Five Steps to a Successful Physical Therapy Cash Based Practice
Declining reimbursement rates with rising administrative burden has been the singular challenge that PT practices have been dealing with. In response to these pressures, many clinics increased productivity requirements with PTs needing to treat more patients per day and bump up patient volumes.
For some PTs, moving to a physical therapy cash based practice has been the answer.
Running a cash based practice means being out of network with insurance payers and getting paid directly by patients. Patients could take the super bill to their insurance provider and get reimbursed for it but that is between the patient and their insurer. For the PTs, they get to work directly with patients from start to finish without hindrance.
Here are the five broad steps to a successful physical therapy cash based practice.
1. Get Patients In
In the cash based practice, there are no insurance payer provided referrals. Patients would need to find the practice themselves and come to the clinic. Marketing the clinic would become a key priority.
- Not all patient types may want to (or be able to) opt for a cash based PT clinic. Identifying the right patient segments (based on income, occupation, age etc.) would be helpful as these would define the patient personas to direct marketing to.
- Having a website that is optimized with the right content and the right keywords based on local SEO principles would ensure organic search traffic and patient conversions.
- Content on organic social media channels primarily Facebook and Instagram and possibly LinkedIn and Twitter would support the organic search channel.
- Sending regular emails to prospective patients who sign up via the website and social media as well as past patients would keep the practice front and center in patient lives.
- Building relationships with local providers, businesses, and other wellness professionals would ensure adding of referrals to the practice.
- Paid advertising through Facebook ads and possibly Google ads would probably come in last to supplement the organic efforts above.
2. Ensure Administrative Coverage
Taking care of administrative processes would ensure that the practice has robust operations established for running a profitable clinic.
- These would include processes for scheduling appointments and follow ups and balance billing patients in case they did not pay in full while checking in.
- Having the right patient forms in place that patients fill out prior to treatment would be important for staying organized and patient ready, some of these forms may be legally required as well.
- Some cash-based physical therapy practices may opt to assist their patients with insurance reimbursements even if the clinic is getting paid directly for care. The EMR would have tools to make this easier and stay involved with a patients efforts to get reimbursed.
3. Establish Quality Documentation
When it comes to care delivery, documenting care would be crucial to ensure quality care is provided and to stay compliant with regulations.
- Instituting care documentation all the way from the initial eval to daily SOAP notes/flowsheets to re-eval and discharge notes would be critical.
- Customizing all clinical documentation to meet the unique needs of the specific physical therapy cash based practice.
4. Manage Compliance Matters
Going cash based clearly does not mean an absence of regulations, just fewer ones to deal with. Compliance would remain an important consideration.
- There would be the state level direct access laws and other laws and ethical obligations to comply with.
- If patients submit bills to their payer as an out of network service then there could be a claim based participation in the payers plan with associated implications.
- Then there is Medicare to contend with in case the practice is treating patients who are Medicare beneficiaries.
5. Institute Scalable Processes
Assuming the clinic would not want to run processes manually, which could quickly become unscalable, having the right technology platforms would make for smoother, sustainable operations.
- There would be the marketing platform(s) to manage patient outreach campaigns, marketing channels, and patient engagement.
- And the EMR and Practice Management platform to automate all administrative and clinical documentation processes and compliance from scheduling to documentation to payments.
End of the day, a physical therapy cash based practice can be a win-win for practices and patients alike:
- Patients get more time from PTs and more personal attention as there is no payer in the middle of the care delivery process that is regulating utilization and authorizing visits.
- By eliminating time spent on billing insurance payers and dealing with rejections and denials, physical therapists can free up even more time to focus on patient care.
- Given the high deductibles prevalent today, patients could also save money with a cash based practice when you look at the total cost of the plan of care: cost per visit multiplied by number of visits. The cost per visit could be higher but the number of visits could be lower.
- Plus, the care advantage could lead to patients becoming productive faster with financial and quality of life advantages.
Going cash based may not be a panacea for all PTs but for those with the right processes and platforms in place, all the benefits may be up for grabs.