Poised for Change

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By Stacy M. Menz, PT, DPT, PCS

While at the Graham Sessions in Savannah, Georgia, I had the benefit of listening to and interacting with some truly amazing people in our profession. What made it even more amazing was this group of people ranged from those who have been involved in the physical therapy profession for years and several Doctorate of Physical Therapy Students (DPT) who are just beginning their journey. The common thread among the group was their willingness to ask questions and raise issues from their individual perspectives. I left the meeting with ideas of next steps for my practice as well as things that I hope to help drive in our profession.

Finding Balance in the Books

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Evaluating and updating physical therapy billing practices can increase profits.

By Janet M. Shelley, PT, DPT

These are tough financial times for physical therapy practices. In addition to declining reimbursement, therapists deal with a mountain of paperwork and regulatory requirements to get paid. Evaluating your processes and changing to some best billing practices today can produce increased profits for a clinic. Here is what you need to consider:

  • Eligibility: Ineligible patient insurance coverage is the most common cause of claim rejections and denials by payers. Patient submission of an insurance card at the front desk does not ensure that your physical therapy services will be covered under the plan. Benefits should be checked prior to delivering care with an emphasis on what portion the patient is responsible to pay. Benefits can be verified via the phone number on the patient’s insurance card, through the individual insurer’s website, or for the most time-efficient method, through automated eligibility subscriptions. Additionally, verifying Medicare status has risen in importance so there is an understanding of how many dollars have been applied to the therapy cap and if the patient has regular Medicare or a Medicare Replacement Plan.
    Best Billing Practice: Purchase an online eligibility verification subscription that will verify coverage and estimate patient payment responsibility in real-time format for multiple payers.

During MLB Playoffs, Networks Encourage Fans to Watch Their Competitors

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By Associated Press | Reviewed by Sturdy McKee, PT

Who is your Competition? According to Inc. Magazine, some networks do not see other networks as competitors during the Major League Baseball (MLB) playoffs. They, instead, hope that promoting the sport and the playoffs will help to build interest in the league and that will, in turn, benefit all of the networks that broadcast that sport. They emphasize that the audience is highly targeted and not loyal to a network but rather loyal to the sport and the league.

Major League Baseball has contracts with Fox Sports and TBS. During the American League Championship Series and National League Championship Series each was promoting the other to enhance the appeal and viewership of MLB in general.

Be Everywhere

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Use client-focused marketing to increase leads.

By Jena H. Castro-Casbon, MS, CCC-SLP

Where You Are vs. Where You Want to Be
Inevitably, every December and January there is much talk of New Year’s resolutions. Whether they motivate you or make you cringe, starting each year by analyzing where you are and where you want to be in your private practice is very important. Chances are, no matter how successful your private practice is, you still have goals to increase income, productivity, and overall success.

If your main goals surround increasing income, you are going to have to tap into additional referral sources to grow your caseload. Although finding new clients is not easy, I urge you to dedicate your 2015 marketing efforts to being everywhere. Before we learn how to have a “be everywhere” mentality, we need to make sure that your future clients know why they should hire you.

Letter to the Editor

Dear Editor:

I am writing comment on the article titled “The Best You Can Be,” which appeared in the January, 2015 edition of Impact.

The article is written by a Private Practice Section (PPS) board director and highlights his experience in receiving physical therapy treatment for a herniated disc. I have to say, I cannot recall a single article evoking so many different emotions in me.

The first question that came to mind is where is there any consideration for evidence-based practice? First, the author states they had a “herniated disc” in the low back. Now I do not know if they had any imaging studies, but given the diagnosis I assume so. If that is the case, why not self-refer to physical therapy first? Assuming imaging was done, it did nothing more than increase the cost for his episode of care as there is in fact evidence showing limited benefit in performing imaging studies routinely; unless of course there are severe, progressing neurologic deficits that were not mentioned. My other thoughts about evidence-based practice relate to the comments the author made that he went daily, each session lasted at a minimum of two hours and the longest three hours and that he “walked, stretched, suffered, strengthened, trained, laughed, was poked, pushed, and manipulated (physically, mentally, and emotionally), heated, iced, lasered and stimmed.” Wow, what happened to the kitchen sink, did they just forget to throw it in the mix? Where is the evidence to support all this time and stuff the author had done to him? I am glad he got better, but how long did it take? What really helped him and where is the evidence?

That is not what I am most disheartened about in this column, however. What concerned me, and upset me the most, is the authors comment that he wanted to remind us all of the incredible impact that more appointments and more interventions provided by a large team of providers can have on outcomes. We do not know what helped him get better, but because he got better he is advocating that more is the reason and advocating for us to take that approach. Do we really want that to be our message? It is for exactly this reason that our profession is where it is at today with all of the utilization management companies scrutinizing us. This is why we now have the Care Core’s, Orthonet’s and OptumHealth’s of the world limiting what we can do. Our profession and association have put in a tremendous amount of resources to provide us with evidence and to overcome this perception of physical therapy just wanting to do more and more. I fear this article has the potential to set us back decades.

The final concern I will address about the article is that it appears in a section called “Board Member Report.” So now the perception will not only be that this is what private practitioners’ are advocating, but it is what the section and PPS Board of Directors are advocating as well.

Sincerely,

Tom DiAngelis, PT, DPT

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.