This morning, I was speaking with one of our coaching clients, a physical therapist in private practice in New York city.
In a span of 7 months, he went from a ‘before’ picture of:
- 80% income coming from Medicare patients
- 20% payment reduction as a result of MPPR
- A disastrous billing software
- An EMR system that charged him $400 per month (he has 4 PTs and 4 PTAs)
- A net profit of $4000 a month on an gross income of $550,000 in 2012 (profit margin of around 9%)
- 40% income coming from Medicare patients and the rest from a mix of high paying commercial payers
- 7% payment reduction impact from MPPR (his payments declined by 7% and not 15%)
- A new billing software, completely integrated with a clearing house with automatic online eligibility verification, automated ERA posting and automatic batch claim creation
- A cloud-based, tablet compatible, iPad friendly EMR system that does more than his previous EMR, at half the cost of his previous EMR system
- Cash paying programs – personal training, massage, group fitness and senior’s wellness programs
- A projected net profit of $17,000 a month on a projected gross income of $675,000 (projected profit margin of 30%)
I’m going to show you how he did it, in this brand new article.
I asked this client 20 questions, and worked closely with him to answer, and implement the answers to these questions.
Before I share all of them with you, I have an important announcement.
I’m going to teach you all the strategies I taught him, LIVE at an upcoming upcoming Ignition 2016 event in San Diego, CA .
Save the dates -September 23, 24, 25. If you want the same transformation in your practice, plan on being in San Diego on September 23, 24, 25 at the Hotel Palomar.
Here’s what it takes to grow a private practice.
1. The right systems. (The 20 questions all revolve around the right systems)
2. The right people.
The right systems must be in place for the before, during and after patient experience at all times. If you want to increase profitability and balance quality patient care, it’s crucial to analyze your payer mix. In fact, it’s important to analyze your ENTIRE practice workflow. I asked my client the following KEY questions and this helped us begin the transformation from before to after:
- Which payers provide the highest reimbursement?
- Are there particular physicians and / or referral sources that are referring patients with certain insurance plans that offer the highest reimbursement?
- What marketing methods can we use to build better relationships with these referral sources?
- How can we encourage more referrals from patients?
- How can we encourage more referrals from and build relationships with local businesses?
- What is the ‘irresistable offer’ that we can provide to patients so they choose us for physical therapy? (think in terms of educational resources like books, audio CDs, free consultations, fitness assessments, free massages etc)
- Are we, at all times, providing care that is medically necessary, and billing for the codes that exactly represent what the patient needs?
- Is the biller staying current with Medicare changes (which are spreading to some commercial payers already) such as functional limitation G code reporting, PQRS and KX modifiers and when to report such parameters?
- How can we shuffle the payer mix and drop certain low paying payers (yes, stop working with certain payers) to increase profitability?
- How can we identify codes with the highest RVUs (that are medically necessary for the patient) and bill in a manner that’s legal and ethical, while reducing the impact of MPPR?
- How many licensed providers work in the clinic and are we paying for EMR, billing software and the clearing house for every person (whether they are licensed or non licensed?)
- What is the total claim volume each month and which are the top referral sources?
- How can we target these referral sources to get a 5% increase in the total claim volume in the next 30 days?
- If we save 5 minutes per patient with an efficient EMR and billing software for physical therapy private practice, how much money would we save?
- What is our claim denial rate?
- Are the ERAs from insurance companies being automatically posted?
- Are we manually creating claim batches and submitting them?
- Do we have to re-enter or edit information from our EMR to billing software?
- Do we have to go back and forth between your billing software and clearing house to get information, claim status and reports?
- Is our EMR and billing software cloud based – so we can access it from any PC or tablet device?
Join us for the #1 Rated Physical Therapy Business Conference in the Country.
www.ignitionevent.com <——— Click here to secure your tickets before the price goes up.
September 23, 24, 25 in San Diego, CA.
Tickets are 65% off for a limited time.
We only have a certain amount of tickets available at this price, so
CLICK HERE TO SECURE YOUR SEAT