(Updated March, 2024)
When looking for practice management tips as a physical therapy startup, our clients often hit roadblocks around the credentialing experience and how to navigate getting insurance contracts. We’re happy to share a handful of tips that will help you make your case to the insurance companies and start serving more patients in no time!
So, you’ve opened up your clinic and now you want to get into the insurance companies to be more inclusive of your patient’s providers. If you’re told no for whatever reason (too many providers, etc.) the first thing you can do is look at your internal systems.
We recommend generating some presentational data that shows you have a quality assurance system in place.. Essentially, the goal is to look like a zebra among providers with a designated quality control officer (this is usually just one of your clinicians) so you can show the parameters that you operate under.
When physical therapy startups have these things in place, it makes their case stronger for insurance companies to consider your clinic. Nevertheless, we have more tips up our sleeve to help get your physical therapy credentialing in order.
Use any or all of the following guidelines of what to present to insurance companies to improve your chances of securing a contract.
Tips to Secure an Insurance Contract for your Private Practice
- Demonstrate that you have a peer-to-peer review system that helps your patients avoid unusually long length of stays.
- Reveal that you have a clinical chart auditing system to ensure medical necessity is delivered and progress is being seen with short and long-term goals being met. The bottom line is to show them that you have all of your policies and procedures in place with a full compliance program and staff who are well trained at delivering in accordance with all rules and regulations.
- Show that you have an internal mentorship and professional enhancement program to ensure that the highest quality of care is being delivered with the best trained therapists. It’s important for insurance companies to know that businesses are investing in their staff through the use of Learning Management Systems (LMS). These LMS programs have a proven track record of delivering positive results from employees who work more proficiently and deliver greater patient outcomes.
- Share your patient survey and outcome data in a presentation style that makes it easy for them to see how well your practice is mapping out and accomplishing goals. Be sure to promote patient results that are in the top 10%.
- If possible, obtain a minimum of five medical doctor letters stating they wish to utilize your services but unfortunately their patients have been unable to participate due to the lack of access to your practice not being under contract.
- If possible, obtain a minimum of ten patient letters stating their dissatisfaction with not being able to access your services due to lack of being under contract.
- Finally, seek to provide a unique specialty service that is not being done within a 5 mile radius of your office such as occupational therapy, speech therapy, pediatric therapy, TMJ, aquatic therapy, or dry needling – to name just a few.
If you’re still having challenges, consider outsourcing these efforts to practice management experts who understand and have experience working with insurance companies on behalf of physical therapists.
Learn more about MEG’s Credentialing Services and let us take on the bureaucracy that is slowing your physical therapy startup down.
