training Program will show you how to get distance from the practice. 

Dave: What do you mean by “distance from the practice?” 

Shaun: Once you have systems in place to drive in new patients, get patients to become more compliant with their treatment program regardless of out of pocket expenses and are able to get large percentages of your new patients referring their friends and family, you’ve really got the results of the first step. 

In the second step, you now have intelligent statistical management throughout your organization. You have an organizational structure and staff who know who does what. You will know who to hire when and for what position and most importantly how to get them as productive as possible in the shortest period of time. The net profit begins to soar. This step is vital. If you have done step one very well and have more new patient rolling in but failed this step, you could have all your profits eaten up by inefficient staff placed into the wrong position, even with a great rise in patient volume. 

In the third step, “distance from the practice”, we focus on financial and remote statistical management so you can find precise problems in your practice without having to be there to “e;put the fire out.” Distance from the practice means the ability to expand the practice without having to be there. At this point the practice owner has a machine that can operate without his direct supervision. 

Dave: Wow! Ok, here’s a tough one: bestPT works with practice owners all the time and many are just plain buried with patient care and fires to put out. What you just covered here seems like it would just overwhelm many practice owners. How do you get all this put into their practice? 

Shaun: When a new client comes into our Executive Training Program the MOST important thing we ask them to do is find a 5-hour block of time during the work week to EXCLUSIVELY work on our Implementation Programs. 

Upon completion of any executive training course at Measurable Solutions, a client is put on an Implementation Program that lays out step–by–step what needs to be put into the practice when he returns home. These Implementation Programs are kept on–line with the client having a login and password to his Implementation Programs. We find that when a client puts in 5–hours a week on the programs the practice begins to run more efficiently, the owner’s time is freed up even more and he or she will begin to find even more time to implement the programs or maybe take a day off. 

Dave: How do you follow up with a client once they return home from your training?

Each client is assigned a consultant. The client’s consultant has a dashboard of all his or her clients and their progress on their Implementation Programs in real–time. If their client is behind schedule the consultant will nudge them along. The emphasis is to push the client to implement the programs. We know that in the beginning, most clients have many “fires” to put out and the consultant really rolls up their sleeves and helps the client. As time moves on the consultant pushes the clients to implement his or her training and the consulting time is more focused in that direction and the client’s need for regularly scheduled consulting reduces and the client becomes his own consultant to their own practice. 

Besides the managing of the clients’ Implementation Programs on–line we also have a cloud-based statistical management program where the consultant can help the client manage by statistics. Their consultant can view the client’s weekly statistics in real–time. There is accountability with our program. This method has produced multi–million dollar growth in many of our clients. Paying for a program and not doing it is a waste of money. We work to ensure your return on investment and pushing you to implement. 

Our “consulting” is mostly geared toward getting the client to implement the tools necessary to better manage their practice. We find that when our consultants spend too much time trying to help a client deal with “Susie” who runs with scissors or doesn’t play well with others, time is lost on implementation and the implementation alone most likely would handle the problem with “Susie.” 

Dave: This was educational. If one of our bestPT clients wanted to work with you guys, how would they go about it? 

Shaun: They would take our New Patient Course. The New Patient Course shows you how to make your practice broadly known for its results in a way that doctors use to evaluate a patient’s results. The course then shows you how to take the conditions you treat the most and make you broadly known as the best in town in the treatment of those conditions. The New Patient Course doesn’t require an owner, who does not have any time anyway, to have to go out and knock on doors to get referrals. 

The New Patient Course stands separate from our Executive Training Program. Someone can do the New Patient Course, apply its Implementation Program and get new patients without doing our Executive Training Program. 

Dave: Can my clients skip the New Patient Course and go straight to your Executive Training Program? 

Shaun: No. Our Executive Training Program is for those who have attended the New Patient Course, have bigger goals and want to grow their organization and have a life and would like our help. The New Patient Course is a requirement to be considered for acceptance into our Executive Training Program. 

Dave: So what’s next? How can our clients contact you? 

Shaun: They can schedule a webinar with one of my New Patient Course consultants. Our consultants can go over the subjects of PR and Marketing as it pertains to the individual’s practice and go over how the New Patient Course could help the competent clinical practice increase its market share and referrals. 

Dave: Thank you Shaun.

Shaun: Thank you.

Physical Therapy Software | teamwork and software usability

“Once you get the hang of it, to open a ticket and send it where on your team it needs to go and just watch how quickly you guys respond back is great.”

