Who is Responsible for Cutting Your Practice’s Fees? Medicare or You?

April 1st brought a double whammy for physical therapy practices across the country. A combination of Medicare Multiple Procedure Payment Reduction (MPPR) cuts and sequestration cuts that represent up to a 10% decrease in your Medicare fees. If you’re like many practice owners, you feel powerless in your ability to improve your income. It seems like you’re just treading water.

You can’t help worrying about what the future will hold for your practice. Before you succumb to those gloom-and-doom predictions, we want you to take a more realistic view of how you’re currently being compensated. And take control of how you should be compensated.

Let us explain: Most payers, including Medicare, expect you to bill 3 to 4 units of one-on-one time in a patient visit. We’ve noticed that prior to joining BMS Practice Solutions, our clients’ therapists only charged 2.5 to 2.8 units of one on one when, in reality, they spent 50-60 minutes with their patients. In essence, they were billing for 40 minutes of time when they should have been billing for 55 minutes of one-on-one time. They do this because they don’t adequately account for the assessment and management time they spend with their patients. What’s an extra unit? Depending on the payer, $22 – $30 per unit. That could have a significant impact on your practice!

Why aren’t your therapists billing more? Chances are they have no idea that they should also be billing for Patient/Client Management Time, which includes:

• Assessing a patient’s progress since last visit
• Clinical judgment to confirm or change treatment time
• Instruction, counsel, advice
• Communications: internal and external
• Discharge planning
• Documentation while you are with a patient

The Red Flags to Look Out for in Your Practice

The old adage that we’ve used on this blog before still holds true: “Don’t expect if you don’t inspect.” You can’t fix something until you know why it’s broken.

1. If your current system doesn’t give you visibility into how your therapists charge for your services, that’s a problem. You won’t know which therapists are under coding and you’ll never have an opportunity to get money back that you legitimately earned. Our RevFlow practice management system will provide you with 24/7 access to coding profiles and other critical data.
2. If you don’t have someone working in your office or a billing service looking at the number of units you’re billing, that’s a problem. You need someone who cares about every dollar as much as you do. At BMS Practice Solutions, we don’t get paid until you get paid. We’ll have a team of practice management experts working on your account to show you how to run detailed reports and ensure your claims are scrubbed clean before they are submitted.
3. If you don’t have the educational resources to address coding training, that’s also a problem. A pep talk from the boss won’t be enough. Your therapists need sophisticated training to ensure they document all of the services they provide. This is exactly what we provide our clients at no charge. We offer continuous training for everyone on your staff.

To learn more, schedule a RevFlow demo. Now is the time to take control of what you can control. With our expertise, training and technology, we’ll help you remain in compliance and, more importantly, in business.