Florida Therapy 101 Video Blog Series

In partnership with TheraPlan, our therapy EMR, we have started a new video blog series. Check out our first installment above!

In this edition, our CEO explains what he’ll be covering in future videos to keep our clients and other therapists and clinic owners informed about everything that’s happening in Florida therapy billing.

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How to Find the Right Billing Agency for Your Therapy Practice

As a therapy billing agency with over 25 years of experience, we understand that billing can be complex, intimidating, and confusing. It is also perhaps the most important function you have to perform as a practice owner; after all, accurate and timely billing is at the core of a thriving practice.

Even if you’ve decided that you need outside help with all tasks related to billing, choosing a trustworthy agency is not a straightforward task. Below, we share our master tips for choosing a billing agency. Read on to get the scoop.

  1. Meet face-to-face. Before you decide to trust anyone with the enormous responsibility of collecting your revenue, it’s best to get a feel for them in person. There is no substitute for face-to-face interaction. It can tell you more than any phone call or online search will. Once you’ve narrowed down your choices, we suggest setting up a time to meet with your potential billers and make final decisions based on how those meetings unfold.

  2. Listen for a high level of industry knowledge. From the first interaction, your communications with an agency should feel right, especially when it comes to industry verbiage. When someone is at ease with the lingo you use every day, including insurance terminology and CPT codes for each discipline, it is a sign that they have a good understanding of the nuances that accurate billing processes require.

  3. Look for an emphasis on great customer service. Any time you have a question or concern, you should feel comfortable calling up your billers and asking them anything. This kind of open relationship is of utmost importance. A billing agency that is willing to go the proverbial extra mile for you is one that will fight for you.

  4. Take note of additional services. While billing agencies focus on properly submitting claims and posting payments for you, some agencies offer services outside of the basics. These can include eligibility verification, authorization requests, and continuous maintenance of aging claims. It’s essential to understand the full range of what you’re getting when you begin a relationship with an agency.

  5. Understand the scope of provider types the agency services. More is not always better. You should select an agency that services therapy providers. Just because a billing agency services cardiologists or chiropractors, for instance, does not mean they can service you. Therapy billing is unique.


We’re confident that following the above recommendations will lead you to the right fit. How do we know? Find out more about what EEP offers, above and beyond the accuracy and integrity you should expect from a therapy billing agency.

How Outsourcing Billing Can Make Your Therapy Clinic More Efficient

If you own a therapy clinic, you no doubt understand that billing involves more than just submitting claims. Duties such as requesting authorizations, applying payments to patient statements, and reconciling can comprise a full-time job. Chances are, you and your admin team don’t have the time to complete all of these tasks accurately. Calling in specialized help is one of the best ways to ensure that you and your therapists get paid in full and on time. Read on to discover why the EEP team suggests outsourcing your billing to a qualified agency.

  • Medical billers will accurately submit your claims. Claim submission can be a tricky process, with requirements varying by insurance provider. An experienced billing agency is familiar with these details, and will get your claims submitted on time and correctly. Instead of spending your time searching for the right way to submit claims, you can let the experts take care of it and reduce the risk of errors in the submission process that could extend your payment turnaround time.

  • They can handle erroneous denials. Trained medical billers will fight for you. Whether it means spending hours on the phone with insurance companies or tracking down medical documentation, billing agency staff do whatever it takes to address any erroneous denials. This saves you and your team precious hours and prevents lots of stress!

  • An agency performs thorough follow-up. Once a claim has been paid by insurance, there is sometimes a remaining balance on a patient’s account. Keeping track of these unpaid balances and invoicing patients is important in order to collect what your clinic has earned for the treatments performed.

  • Specialized knowledge. If you choose to work with a billing agency with expertise in your particular specialties, you will get even more out of the relationship. Billers who work with just therapy clinics always know which CPT codes are appropriate and understand the nuances of billing for treatments, evaluations, IFSP conferences, and more.

There are countless other benefits to outsourcing your therapy billing to an agency. Read more about the services a therapy billing agency like EEP can provide.

Once you’ve decided to go with a billing agency, selecting the right one doesn’t have to be a daunting journey. Check out our blog post about how to find the right fit for your practice.

 

Insurance Authorizations 101

When a new patient arrives at your therapy clinic, there are several bases to cover before he or she can be treated. Along with standard intake forms and insurance verification, we recommend checking benefits and requesting an authorization. Following these best practices will protect you from the dreaded scenario in which you perform treatment and do not get paid. 

Although therapy clinic owners and admins are generally most familiar with the process of obtaining an authorization from an insurance company, it's wise for therapists to understand the process and act as another set of eyes. Let's go over the basics: 

What is an authorization? An insurance authorization is a determination by a patient's health insurance carrier that treatment is medically necessary. Since commercial insurance plans consider therapy a specialty, authorizations are required in many cases. Florida Medicaid requires authorization for all therapy disciplines. While an authorization is not a guarantee that the insurance will pay, it is much more likely that benefits will be honored when the authorization is on file.  

Why should I worry about authorizations as a therapist? You may feel that your responsibilities follow the paperwork process that your admin team normally takes care of. However, if you unknowingly treat a patient without an authorization on file, you could risk spending valuable time treating a patient and not getting paid, or experiencing a lengthy delay in payment time. In addition to the risk of lost revenue for you and your clinic owner, lack of an authorization can throw off your plan of care. Since the details in your plan of care depend upon your expectation of when a patient will meet certain goals, the amount of benefits and number of pre-approved treatments can impact whether you will be able to follow the plan. Keeping an open line of communication with your owner and admins can help you avoid any miscommunication about the type and quantity of treatment you provide your patients. 

Though you may not be responsible for requesting authorizations or attaching them to a patient's file, our expert billers at EEP advise that you check to see if there is an authorization assigned to every patient case, especially for new patients. A few moments of due diligence go a long way towards making your treatment plan and payment process as smooth as possible! 

Want to learn more about insurance authorizations? Check out how our partner EMR, TheraPlan, eases the job of a therapist by tracking authorizations for you!