Thinking On the Run

Thinking On the RunPhysical Therapy Software

by Erez Lirov

Stretching expectations to find an ideal solution

Can Shannon find a credit card processing system that will meet her definition of excellence?

Mike and Shannon rounded the bend of the track through the park. The weather had kept them from running for a couple of weeks, and Shannon was enjoying the feeling of getting out in the fresh air and moving through the beautiful scenery.

“Isn’t this great?” Mike asked, puffing a bit. “I love getting into the moment and not thinking for a while.”

“How can you do that?” Shannon asked, slowing to a walk. “I think even more when I’m running. In fact, that’s one of the benefits. I can think more deeply as I run.”

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“What’s on your mind?” Mike asked, slowing to match her pace.

“Credit card processing,” Shannon answered quickly. “I know I need to do some research to find the best system for the center, so I’ve been organizing my thoughts. Can I try it out on you?”

“Sure.” Mike plopped down on a bench that gave a view of the park.

“Stretch out first!” Shannon urged him. “Cool down!”

Mike stretched out flat on the bench with his arms and legs hanging down. “This is the only kind of stretching I plan to do. Now tell me your credit card processing ideas.”

“Okay,” Shannon agreed, pulling her nose to one knee. Her hair fell down to the ground, but Mike could still hear her as she continued, “I figure the least a system would have to do for it to be worth the trouble of changing would be to help us catch errors.” She drew her nose to her other knee. “If it would post the payments automatically to the patient accounts, charge the accounts back if the payment got declined, and send us a report at the end of the day, that would make it worthwhile. I figure it takes a full day over the course of a month for us to take care of those things, and I don’t see why a computer couldn’t do it.”

Mike nodded. “It sounds like that would help quite a bit.”

“Right, and it should also let us charge products to the patient accounts. That seems completely realistic.” Shannon pulled her arms behind her, stretching out her chest. “Next level up, if it would notice when recurring payment information we keep on file is about to expire, and maybe alert patients about expirations and if a payment is declined so they can take care of it. It would have to alert us, too. And it could alert us when someone is getting behind, too. That would not only prevent a lot of the errors we face, but it would also improve customer service.”

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Mike sat up and swiveled to look over the park. “Okay, That’s the fair-to-middling solution. What does it take to reach excellence?”

“If the payment system would send out invoices automatically and let us accept payments electronically, we’d shorten the billing cycle and save a lot of time.”

“People prefer to pay bills electronically, anyway,” Mike pointed out. “Most of us are used to paying our bills that way by now.”

Shannon pulled Mike up from the bench and they headed back toward their car.

“So this paragon of a payment system,” Mike asked, “what’s it going to cost?”

“That’s part two,” Shannon laughed. “If I can find a system that meets my definition of excellence, then I’ll just have to see whether I can afford it. But I think that a system like that could result in some real savings just because of the efficiency, so it’s worth spending some time in research.”

Can Shannon find a credit card processing system that will meet her definition of excellence?

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Physical Therapy Software | New Network Members in March 2014

Physical Therapy Software_new-network-members

Sixteen new members across five practices joined bestPT in March. Each member benefits from and contributes to 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. Ana Aparcicio and Olivia Shook of Big Sky Pediatric Therapy North Star Llc, Round Rock, TX.
  2. Georgianna Martinez of Elite Orthosport Physical Therapy, Los Angeles, CA.
  3. Molly Moore of Kalispell Rehab. Assoc Dba Professional Therapy Assoc., Kalispell, MT.
  4. Britta Eden, Jennifer Mason, Mary Brittany Young, Melissa Tabor, Kelly Ellis, Kathy Lord, Elizabeth Trimble, Ashely Whitaker, Carla Clevenger, Deborah Wenger, and Racheal Jessee, all of On The Move Pediatrics Therapy, Pllc, Lexington, KY.
  5. Leah Tompkins, of Physical Therapy Consultants, LLC, Bettendorf, IA.

Boxed In?

Boxed In?

by Erez Lirov

Breaking things down helps indentify needs, avenue to expore

Will Shannon’s lack of knowledge keep her trapped in credit card inefficiency? How can she find the change she needs?

“Why Shannon, you look radiant!” Theresa said as Shannon stepped into the office. Theresa was cutting down cardboard boxes. “Taking a little break with your husband really perks you up!”

“I think that this time it’s adrenaline,” Shannon said. “I’m feeling very motivated to fix the issues with our credit cards.”

