Physical Therapy Billing Guidelines and Mistakes to Avoid

physical therapy billing guidelines and mistakes to avoid

Handling your clinic’s billing may not come as naturally to you as patient care. Thankfully, there are a few physical therapy billing guidelines that will help you avoid mistakes that could be holding up your payments from insurance companies. Take a few steps to make sure the financial side of your physical therapy clinic is in good shape now and for the future, so you can continue to provide the same level of excellent care.  

Guideline #1: Submit Claims Electronically 

One of the greatest hinderances for physical therapy clinics is revenue cycle management. This means that somewhere in the claim process, mistakes or errors are causing delays that prevent therapists and clinics from getting what they are owed from insurance payers when they are owed.  

By submitting electronic claims within your EHR’s revenue cycle management system, you eliminate the time claims spend in the post. This way you also no longer have to worry about all the different deadlines for all the different payers, as claims can be denied if not submitted on time. 

Guideline #2: Submit Clean Claims 

Another way to maximize the revenue from insurance claims is to make sure you are submitting accurate claims. Coding errors, missing information, and so much more can cause your claims to be denied. In order to keep your revenue cycle moving forward, submitting clean claims is a MUST on every list of physical therapy billing guidelines.  

With A2C Medical, you work with our experienced Denial Management Experts to ensure the claims you are submitting are clean and accurate, rejected claims are re-submitted on time, and collections are maximized. 

Free ebook with physical therapy billing guidelines.

Guideline #3: Keep Thorough Documentation 

Keeping pristine documents and records of everything that occurs in your clinic is not only important in order to draft accurate claims, it can also help prevent an insurance audit, which can truly slow down your business. This begins with detailed intake forms and making copies of insurance cards and is carried out through every session with a patient. 

We recommend keeping SOAP notes to keep accurate, concise, and precise records regarding every patient encounter. Make your documentation time efficient with A2C’s 80+ built-in templates and quick phrases. A2C’s Dynamic flow sheet helps clinics keep great documents. Built for efficiency and compliance, our electronic flow sheet allows the therapist to:  

  • Make note of what they have done with the patient 
  • Automatically populate the objective portion of the daily note 
  • Create the charge that goes through a series of validations, and automatically add modifiers as needed 
  • Keep all data in agreement ensuring compliance 

Guideline #4: Use Fully Integrated Tools 

When it comes to managing your clinic, make sure you’re able to access all of your tools from one log-in. When your systems are fractured, they are more difficult to learn and keep track of. When everything you need to manage your clinic, including billing, is only a click away, you can streamline your workflows and make better use of your valuable time. Fully integrated billing software accessible right within your EHR is an absolute must for efficient therapy clinics.  

A physical therapist following physical therapy billing guidelines.
The ability to access all your tools from one simple log-in can save you a lot of headache.  

Mistakes to Avoid 

Lagging to Implement Credit Card Payments 

When your clinic accepts credit card payments, you’re not only offering a convenient online payment option for clients, your staff will thank you too. With immediate payments and comprehensive transaction reporting, you’ll see the money from self-pay clients in the bank sooner. And your team won’t have to waste time tracking down nonpayment like bounced checks.   

Just like your billing tools, your credit card payment processing service should be fully integrated within your EHR to eliminate unnecessary hassle.  

Overtaxing Staff 

We all know the frustration of needing more hands to run a clinic – even in times of growth (we like to call these growing pains). One of the strongest physical therapy billing guidelines we like to share is to free up your staff, so their time is used more efficiently. By enlisting helpful tools, your team can redirect their energies to patient, to putting together that plan for a potential new clinic or simply be freed enough to think creatively and solve organizational roadblocks. Though we’d all love to hire more staff, imagine the potential of your current team if you were able to outsource some billing functions through your EHR.  

Erroneous Coding 

Coding errors are one of the most common reason claims are denied. And one of the easiest to prevent. Additionally, repeated coding issues can trigger a health insurance audit. With Revenue Cycle Management services from A2C, you can have a fully integrated resource to help identify coding errors and submit cleaner insurance claims.   

If you’re looking for more guidance on insurance coding, check out these quick reads: 

Failing to Follow up on Denied Claims and Payments 

A denied claim, though frustrating for practitioner and patient, is not the end of the world. Denied claims can be amended and appealed. So, make sure you’re staying vigilant and correcting and resubmitting claims as quickly as possible.  

Even if your claims are perfect and accepted, don’t forget to check-in to make sure the payments are reflected in your accounts. Don’t assume the insurance company will go out of their way to make sure you receive all of your payments.  

What’s Next? 

As we’ve said, billing can be complicated. But you are not alone. Our team specializes in billing for physical, occupational, and speech therapy, so we know the unique challenges you face. Schedule a demo of A2C Medical today to learn how our software solutions can help you run a more effective and efficient clinic.  


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