How Does Physical Therapy Billing Work?

Physical therapists can use medical billing and revenue cycle management software to increase profitability. A physical therapy (PT) billing service works like most medical billing processes. The therapist must match services rendered with standard billing codes that insurers know. Billing codes define the treatment received and how much the practitioner is owed. Here’s an overview of how physical therapy billing works:

1. Pre-authorization

The first step of any medical billing is pre-authorization and insurance eligibility verification. As a physical therapist, your revenue cycle begins with gathering patient data, including insurance and demographic information. The goal is to verify if the patient can pay for your services, has insurance, or is eligible for financial assistance. During pre-authorization, you’ll capture patient registration data and establish how they’ll pay for services rendered.

Implementing transparent pricing structures and policies can make pre-authorization simple. You may also need reliable medical billing software to automate the process. Leading physical therapy billing companies to use automated insurance verification tools and straightforward pricing. You can filter out patients who can’t afford your therapy and determine whether the patient’s insurance will cover their treatment. Pre-authorization may help save time and resources.

2. Physical Therapy Bill Capturing

Bill capturing is done when rendering physical therapy services. Once you complete the patient’s pre-authorization paperwork and verify their eligibility, you can proceed to render services. All charges are transparent and feature a standardized code that insurance companies use. Record everything using the right codes to qualify for compensation. Automated billing software can help you find and enter codes quickly and more accurately.

Bill capturing and coding is menial without billing software. Implementing billing software allows you to set up the services, charges, and codes for easy access and use. You can use sophisticated tools to access patient records, rendered services, cash payments, and insurance details. Billing systems prevent double entry and correct basic human errors. The software also increases automation and reduces the time needed to capture and code bills manually.

3. Claim Submission

Once you capture and code all physical therapy charges, you can submit them to the insurance company for reimbursement. Medical billing systems make claim submission effortless because the activity is integrated into the workflow. You can submit your bills to relevant insurance companies with the press of a button. Billing systems may also increase your clean claims rate, which is the likelihood of your claims being accepted with the first submission.

Insurance companies can reject claims for various reasons, including errors and typos in the paperwork. Some companies clear part of the bill. Automated billing software will help prevent the number of rejections by increasing accuracy. Leading systems use claims scrubbing and clearing and follow up on all rejected claims for resubmission. The system will also provide automated reminders and corrections to avoid delayed resubmissions.

4. Payment Collection

After submitting a claim, the insurance provider will review and clear their part. Sometimes the insurance covers everything, so you can close the record. Other times the insurance reimburses part of the bill or rejects it. Most physical therapy services feature out-of-pocket costs, so determine how much the insurance will cover early. A physical therapy billing service can help you collect payments from patients and balances left by the insurance provider.

Medical billing systems and companies make it easy for patients to calculate their bills. Patients should know what the insurance covers and what they must pay out of pocket. Top billing software offers integrated payment solutions that patients can use to pay online. Automated billing reminders will also notify patients to clear their balance promptly. The goal is to collect all revenue within a quick timeframe.

Once you receive payment for your physical therapy services, you can close the account and complete the necessary reporting. Automated billing systems provide a digital dashboard to view reports and measure performance. Reporting allows you to improve the process and understand the baseline average for revenue cycle length, patient intake, and other metrics. Working with a reputable billing company or system may help you improve the billing cycle.

Work With a Physical Therapy Billing Company

You can audit and streamline your revenue cycle and use sophisticated systems to reduce errors and delays. Stick to leading billing companies specializing in physical therapy billing systems. The best billing companies partner with physical therapists for efficient revenue cycle management. Streamline your physical therapy billing services today.