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Five Common PT Billing Errors – From Pre-Care to Denial

Your physical therapy practice may be busy with patients, but it can often seem most beholden to insurance companies – at least for cash flow. In the health system as it is now, because doctors or even insurance companies have recommended that people come to you for treatment, insurance claims make up the bulk of your revenue. That means you’d better be sure the bills and claims are submitted correctly. Otherwise, PT billing mistakes, from pre-care all the way up to a denial notice, can cost your business thousands of dollars in delays, rejections, and denials. In some cases, it can even directly hinder the treatment of a patient.

Avoid these common billing mistakes and keep the cash flowing for your PT practice.

  1. Typographical Errors

We’re all human and therefore fallible. Unfortunately, the insurance companies don’t often give us the benefit of the doubt. Their systems demand perfection, otherwise… denial and delay. The most common PT billing mistakes come from typos. It can be a billing code, patient name, practice name, insurance company name, the patient’s sex, clicking the wrong box… virtually anything. Check, re-check, then check again to avoid a denial based on a typo. Or else employ a physical therapy billing and collection service to take the strain off you and boost the accuracy of submissions.

  1. Sometimes It’s the Codes

There sure are a lot of insurance codes. Thankfully, many of the codes are universal; but there are quite a few that are unique to particular insurance companies. Confusing CPT codes with ICD-9-CM codes and PoS codes can easily cause a denial. Failing to enter the correct number of digits or using the wrong format are among the most common PT billing mistakes. If you forget to enter all the codes for all the treatments and services provided, or if you use mismatching treatments and diagnosis codes, you’re sure to land in the denial boat. It requires having people who are always on top of the quirks and details of PT insurance.

  1. Duplicating a Claim

Duplication is when a service is billed for but not checked and has already been submitted or even paid. It’s amazingly easy to duplicate a claim. It’s equally easy that both will be sent back to you. Sometimes software will warn you that you’re duplicating, but don’t rely on technology for everything. Keep your eyes open and go over the super bill of the patient to help reduce instances of duplicate claims.

  1. Lack of Verification

Denial under these circumstances can be tough to hear, especially for a patient coming back for more help. Always verify that a patient has insurance prior to conducting a service or sending in a claim. Out of all the PT billing mistakes on this list, this one could often be avoided with a phone call. When an insurance company denies a payment or drops a person from a policy, sometimes it’s legitimate, sometimes it’s their own clerical mistake, and sometimes a change in employment and carriers caused the snafu.

  1. Overbilling

Overbilling can be due to a simple clerical error, but charging too much or charging for services not provided can have a very negative impact on the loyalty of your practice’s clientele. Nonetheless, it happens. Quite frequently, too.

Avoiding all these PT billing mistakes requires having a team of people who are knowledgeable, skilled, up to date at all times, and working together like a smooth machine. There is a huge amount of detail to keep track of. We recognize from experience that sometimes it can become too much for a practice’s valiant and dedicated admin staff to handle entirely. This is where hiring a PT billing and collection agency can be a lifesaver to a practice and allow everyone to enjoy their jobs again without the threat of insurance denials and cash flow problems.

Creative Commons Attribution: Permission is granted to repost this article in its entirety with credit to Jet PT Billing and a clickable link back to this page.

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    • "Jet PT Billing is the best billing company that I have used. They have a comprehensive statistical approach to billing..." Read more »

      Scott Cole

      Franklin Rehabilitation

    • "This rapidness has completely turned my company around and I highly recommend this team to all physical therapist." Read more »

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      Lonoke Physical Therapy, Inc

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      Nathan Stack

      Optimal Physical Therapy


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