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“Issues?” Theresa cocked an eyebrow. “Like high fees, errors, and the time we spend on this stuff?”

“Exactly. I know you said we should shop around for a better rate, and Mike had some ideas, but do we have to have special HIPAA-compliant processing?”

“The compliance standard for credit card processing is called ‘PCI.’ I know we’re responsible for it and that the rules change sometimes, but I don’t know how we make sure we’re up to date on that. I have heard that penalties for noncompliance are high, though — you remember when Target had a security breach? They paid more than a billion dollars in fines.” Theresa shook her head and stacked the flattened boxes. “It’s no different for health care. Besides, look at all these boxes! This is from merchandise we sell. We’re making good money from that retail area. We should get a POS — a point-of-sale system — so we can check people out easily.”

“Hold on,” Shannon objected. “I’m trying to make things simpler here.”

“It could be like the practice management software. That seemed complicated when we were just thinking about doing it, but it has actually simplified our lives a lot — and saved us money.”

“That’s true. There might be an integrated system for credit cards.”

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Theresa agreed. “If we were able to reduce errors, we’d probably save enough to pay for it. I heard that something like 8 percent of recurring payments get declined, and I’m not sure we catch all those.”

“I’m completely convinced that errors and efficiency are enough of a reason to make changes, but do you think we can do anything about the size of the credit card processing fees?”

Theresa thought, her eyes on the pile of cardboard at her feet. “I still think it would make sense to shop around, but I know that the fees are based at least in part on how much volume we have. Maybe making the process easier would encourage people to use their credit cards more.”

“If it’s about volume, though…” Shannon shook her head. “We’re never going to have the kind of volume Target has. Or even Mike’s rest

aurant. A lot of people pay by check and of course insurance is a big part of our income, too.”

“Maybe we could get group rates, like with insurance,” Theresa suggested.

Shannon laughed. “I think we need to do some research. At least now we know what we don’t know! Come on, I’ll help you get all this out to the recycling bin.”

Will Shannon’s lack of knowledge keep her trapped in credit card inefficiency? How can she find the change she needs?

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ICD-10 | Five Building Blocks | bestPT Webinar | Q&A


As you get your practice ready for the ICD-10 changeover, you are bound to have questions regarding documentation and compliance. To help you get the answers you need, we have compiled all questions that were asked during our recent webinar “ICD-10 | Five Building Blocks,” along with the presenter’s responses. Feel free to add any new questions in the comment section below.

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Q: Where can I find CMS guidelines in written form?

A: On, click on the Medicare link and you will find a link for both local and national coverage determinations.

Q: When can I start finding ICD-10 codes within your software and submitting them?

A: Our software already has all the ICD-10 codes listed; we are building the crosswalk now. We recently completed ICD-10 testing with Medicare, and were successful with our front-end edits. We are looking to have this available to practices by June, to really start testing and crosswalking. At this point, payers are not accepting claims in ICD-10; they are not coming over until October 1, but we are testing with payers and clearinghouses directly.

Enjoy this ICD-10 webinar?

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Sorting It Out

Sorting It OutiStock_000015493750XSmall

by Erez Lirov

Credit cards can create a variety of compliance issues for practices

What are Shannon’s next steps to sort out her credit card system?

“Mike!” Shannon checked everything in the physical therapy facility with a practiced eye as she walked across the carpeted floor. She loved to see everyone busy and engaged, and things were going well at the moment. She had a word with the receptionist and steered her husband out the door.

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“I was hoping you’d have time to come for a walk,” Mike said. “I needed to get away from the restaurant for a bit.”

“Problems?” Shannon’s voice was concerned.

“No, just a need for a change of scenery, a breath of air.” Mike took his wife’s hand. “It looks as though things are going well at your place, too.”

“Definitely,” Shannon agreed. “I know it won’t last –”

Mike laughed. With two small businesses in the family, there were bound to be plenty of problems to discuss.

“Seriously,” Shannon continued, “I want your advice about something. It’s not really a problem, but I think I could cut costs if I made some changes with the credit cards.”

“Now you’re talking!” Mike threw his arms wide. “I can’t believe you guys post everything manually!”

“I never really thought about it before,” said Shannon, “but today I was watching and it just seems so complicated. We take cash, checks, credit cards, and debit cards for deductibles, balances, all the things we sell at the counter… And we take the information over the phone or copy it off the card. Tana took the info via text today.”

“I’d have thought that might be a HIPAA issue,” Mike said with one eyebrow raised.

