Billing for Rehabilitation Clinics

Print off an invoice, lick a stamp, wait a few days and you get a payment in the mail, right? Those of you who started out as a “one therapist” clinic can attest to the fact that physical therapy billing, even for a small clinic, is not that simple.

Those of you who started out as a “one therapist” clinic can attest to the fact that physical therapy billing, even for a small clinic, is not that simple. In fact, billing for rehab services is one of the more complicated processes in comparison to other medical specialties. Therapy Billing doesn’t fit into the mainstream of one visit and one bill like a typical physician practice. It involves an ongoing, pay-for-service relationship that relies on both subjective opinions and objective data as to whether the patient is “well” or requires ongoing treatment. That’s a scary thing for payers so it’s not surprising that many therapy billing departments experience a long period of time between the initial bill and the final receipt of payment (AR days). Payers require specific documentation on the types of services provided and when that documentation is not presented in a readable and understandable format, the claim goes in the rejection file.

As the baby boomers age, the need for therapy services has risen exponentially which places a larger strain on Medicare. The Medicare Cap limitation imposed on therapy services is yet another obstacle for therapy billing departments. Not only does Medicare require documentation over-and-above the other payers. . . they have a specified limit on the amount they will pay for each patient during the course of a calendar year. TherapySource also makes available specific modules that will give you a real-time view of the total amount of Medicare coverage each patient has used so that you will know how much will be owed to you by the patient. In Many cases, the clinic will know when the cap is reached before the patient. This allows the clinic to let the patient know, up front, when a service will need to be paid out of pocket.

The benefit of using a software program like TherapySource in combination with RehabToolkit Billing module, is the integration between documentation and billing. You have complete confidence that everything that is documented will be billed appropriately, and more importantly, everything that is billed will be completed and supported in the documentation. The software prompts the therapist for the correct documentation as the service is being performed, leaving no room for errors or missed charges.


Also see our information on Physical therapy documentation software and Physical therapy scheduling software.