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Unwarranted Variations in Billing and Collections

By Kevin Hulsey, PT, DPT

Most physical therapists (PTs) are familiar with the concept of “unwarranted variation” when it is applied to the practice of treating patients. However, many PTs are not as aware of the “unwarranted variation” of billing and collections processes that exist.

My reference to “unwarranted variation” of billing and collections is not necessarily intended to reference the vast array of federal, regional, and local payers that frustrate us with myriad payment contracts and regulations—nor am I referring to the equally frustrating variations in payment across practice setting. I wanted to address the “unwarranted variation” of billing and collections processes practiced by those of us in physical therapist-owned outpatient clinics.

During the past 15 years, my service in the American Physical Therapy Association (APTA) and my work history have led me to many wonderful interactions with many physical therapy business owners from across the country. Discussions between these owners almost always result in discussions of payment. A superficial discussion of payment is always interesting, “I get $50 per visit,” “We are paid $75 per visit,” or even the rare “We get $191 per visit!” The superficial conversations are always fascinating, yet, without a deeper dive into the data and the processes, making comparisons between the stated payments may not be helpful in benchmarking your success or lack thereof when trying to assess your billing and collections success.

A Winning Combination


Celebrating individual successes is key to organizational success.

By C. Jason Richardson, DPT, OCS, COMT

As a practice grows, one of the hardest things to maintain is a culture that celebrates the wins. Adding therapists, support staff, and billing personnel makes it infinitely harder as a practice owner or manager to remain in tune to everyone’s impact on their areas of responsibility. This growth also increases the degrees of separation, which further dilutes our abilities to recognize staff for excellent work that fuels a private practice’s successes.

With growth, it is imperative for organizations to understand the psychology of praising staff for their great work and creating an employee recognition program. Making a conscious effort to foster a culture of recognition and create an infrastructure that celebrates the wins and publically acknowledges those who go above and beyond for our patients and teammates will yield massive value on investment.

New Relationships


A great time to partner in health care.

By Sean McEnroe, PT, SCS

The U.S. national debt is over 100 percent of Gross National Product (GDP)!
Health care has grown to more than 17 percent of GDP!
ICD-10, Functional Measures, Multiple Procedure Payment Reduction (MPPR)

Whatever your worry or concern, today is a great day to be in health care. This month’s Impact magazine is dedicated to heady topics including compliance, reporting, and the struggle for profitability. Even so, today’s evolving health care marketplace offers us the greatest opportunity to effect change and build the business we desire—if we are willing to explore the new models of delivery.

The Best You Can Be


Are you racing to the bottom or climbing to the top?

By Kevin Hulsey, PT, DPT

Have you ever been a patient? Many physical therapists (PTs) have been a patient. Many PTs have experienced significant injuries during their lifetime. In fact, many PTs are drawn to the profession after having a great physical therapy experience following a significant injury.

Thank You, Tom


A farewell to PPS president Tom DiAngelis.

By Kevin Hulsey, PT, DPT

Please join me in recognizing and thanking Tom DiAngelis for dedicating the past six years of service as president of the Private Practice Section (PPS).

On behalf of the current PPS board, past board members, past and present committee and task force leadership and membership, staff, and the entire membership of the Private Practice Section, we dedicate a few words to honoring Tom’s leadership and contributions to the section and to the profession.

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