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“I think it might be all kinds of an issue,” Shannon confirmed. “Plus, since we have so many different things going on, I can really see how there could be errors. Theresa said she wasn’t sure we always know when a card is declined, or if we always follow up on those cases to get alternate forms of payment, and I can believe it. It seems like practically everyone in the place took a payment at some point this morning. I don’t see how we could keep track of everything.”

“At the restaurant, the server picks up the card at the end of the meal. One type of transaction, and we know exactly who did it and when. It doesn’t sound like that’s true for you.”

“Exactly. I wonder, too, whether there isn’t a bit of psychological barrier in having to pull out that credit card.” Shannon checked her watch. “I’d better get back to work. Thanks for listening.”

“I’m happy to listen,” Mike said, turning back. “What’s your next step? I could hook you up with the company that supplied our credit card terminal.”

“I don’t know whether that’s what we need or not,” Shannon said. “Do you think we have to have something different  to be HIPAA compliant?”

“I don’t think I can answer that question,” Mike said. “Time for me to get back to my own credit card machine.”

What are Shannon’s next steps to sort out her credit card system?

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A Missing Piece

A Missing Piece Fortis is integrated into bestPTbilling software.

by Erez Lirov

In the budget of a busy practice, credit card fees can add up.

Could Shannon handle credit cards better in her physical therapy practice?

Getting the family out the door in the morning was always a challenge for Mike and Shannon, but they felt like they had a great system. Each child had a hook for a jacket and a cubby for shoes at the door. Homework went in the cubby, too, and lunches were packed and lined up on the counter. The kids knew they had to stand touching the car door till Mom or Dad arrived to unlock it, and then they scrambled into their seats and waited patiently to be strapped in with seat belts before taking off. It was noisy and it sometimes felt chaotic, but things always went pretty smoothly and everybody got where they were supposed to go.

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Once Shannon dropped off their youngest at daycare, she headed on into the office, thinking about that system. She knew that Mike would get the older kids to school on time before he went to the restaurant. Sometimes his schedule was different so they divided things up differently, but it always felt like good teamwork, and she loved that feeling.

Things had been going more smoothly at work, too. Shannon thought back to her conversation with Mike that morning as they both got ready for work. “It seems like you’ve got your team back together,” he had said, and that was just how it felt.

With that issue off her plate, Shannon could think about some of the other matters that had been on the back burner for a while. She knew the facility needed updating, for example, but that was going to need funds, so Shannon was looking at her expenses closely to see where she could cut costs and free up some cash.

It wouldn’t take much, she thought as she parked and walked into the building. There were bound to be areas where she could streamline things a little bit and achieve some savings.

She asked Theresa’s opinion as soon as she got inside, and Theresa immediately had an answer. “Credit cards.”

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Shannon was surprised. She had been thinking the free coffee in the staff room might be an avoidable expense, or that marketing costs could be cut. “What do you mean?”

“I think the fees are higher than they should they be,” Theresa said. “I know it’s a basic cost of doing business, but maybe we could shop around and see if there’s a cheaper alternative.”

Shannon nodded. They really hadn’t compared prices; when she first set up the practice, she had basically just asked the guy who installed their telephones for a recommendation, and they hadn’t revisited the question since.

“Plus, since we post all the payments manually, there’s a possibility for error. We’re all careful, of course, but I can’t swear that we catch every time when a card is declined, for example. Sometimes the person who takes the information is not the same person who posts the payment, and some are sort of automatic.”

“Sort of automatic?” Shannon hadn’t realized things were so shaky in this area.

“Well, we have clients who have set up an automatic bank draft or we have all their information in the system already, and some who are new…” Theresa’s voice trailed off. “I guess there are a lot of variables in the way we take payments.”

It was a lot like the way they got their family out the door in the morning, Shannon thought, but in this case every little extra bit of chaos could mean extra costs, not just extra noise.

“This might be the last piece of the puzzle,” Shannon said. “Or at least the next one. It sounds like a real opportunity for improvement.”

“And we could finally get some new paint in here?” Theresa joked.

Shannon smiled. “The first few hundred we save goes straight into the redecorating fund,” she promised.

Could Shannon handle credit cards better in her physical therapy practice?

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Stop Your Staff From Fighting | bestPT Webinar | Q&A


Does your office staff argue about who is responsible for completing tasks generated by your patient visits?

How do you assign those tasks to your staff?

How can you see if the tasks have been completed?