– David Alben, Clinic Director, Axiom Physical Therapy and Occupational Therapy, Tuckahoe, New York

David Alben: “The system is really only as good as my ability, or the therapist’s ability, or the receptionist’s ability to use it. And the deeper you get into it, the more you realize what you don’t know and you need to know. The tickets have been a very easy way to learn those pieces.

Once you get the hang of it, to open a ticket and send it where on your team it needs to go and just watch how quickly you guys respond back is great. The level of detail that comes back, so either the response is an actual answer, or usually typically it’s an answer coupled with a link to the academy or elsewhere in Vericle where you can see it in detail and refer back to it, and you know repetitive situation, but that’s how you learn.

 

Because I have worked in different aspects of healthcare, I have a slightly different world view than a clinician might, and you and your team have been very receptive and helpful to me with that. We have talked about it on the phone, we’ve gone back and forth with emails and with the communication package in Vericle and I think that you guys have been very receptive to those thoughts and I have seen some of them be incorporated into the program.

 

Let’s look at our relationship, and I think to your company’s great credit, this is about the money, and it’s ok to be about the money, and the fact that the business model that your company has come up with, links your interest and our interest, then what ever bumps that we come up on, it’s to our mutual benefits to fix them, smooth them out together.”

Physical Therapy Practice Profitability | Real Cost of EMR

Calculate physical therapy practice profitability by discovering the real cost of documentation and EMR.

“The real problem is that even with a 20-minute SOAP note, I need a tremendous amount of time just for documentation. Peter wearily continued, “If I had 4,000 visits a year, I could make $312,000 a year. But even with the best documentation system I would need an hour to document 3 visits. That’s 1,333 hours a year just for documentation!”

“Wait a minute, Peter,” Alicia said, raising her voice. “those 1,333 hours ARE the evenings and weekends you miss with your family. When you see patients, your average revenue is $156 per hour. But when you document their visits you make zero, nada, zilch! Peter I think our mistake is that you only focus on increasing the number of patients you see. I understand you must invest time for documentation compliance. But we should find a way to reduce that unproductive time which pays you nothing.

“I do understand your rational Alicia, but the best documentation system only gets us down to 20 minutes per note. That’s still a problem. It places us in a dilemma to either spend 1,333 hours documenting or see fewer patients and lose revenue. What should we do?”

“Peter, let’s first figure out the REAL cost of your current documentation system. Alicia continued, “Let’s see if the computerized documentation system is better. Then we can think about our next step. Does it sound like a plan?” Peter relented and agreed with Alicia.

“So, if your average revenue for patient care only is $156 per hour, then that’s the best you can do. Every other activity dilutes the revenue. Now lets estimate the COST of other activities in terms of the best value you could be getting by seeing the patients. Does that make sense Peter?”

“First, let’s see how long it takes you to write an average note with your current system. An hour? So you see Peter, you are spending that time writing a note instead of seeing a patient for $158 per hour. How many notes do you write per year? 2,000? OK, then your current manual documentation system costs you $316,000 every year. Do you care to know how much that is in 10 years? Right! Three million, one hundred and sixty thousand dollars . . . That’s a very expensive compliance requirement, would you agree Peter?”

“Next, let’s estimate the documentation cost of your 20 minute notes. One 20 minute note will cost you a third of your best performance revenue, or $52. If you multiply $52 by your total annual visits, which is 2,000, that’s $104,000 in annual documentation costs. Care to extrapolate that into a decade? That would be over One Million and forty thousand dollars. That’s better than three million but still VERY expensive.”

“So, what can we do? Where can we find a documentation system that costs less?” Peter sounded discouraged as he felt his rosy plans being crushed by the cold hard facts of Alicia’s reasoning.

“Well Peter,” said Alicia, relieved that she was able to get Peter to finally think about the business side of his practice, “We must find a documentation system that does not take more than 3 to 5 minutes for a single note. Just imagine, if we had a system that took 5 minutes per note, you could do 12 notes an hour. In other words, your per note cots would be “only” $13 per note. Therefore, documentation of your entire year would cost you $26,000, or $260,000 over a decade.” chimed Alicia. “Now that’s a cost we can live with!” exclaimed Peter.

“And in terms of hours,” added Alicia, unable to hold her excitement, “you would only need 167 hours to spend on visit documentation for entire year. That’s just a tad over 3 hours extra a week! Imagine being able to work almost regular hours and still see 2,000 patients a week.”

“So, Peter,” concluded Alicia, “until we find such a system, you have to choose between your family and your practice.”

What do you think? Is Alicia right in her calculations?

Do you know of a PT-specific documentation system that could make Alicia’s and Peter’s dreams come true?

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.