Physical Therapy Billing: In-house or Outsource?

The decision whether to handle physical therapy billing services in-house or turn to a third-party biller is a critical one for every physical therapy practice. A number of factors go into the decision, including the size of your practice, competence of billing staff and your comfort level with keeping track of the billing process.

Lets examine each factor in more detail, along with scenarios when you should consider making a change.

Physical therapy billing services | Size of practice

The inflection point where it makes more sense to bring billing in-house will vary based on the other factors, but 10 therapists is a handy benchmark. Third-party billers generally charge 5%-8% of claim amounts. Paying a percentage of claims from 10 therapists would likely be enough money to bring the work in-house.

If you choose in-house, however, be sure youre ready to manage the work to maintain proper cash flow.

Physical therapy billing services | Billing staff competence

Physical therapy medical billing is part art, part science, and competent billers can be hard to find. A biller with 20 years experience may know nothing about the PT industry and its intricacies, because every specialty has its own nuances.

A physician may see a patient once, then schedule a follow-up visit in several months. Physical therapy, as you know, usually involves several visits a week for a certain time period. The methods to maximize revenue capture differ, as will contracts with insurers.

If you cant find a competent biller who has experience in the PT industry, you may want to outsource.

Physical therapy billing services | Comfort with billing practices

If youre the practice owner, its likely you dont have a billing background. Some people arent good with numbers and may have a hard time managing billing staff, even if the practice is large enough to support in-house claims staff.

An outsourced biller will have experience dealing with insurance rules and payer contracts that the practice may lack. You should also expect detailed reports outlining the state of collections and cash flow reports.

When to look at billing options

Just like any other contract, a therapy practice owner should consider options from time to time to determine whether the current method matches current needs. If youre not happy with the amount of collections the practice is receiving, its time to check your options. Another time is when a biller leaves. It may be cheaper to outsource than it is to advertise, hire and train a biller who has the proper PT industry experience.

Practice Pro, like many PT EMR vendors, offers outsourced billing services. Unlike some other outsourced vendors, however, Practice Pro uses U.S.-based billers that have therapy-specific billing expertise.

Our billers become virtual users in your Practice Pro EMR, so leaders can see everything thats going on. Our outsourcing services average a clean claim rate of 95%, 20 days in accounts receivable (A/R) and a 2% A/R ratio.

Cash flow is the lifeblood of your business. You owe it to yourself and your employees to take billing and collections seriously.