Can you track those tasks automatically?

Do you micro-manage your staff?

How can you foster staff teamwork, promote staff autonomy and reduce the time you spend on staff management?

These are questions that each physical therapy practice owner has to answer. Each patient visit generates a list of tasks that need to be completed. Each patient needs an account set-up with their complete demographic information, their insurance information and other details you need to file insurance claims and to collect cash or co-payments.

If you break those tasks into a step-by-step list, then how do you assign those tasks to a member of your staff? How do you determine if every task has been completed for every patient? What happens if steps are forgotten? How will your patients judge your mental health practice if your staff forgets something? Would your patients think your office is unorganized?

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Q: What’s the problem?

A: Office staff including the front desk, the office manager and any employee physical therapists are supposed to make life easier for the practice owner. However they often inadvertently create additional challenges regarding patient retention, revenue and compliance. Many of these challenges are related to issues that the practice owner simply doesn’t have time for. If your staff goes on vacation or calls in sick then a backlog of tasks is created, resulting in tasks being forgotten about and mistakes being made. Every member of your staff needs to be managed and be held accountable to ensure that each task is completed correctly.

Q: Why is this problem important:

A: The short answer is Cost, Compliance and Patient Attrition.

  • Cost – Front office tasks prevent the practice owner from seeing patients, which is the only billable time for your practice. Mishandling of billing and collections results in lost revenue with denied claims and delayed payments. Ineffective patient relationship management leads to attrition.
  • Compliance – Includes incomplete/incorrect documentation, interrupted care plans, incorrect CPT/Diagnosis codes, staff unfamiliarity with procedures and staff failure to collect copays leads to overpayment by the Payers.
  • Patient Attrition – Failure by staff to follow-up on no shows, incomplete care plans and patients with no future appointments.

Q: Why is this problem difficult to solve?

A: There’s high front office staff turnover which could be due to poor training, lack of knowledge and unorganized micro-management. Some staff have a poor attitude towards training on new procedures and systems and they’re more comfortable with the old way of doing things. There’s also a lack of redundancy leaving tasks undone when somebody is absent and the ultimate responsibility falls to the practice owner.

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Q: What’s bestPT’s approach or solution?

A: A complete practice management solution for your office.

  • Improve staff teamwork with effective training to ensure optimal practice performance.
  • Improve teamwork and staff autonomy with automatic checklists of tasks that need to be completed when patients are checked-in.
  • Track practice goals to more easily improve the number of patient visits, increase revenue, submit every insurance claim, follow-up with every no show and schedule patients with no future appointments.
  • Manage staff remotely on your laptop or your smart phone by tracking task completion.
  • bestPT is a complete practice management solution that includes:
    • office workflow
    • patient relationship management
    • staff management
    • while also incorporating everything else you need like:
      • scheduling
      • billing
      • EHR
      • claim scrubbing
      • claim submission
      • claim follow-up
      • staff task checklists
      • training, etc.
    • bestPT also includes a Coach to ensure your practice uses everything in the most efficient way possible.

    Enjoy this office workflow webinar?

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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.

Robot to the Rescue?

Physical Therapy Software improves office workflowRobot to the Rescue?

Automating processes can help ease office tension

What would a tech solution look like?

Shannon took a deep breath. She had gathered her team again, and this time she had everyone’s attention.

“I know yesterday’s meeting didn’t go that well,” she started, “and I appreciate everyone’s coming back today. I want us to approach the issues differently.”

The faces in front of her were wary.

“Instead of looking for who’s at fault, let’s imagine a tool that would be perfect for us.”

“How ‘bout a robot that would do all the office work for us?” suggested Tana.

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“Don’t try to put me out of work,” Theresa objected. “You’d miss me!”

Shannon was glad that the team was taking a lighter tone. “We would definitely miss you. So not a robot, but what if there were some way to use technology to help? What would it have to be like?”

“Easy to use.” “Easy to learn.” That came from all over the room.

“We can learn to use software,” Theresa said, “but it would be great if there was just one thing to learn, not a whole bunch of different things that only sort of work together.”

Shannon wrote on the markerboard. “So, an integrated, turnkey solution.”

“It should be set up so we can all use it,” Roger said. Shannon knew that Roger ended up doing most of the billing. The better he got at it, the more others relied on him. “If one person answers the phone, they should be able to find the information and answer a question. They shouldn’t have to send the call to someone else.”

