Hi, this is Dave Kats and I have a tip for you.
People a lot of times ask us, ‘what are the most prevalent and best software out for billing insurance?’. The first thing I would say is this, every therapist should be using their own software. Sometimes I see a therapist that accepts insurance and they will go to Blue Cross to file, Aetna to file, UHC to file. It is better having your own software. If you would like to have something free, I suggest that you use Practice Mate which is by Office Ally. Just look up Office Ally and Practice Mate. It has a great billing system and is absolutely free. If you are a cash practitioner, I would use this type of software to keep your practice organized and your notes organized. If you can afford to pay for software, there are two that have become the king of the hill in the last few years. These are Therapy Appointment and Therapy Notes. We use Therapy Appointment in our office, and we are fans of Therapy Appointment. It cost...
Hi, this is Dave Kats, at Therapist Consultants and I have a tip for you.
There’s a right way and a wrong way to schedule patients as far as scripting is concerned. I'd like to go over the right type of script to use when scheduling a patient. Let's assume you're in a counseling session and your phone rings, and somebody leaves a voicemail that says we may need to come in as new patients. As soon as you have the opportunity, you call them back and you'll say, "Hi, this is Judy Lewis, the therapist that you called about getting in for some care. I have just a few minutes before my next patient. Can you tell me briefly what your situation is?" "Well, yes. My wife and I have been married for 26 years, but four years ago we lost our adult son. It’s made our marriage fall apart. We decided that we either have to call it quits or that we have to get some marriage counseling. So we were thinking about possibly getting marriage counseling.
Now, when they pause or if you break...
Hi, this is Dave Kats from Therapist Consultants and I have a tip for you.
Some people, some therapists have trouble collecting money. They have, what I call, a poverty complex, and I found the best thing to help you with a poverty complex is to have a set of scripts that you use when collecting money from the patient.
For instance, here's one script that we always use in our clinic. When the patient comes to the front-- if you haven't charged them before they go back, and they come up to the front. You say, "That will be $125 for today. Do you prefer to pay by cash, check, or credit card?" And then you just look down and let them decide. But always use that, "Do you want to pay by cash, check, or credit card?" Because then that gives them a choice of yes's. Yes, I'll pay cash, yes, I'll pay by credit card, or yes, I'll pay by check. Always use that one when they come to the front, "Your fee today was $125, do you want to pay that by cash, check, or credit card?"
Of course, once...
Hi, this is Dave Kats, with Therapist Consultants and I have a tip for you.
You know I believe you I have a way that will make your new patients that schedule with you show up with great regularity. That is by asking them for 50% down to hold the appointment. Now that might sound like a bold thing but the first time I taught it, I had an audience of about 50 people and I said, “Is there is anybody in here that asks for 50% down?” Two middle aged ladies that were therapists raised their hand and they said, “We practice together,” and I said, “Do you ask for 50% down?” They said, “No, we just ask for it all down in advance.” So if you think 50% is a lot try all. When we schedule patients, after we schedule them for the time and the day then we say, “In order to hold that appointment, I ask you to put 50% down which will be $75. Which credit card would you like to put that on?”
Let me go over the script, it goes like this,...
Hi, this is Dave Kats from Therapist Consultants and I have a tip for you.
As insurance weakens, some insurance companies pay less and less and less, and there comes a point in time where you have to kick the low payers to the curb.
Where you have to look at the insurance companies that you have and see what they’re paying and if they’re not paying enough, I think you have to get off that panel and then charge the patient cash.
I think in the Mid-West, in Florida, in Texas, probably most areas in the United States; probably $68 is about the breakpoint. If they’re not paying you at least $68, you probably just need to get off that panel, be an out-of-network provider, and then have the patients pay cash because, here’s what we’ve found out, it actually cost between five to ten dollars to have you file insurance especially if you have some outside company doing your billing.
Instead of the insurance company paying you $58, really they’re in...
I’ve noticed that some new therapists have a very low Patient Visit Average (PVA).
In other words, for the number of new patients they see, they don’t see those patients very much. I see some new therapists with a patient visit average of two, two and a half, three, maybe as high as five or six. But, I want to explain something. That’s probably not because you’re getting the patients better. It’s probably because they’re discontinuing care or you’re having them discontinue care prematurely. Now, what do I base it on? You say, “Maybe they are getting better. Maybe I’m getting better.” It could be, but that’s not what’s typical of the profession.
I will tell you that typically the average therapist sees the average patient 15 times over their lifetime, so your PVA should be 15. If you take the number of people that came in this month and divide it by the number of new patients that came in this month, you will...
If you take insurance and even if you are a cash practitioner, you should run an aging of accounts every month. What I mean by an aging of accounts is just a report that tells you who owes you money and how long they've owed you that money. And you have to decide based on that report what you need to do for collections.
I have here a hypothetical aging of accounts that I'd like to go over with you and show you what we would do if we found these on our aging of accounts. Let's look at the aging of accounts.
You can see the first person there is Bill Jones. Now he doesn't owe anything for 30 days, 60 days, 90 days, but from 90 days to 120 days he owes $100 and for over 120 days he owes $400. So he owes a total of $500. Now it appears to me that he has stopped coming in some time ago, about three months ago, and we have not collected from the times previous. Something went wrong, we sent it to the wrong insurance company, or we didn't bill it because we didn't have the right...
David: Hi, this is Dr. David Kats and Dr. Michael Perusich. Today we have a video tip for you. I'm going to talk to you about verifying insurance. Let me start, and then you finish on this. It's important that you verify insurance on every patient that has insurance if they're going to use the insurance in your office. Now, it used to be in the old days, which means a year or two ago, we called all the insurance companies to verify the insurance coverage, and we'd sit on the line for 15 or 20 minutes waiting for them to come on the line to give you the insurance coverage. Right now the online verification has gotten so good that nearly everybody has switched over to online verification, and if you haven't, probably now is the time to get started.
Michael Perusich: That's absolutely right. You said something very important in there. You don't just verify insurance with new patients, you verify a patient's insurance every year. That's really important, and not just to find out if...
Dave Kats: Hi, this is Dave Kats and Dr. Michael Perusich with Therapist
Consultants, and we have a tip for you. You know, you need to know what each
insurance company is providing as far as repayment to you, so you're aware of
where you stand with each insurance company.
Dr. Michael Perusich: That's absolutely right, David. You know, it's always amazing
to me that we go through our practices, we're busy seeing our patients and doing
those things, and yet, we never take the time, in some cases, to really stop and think
about what are we getting paid. Are we actually getting paid enough to actually
make some money because that's why we're in business?
Dave: Yes, sometimes your overhead is actually more than the amount you're
getting paid for that hour.
Michael: That's right.
Dave: If you don't get rid of the low payers, you won't naturally create room for the
high payers. Another reason you should lay out as list of what each insurance
company pays you, is because then you know who to go after as...
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