Fee Schedules and Allowed Reimbursement in Physical Therapy Billing

I just ran into a series of blog articles that included some misinformation on fee schedules.  Although I would much rather write on clinical management, I felt obliged to write on this, because it is a constant source of confusion.

By and large, you should not charge different payers different fees for the same service.  If you do want to consider creating multiple fee schedules, talk to a knowledgeable healthcare attorney or consultant and have them walk you through the contractual, regulatory, and legal minefield of implications first.  We recommend ONE fee schedule for all payers and systematically tracking your expected payment in Allowed Reimbursement Schedules for accurate management reporting.

Charging all payers the same fee does create difficulty in using Accounts Receivable to accurately predict cash flow.  Applying a discount based on the relationship between your fee schedule and the amount you actually expect to be paid, and applying this to your Accounts Receivable is one method for better predicting cash flow. Choosing the right physical therapy billing software can simplify this for you. Clinicient helps you solve this problem by allowing you to systematically track your expected payment in Allowed Reimbursement Schedules, which can then be used to track the accuracy of payments from your payers, and to automatically determine the cash value of your Accounts Receivable.

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  1. Tim Snyder, PT, DPT
    Posted June 5, 2012 at 3:05 am | Permalink

    Starting an out-patient practice and looking for ways to manage billing and documentation.

  2. Posted December 13, 2012 at 2:34 pm | Permalink

    Please advise the best way to implement a billing process that includes various insurance carriers in a small PT pilates practice. Have been private pay and am struggling how to offer a more affordable way that could include insurance to better serve the general public in need.

    Thank You in advance for your time and consideration in providing me with a step by step elementary plan that may be doable for my clinic/Pilates practice.

    Dr. Deanna Lesmeister

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