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  • 2014-11-November

The Right Moves

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Six steps to avoid workers’ compensation claim denials.

By Connie Ziccarelli

The center of any workers’ compensation case management process should be proactive and efficient communication. Patients who are injured on the job automatically assume someone else will pay their claims, so it is the physical therapist’s responsibility to document and communicate effectively with the adjustor and case manager to ensure no hiccups disrupt the payment process.

Denials can be frustrating. In the worst case scenarios, which are typically caused by poor documentation that can lead to the patient footing the bill, adjustors and case managers become irked with the lack of efficiency, and employers lose trust in a physical therapist’s (PT) services. A PT may initially think that one denied claim is no big deal, but soon realizes that customers are three times more likely to share negative experiences with others—and it takes 12 positive experiences to make up for one negative one. To keep all parties happy and ensure the claims process runs speedily and smoothly, there are six steps you can put in place to help avoid claim denials:

Added Value

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Contracting with employers is good for business.

By Wade VanDover, PT

In the past, when we talked about workplace and occupational health services, we found employers to be more “reactive” than “proactive.” However, due to rising health care costs, including increases in workers’ compensation and health insurance, and limited budgets, we find employers finally interested in getting injured workers back to work quickly and keeping workers from being injured in the first place—as a measure of cost-saving strategies. More and more employers value “proactive” steps and value contracting physical therapists who can provide not only treatment, but also injury prevention and other occupational services.

A Sale or Merger

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What you should consider when selling your business.

By Chris Reading, PT

Much like a marriage, the sale of your business should be considered carefully—matched for goals, personalities, and values on the front end and predictable, long-lived, and happy life on the back end. Therefore, make sure your partner is going to be a good long-term fit for you, your employees, and your business.

One of the first decisions that you will need to consider is whether to explore the marketplace yourself or whether an advisor should guide the process. Your decision will depend on your business’s resources, your understanding of the process, and potential buyers in the market.

Familiarity can be gained through straightforward conversations with potential buyers. As a frequent buyer/evaluator of physical therapy practices, I have found the following are key aspects in the process.

Creating Practice Opportunities

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Using job requirements as the foundation for an effective warm-up program.

By Deirdre Daley, PT, DPT, Laurie J. Johnson, PT, Lisa Krefft, OTR/L, and Margot Miller, PT

Employers have been on the fast track to implement fitness and wellness programs ever since the Department of Health and Human Services (HHS) issued its final rules on employment-based wellness programs in May 2013, effective for plan years beginning on or after January 1, 2014.1 The rules support workplace health promotion and prevention as a means to reduce the burden of chronic illness, improve health, and limit growth of health care costs to our nation. At a time when there is more competition for available jobs and an aging workforce, promoting employee health and fitness is key to a company’s success.

Private practice physical therapists have an opportunity to provide employment-based wellness programs, meeting employer and employee needs, while driving bottom line revenue for the practice.

The Guest Experience

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How you treat your patient before, during, and after physical therapy is your best marketing tool.

By Kristen Gerlach, Steve Ziccarelli, and Mark Nelson

Rehabilitation providers today face high competition for the consumer’s health care dollar. Unlike some of the larger hospital systems, those of us in private practice do not have a constant stream of patients being sent to us from down the hall. Therefore, we have one thing and one thing only to leverage: the “guest” experience. The goal of such an experience is to build long-term relationships with your patients through all encounters including prior to, during, and after patient care.

Before marketing, identify your practice’s strengths and weaknesses. Compare these to your competition and learn what makes you unique, or in other words, what sets you apart. In addition, everything you market should show a benefit to the patient. Patients do not want to know what you can do; they want to know what is in it for them.1 Now that you have identified your key difference makers and benefits, it is time to begin marketing to potential patients.

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