Troubleshooting 3 Common Physical Therapy Billing Challenges

The physical therapy field is brimming with issues concerning billing. Obscure rules, ever-changing guidelines, and difficulties tracking claims are just a handful of the problems that leave physical therapy practices out in the cold when it’s time to get paid.

To help combat these recurrent issues, our physical therapy billing specialists have prepared a guide outlining three common problems and how private practice industry experts tackle them.


1.  The Eight Minute-Rule: Why Businesses Underbill

The eight-minute rule, a guideline used by all federal insurance programs for time-based direct contact physical therapy claims, is frequently misunderstood because of its complex nature. This confusion often results in businesses underbilling for their services.

Per the rule, activities are billed according to the length of time and a corresponding number of units. At a minimum, time-based services must last at least eight minutes to account for one unit. Further physical therapy billing units are billed in fifteen-minute intervals up to a total of six units.

While the core principle behind this policy is somewhat intuitive, it’s complicated by advanced concepts like mixed remainders and the rule of eights. Having complete knowledge of the policy is a time-consuming process most working professionals don’t have the resources to keep up with.

However, our PT-only experts are trained to know everything about the billing process and how to best maximize your chances of approval. The easiest way to understand confusing policies is to hire someone whose job is to do exactly that.


2. Denial, Denial, Denial: How Experts Handle Rejection

Many private practices began using telehealth as a way of circumnavigating non-essential contact following the onset of the Covid-19 pandemic. However, billing guidelines for telehealth can differ significantly from in-person treatment and are often not self-evident.

Whether they are in-house or outsourced, non-experts often make mistakes in the claim scrubbing process, especially as it concerns more obscure fields like telehealth. And if their claim is rejected, they often lack the resources to adequately handle the claims process.

With health guidelines continuously changing, the need for someone who completely understands them is at historic heights. Our experts have been invaluable in both proactively and relatively handling claim rejections on behalf of our clients.


3. Tracking Reports: Don’t Get Lost in the Shuffle

Another frequent issue that plagues companies trying to tackle the basics of physical therapy billing on their own concerns tracking and analyzing ongoing claims cases.

Businesses can easily send out dozens of claims each day, but the approval process does not occur on a similar time-scale. Hundreds of claims cases may be out at any moment, which makes it easy to lose track of the bigger picture.

Conversely, with a billing expert on your team to oversee the process, you can easily track the success of your claims and evaluate how your team is performing. This allows for recurrent filing issues to be resolved before they became a systemic liability.


The Importance of Physical Therapy Billing Experts

While there are many billing challenges that face your private practice, including insurance pitfalls, customer communication issues and internal structure breakdowns, with proper guidance from PT-specific billers, they can be avoided. 

While hiring someone to oversee the process may seem like a luxury, physical therapy billing experts ease the strain on your limited resources while maximizing your potential earnings.

 Want to see if you’re leaving money on the table? We’ve taken the stress out of stress-testing your practice to see if you’re optimized for success. Take our 2-minute quiz today and start the new year off right! 

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