Physical therapists usually focus their skill sets on helping patients in their field, so billing for physical therapy is not something most of these professionals know a lot about. Bringing in the aid of a billing service can definitely help. Here are a few specific challenges you may face with billing an insurance company as a physical therapist.
Units of time have to be counted and documented carefully.
For billing purposes, units of time with PT services have to be clearly documented, and this can be challenging with the nature of the treatment. Patients who come in for therapy may use up several blocks of time depending on the nature of the treatment required. For example, a full-time block may be used for the initial evaluation, but then another time block may be used for therapeutic activities. When billing for some insurance providers, all units of time have to be offered separately in order for the claim to be approved, but it is only natural for a PT provider to look at the whole of treatment as one unit of time.
Specific bodily regions may need to match referral documents in billing.
Most patients who come to PT for treatment will have specific parts of the body that are going to be primarily treated when they come in. However, you may run into issues with billing the insurance company for physical therapy if the region treated does not align with the specific diagnosis and the referral. For instance, if a patient gets a referral from their doctor for back pain, but presents with pain in the hips and legs by the time they get to PT, this can generate some issues with billing and a claim may be denied because of the misalignment.
Codes have to be distinguishable between timed and untimed treatment.
Naturally, pretty much every type of PT is timed, but there are differences where billing codes are concerned between timed and untimed treatment. You can only bill for a timed treatment with some insurance companies if the provider was actually physically with the patient the entire time. For example, if you hook a patient up for electrical impulse therapy, and then walk away to see another patient, this may technically be considered an untimed treatment for billing purposes. However, if an assistant stayed with the patient through the treatment, this may be able to be billed as timed treatment.
Contact a company like Midwest Medical Billing Service to learn more about billing for physical therapy.