Shannon heard muttering from some of the others, but Theresa jumped in. “I agree! I hate it when I can’t find the information to answer a question. I don’t like to look incompetent.”

“It reflects badly on the practice,” Tana agreed. “It shouldn’t be like the days when we had to look on every desk to find the folder. Everyone who needs the information should be able to find it, and it should be hard to make a mistake.”

There was laughter at that remark, but Shannon wrote it on the board. That made sense.

“I want to be able to use my phone, too,” said Tana. She was getting excited. “I’m in the room with the patients. There’s no reason I should have to go to the office and borrow a computer for every little thing.”

There was a lot of agreement at that. “I don’t like to have to come in just to get information to solve someone’s problem,“ Shannon chimed in.

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“All of that’s good,” Roger said, “but we have to get back to ‘easy to use.’ And we have to admit that one person’s idea of easy might not be another person’s easy.”

Shannon frowned. Roger was right. With people of different ages and backgrounds, just looking for something easy to use might not really be the solution. “Maybe we need training.”

“And coaches!” added Roger. As laughter filled the room again, Roger insisted, “I’m serious. Why can’t we have somebody who can help us learn it? Or help us get the most out of it.”

“Or help us when we’re about to tear out our hair,” added Tana.

“Okay,” Shannon beamed. “We know what we’re looking for.”

She thanked everyone as they gathered their cell phones and coffee cups and got to work. As usual, Theresa was the one who stayed to help her clean up, but they were happy as they pushed in chairs and picked up paper napkins.

“We might not be able to get a robot,” Shannon said, “but the right software really could make a difference.”

What would a tech solution look like?

Want to know how to improve your own practice workflow? Register for our Webinar ‘4 Steps to Stop Your Staff from Fighting.’

The Right Combination

physical therapy workflow The Right Combination

Work with patients and office management is like PB&J

How can Shannon get her practice back on track?

“I feel like all I ever talk about nowadays is work,” Shannon sighed. “Am I getting boring?”

“I’m your husband,” Mike pointed out. “You don’t have to entertain me.”

Shannon smiled. “I can’t decide whether that was a romantic thing to say or not,” she teased.

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“I’m serious. We have good times, but I’m here to support you just the way you support me — with the kids, with the restaurant, with everything.”

“In that case, let me tell you about my day.”

“Shoot!” Mike settled back and sipped his coffee.

“First Theresa set up a speaking engagement for me –”

“That sounds good!”

“It’s great; it lets me reach lots of new doctors who might choose me next time they make a referral. But it involves travel time, and she didn’t consider that at all when she scheduled it. To make it work with the rest of the day would require teleportation.”

Mike rolled his eyes.

“Then we got a bunch of unpaid claims back from one of our payers. Lots of different reasons, from coverage that had lapsed to errors in the filing, and the worst thing is that the claims had been sitting around for ages. They all got filed at once, and now they’re all coming back, and that’s money I thought was already in the bank.”

“Sounds like your staff needs to step up their game.”

“Theresa’s great –”

“You always say that,” Mike interrupted her, “but I know how it is with employees. You hire someone and you think that doubles the amount of work that can get done. In reality, you’re adding management time to your own workload, and all the work your people do is still your responsibility. No matter how great they are, employees equal problems.”

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“I can’t agree with you there, Mike,” Shannon protested. “Anyone can make a mistake, including me. And the person who does most of the billing was out of the office with a family emergency, so things got backed up.”

“Nobody else can do that?”

“Not really. Everybody else has work of their own to do. The guy who does the billing is also the guy who calls and reminds people about their bills, too. Nobody else wants to do that, so that also got backed up while he was gone.”

“So everybody has to pitch in and catch things up. That’s how it is at the restaurant. If we get too busy and the service is slowing down, I help the waiters or we pull in the front of house manager to peel potatoes — whatever it takes.”

“That’s how you get mistakes, Mike. Maybe not at the restaurant, but in my physical therapy practice there are compliance issues, complicated billing issues, and patients we have to keep happy. Accuracy suffers when people try to hurry too much or try to fill in on things they don’t really understand.”

“Try switching out salt and sugar in a recipe and see how important accuracy can be in a restaurant,” Mike growled playfully.

Shannon laughed. “Okay, I’ll quit complaining. But I hope you can spot me lunch at the restaurant until I get some of these payments in.”

How can Shannon get her practice back on track?

Want to know how to improve your own practice workflow? Register for our webinar ’4 Steps to Stop Your Staff from Fighting.’