Medical Billing is a systematic process which involves multiple factors for easy and smooth reimbursement of medical claims. Following are the main steps in Physical Therapy Billing Process and Procedure.

Prior-authorization eligibility and verification

Physical therapy revenue cycle begins with collecting patient and insurance information and determining eligibility for additional funding. During the pre-authorization and registration process, you will determine how patients will dues for services provided.

By implementing a transparent pricing policy and using automatic insurance coverage tool will help filter out patients who cannot afford your services and make your practice more efficient. Automated patient eligibility tools save your staff time by instantly letting you know whether a patient’s insurance will cover treatment costs.

Coding and Charging in Physical Therapy Billing

After patient’s authorization and eligibility, it is translated into alphanumeric codes, ensuring accurate billing and reimbursement. The coding system is based on standard procedures such as ICD-10 (International Classification of Diseases) and CPT (Current Procedural Terminology) to ensure consistency and compatibility while respecting health. Accurate coding and documentation is essential for accurate billing, demonstrating medical need, and providing appropriate coverage to insurance companies. Accurate coding helps prevent denials and encourages timely reimbursement, ultimately increasing the financial stability of the healthcare organization. It also supports research, quality improvement and accurate health analysis by storing important medical information.

Claim submission

In Physical Therapy Billing, the main step is submitting claims after capturing charges, involving sending information for scrubbing. The revenue tour team reviews costs, CPT codes, and diagnoses to ensure proper labeling and support for each service.
Payment will be faster if the compensation reaches a good insurance company. This process involves sending applications from your practice management to the clearinghouse.
While the delivery report shows the forwarded statement, returned statement, and lost statement, the rejection report shows the error.

Remittance process in Physical Therapy Billing

Remittance process is termed as payment posting or collecting payments from insurance companies. Instead of paying each session you complete, the insurance company will pay you whole together.

Doctors and carriers negotiate contracts for batch payments, ensuring regular fee evaluations to avoid missing potential revenue opportunities. A common mistake in remitting process is “send and go.” As electronic advertising becomes the norm in the billing cycle, apps can run into problems when they send money back and never see it again.

Insurance Follow up

The next step came out to be insurance follow-up in the physical therapy billing process. Insurance follow-up is simply taking of claim and looking for its resolution with the help of insurance company. And then the insurance company cleans the claim and if not, then may be some issue in the process. The AR report will show if insurance follow-up is broken and why it is taking so long to get it paid.

Ensuring accurate insurance details helps bill the correct company, considering both paid and unpaid services for comprehensive healthcare billing.

There is need of predetermined knowledge base and process for outstanding claims to resolution because claim is not always clear. In this process, outsourcing companies begin to add significant value in terms of time savings and refunds from insurance companies.

Patient payment collection

Payment collections are critical because it focuses on the financial interaction between doctors and patients. Payment collection contributes to physicians’ financial well-being, and also improves the patient experience by reducing conflicts and inefficiencies.  For this purpose, the RCM team tracks outstanding debts and works to expedite the collection and resolution of outstanding balances.

Unpaid hospital bills lead to payment collections, involving the hospital’s efforts or, in extreme cases, a collection agency. Ideally, you won’t need this step, but if required, there are excellent resources to assist in patient recruitment.

Today using integrated solutions that enable online payments through patient portals. This is much easier than sending a check or calling to share credit card information so patients’ bills will be paid quickly. Automatic reminders will help you make payments on time.

Data Recording and Reporting for Physical Therapy Billing

Data reporting step reflect over the measurements behind your practice’s success so you can work upon them.

Recording weekly or monthly practices in one place, like a bent drive, helps improve and overcome average financial performance.

Weekly or monthly financial reports show a healthcare organization’s revenue, cash flow, and RCM strategy impact on profitability. These reports aid decision-making, enabling providers to optimize RCM, reduce rejections, improve financial performance for individuals or healthcare organizations.

Data reporting is beneficial for maintaining the financial stability of the healthcare organization. Identifying inefficiencies, improving processes, and using data can boost revenue, cut costs, and enhance patient care for providers.

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