Today on the Podcast: The Silent Revenue Leak: Why Most PT Clinics Are Getting Underpaid and Don’t Know It
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About This Episode
Most physical therapists are getting underpaid…and you don't even know it!
This week, CEO Neil Trickett, PT talks to Andrew Dombek, a physical therapist and the owner of AID PT. Andrew has spent years on the front lines of running an independent clinic and navigating the complexities of insurance reimbursement.
After discovering that PT owners across the country are routinely leaving money on the table through insurance underpayments and unchallenged claim denials, Andrew built Claim Logic OS — a software solution designed to help PT owners identify, recover, and protect the revenue they've already earned.
Today, he’s going to share where PT Owners are losing money due to underpayments – and what you can do about it.
Connect with Andrew on LinkedIn!
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Listen Above or Read The Summary Here:
Understanding the Silent Revenue Leak in PT Clinics
Neil Triggitt, CEO of Practice Promotions, and Andrew Dombeck, owner of Aid PT, explore the issue of underpayments in physical therapy clinics. They highlight how PT owners might be losing significant revenue without realizing it due to complex insurance contracts.
The Complexity of Insurance Contracts
Andrew explains that insurance companies have varying contracts with each clinic, leading to discrepancies in reimbursement rates. He notes, “The clinic across the street could be getting different reimbursement than new facilities have different codes.” This complexity means that clinics often need to identify and challenge underpayments themselves.
- Insurance companies operate with different contracts for each clinic.
- Discrepancies require clinics to proactively identify underpayments.
- Manual tracking of claims is challenging due to numerous billing codes and units.
Identifying Patterns of Underpayment
Andrew shares how his experience with UnitedHealthcare’s daily max led him to discover numerous underpayments. He recounts, “I wrote an email or called the billing company and said, ‘Hey, are you noticing this? I need you to do an audit of this stuff.'” This resulted in recovering between $9,000 and $11,000 from 600 to 800 claims.
- Tracking underpayments manually is difficult but crucial.
- Using historical data can help identify and recover lost revenue.
- Regular audits and monitoring can uncover unnoticed discrepancies.
Solutions with ClaimLogic OS
Andrew developed ClaimLogic OS to address these issues, offering a software solution that identifies and recovers underpayments. The system organizes claims by priority and highlights patterns of underpayment and denials.
- ClaimLogic OS analyzes payment data to identify discrepancies.
- The software helps prioritize claims based on dollar value.
- It includes features like an appeal letter generator to simplify the claims process.
Andrew emphasizes the significance of addressing these revenue leaks, stating, “Small leakages add up to hundreds and thousands of dollars.” With ClaimLogic OS, clinics can systematically tackle these issues, ensuring they receive the compensation they deserve.
For PT practice owners, understanding and addressing these silent leaks can significantly impact their bottom line, making systems like ClaimLogic OS an invaluable tool in their financial management arsenal.
Common Questions Practice Owners Ask About This Topic:
- What is insurance reimbursement for physical therapy?
- How do physical therapy clinics handle claim denials?
- What are common reasons for insurance underpayments in PT clinics?
- How can PT clinics recover lost revenue from insurance claims?
- What software solutions exist for managing PT clinic finances?
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