Physical Therapy Billing

[Jdmontee]

Hi All,

Received a call today from a physical therapy center that's looking to change billing companies.  We have not done PT billing before and was wondering if anyone has any pointers on how difficult this billing is to do and any "wisdom" to impart???

Thanks!

Joanne

[Michele]

PT billing can be a little tricky.  There are requirements regarding the ordering/referring provider and how often they have to be seen by them.  Medicare requires that the ordering dr see the patient at least every 30 days during therapy and the last date seen must be indicated on the claim.  The PT should be giving you the claim fully coded, but it is helpful to understand what codes are allowable for what diagnoses, and the correct use of modifiers.  I'm not saying you should code the claim to maximize payment, I'm just saying it is helpful to understand how the PT codes are allowed, etc.  As I stated, the claim should be coming to you fully coded.  But some providers do not understand all of these things and sometimes it's necessary to educate them or make sure they at least understand how they are coding.  If you don't understand then you can't be of much help.

[Jdmontee]

 I appreciate you quick response. I have done a lot of internet research as to the specifics regarding workers comp in Ohio but what would you suggest we do as far as getting familar with the modifers and so forth to help the learning curve.

Thanks much!

Joanne

[vitalmedclaims]

I am in a situation where I have to call a PT practice that has indicated its interest in billing with our company.  And I have several PT practices and clinical social workers that I have to call also.

Since I am very new and this could be a potential client I do not want to miss the opportunity. I wonder if anyone can help me with what questions I could be asked after I have asked further questions relating to the survey this practice completed and sent to me. I do not want to appear as if I do not know anything as I have studied hard to learn this business.

What PT billing info do I need as I have to call this practice back tomorrow or I might lose their confidence.


Linda or Michell might be very useful to me here

Thanks

Richard

[Michele]

Well, I don't know what questions were on the survey, but I will try to give some suggestions.

• how many therapists are in the group
• do they bill all insurances and are they in network
• do they have any insurances that are currently problems
• how many patients do they see in a week? month?

Let them talk as much as possible, listen to what they say, look for any problems they may be having and show them how you can solve them.

Good luck.

[vitalmedclaims]

Thanks a lot, Michelle.

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