How to Optimize Your Occupational Therapy Billing 

Author: Paul Singh
Categories:  Occupational Therapy

Occupational therapy billing is one of the biggest challenges that clinics face. 

As the processes for submitting claims differ from insurer to insurer, it’s difficult enough to keep track of what payers require. And if you’re offering different types of therapy—such as occupational therapy (OT) and physical therapy (PT) together—there are even more complexities to keep track of. 

Any mistake in the documentation or billing process leads to claims being denied. These denied claims build up, and your admin team’s left with the exhausting task of correcting, resubmitting, and following up. It’s such a cumbersome process that clinics now expect many of their claims to remain unpaid forever. 

In fact, many OT practices we speak to see 20% of their revenues go uncollected.

Most ‘guides to occupational therapy billing’ share the different OT billing codes and expect you to handle the rest yourself. But when your priority is to manage your practice, that’s no easy task. Using the right CPT codes is only part of the problem of OT billing—and it won’t prevent denied claims all by itself.

Here you’ll learn how to get reimbursed for all the work your practice does. We’ll explore how StrataPT’s platform and billing service will help you collect more than 99% of what you’re owed by insurers and patients. 

But first, let’s look at how conventional billing practices are costing you money:

Poor occupational therapy billing processes are costing you money 

Your OT clinic might be managing billing in-house, through outsourced billing services, or through a bolt-on to your electronic medical records (EMR) software. But if you’re reading this post, it’s likely that whatever process you’re using isn’t up to scratch.

Poor billing processes are not only tiresome to manage, but they’re often a financial drain, too. Costs can accumulate through:

  • Unpaid reimbursement claims. If your billing isn’t done right, you likely won’t be paid for all that you’re owed. We’ve seen clinics that are losing as much as 50% of their revenue to billing problems. That’s a huge issue that must be addressed. 

  • Sprawling staff hours. If you’re managing your billing in-house, you’ll be paying for someone to double-check billing requirements, correct, submit, and chase. As your clinic grows, you may need to hire again—or pay overtime—to manage this swelling workload. 

  • Billing services fees. Because outsourced billing services are often small businesses, they often only chase the larger collections. The problem is that those smaller claims really add up. If they’re not being chased, you’re leaving money on the table. 

  • Software costs. Many therapy practices we speak to are using a range of tools for the different processes in their business. They’ll often have an EMR for the clinical documentation alongside a separate billing tool or an extra software module. But the more tools you add, the higher your bills. Costs also rise as you add more therapists. 

We designed our all-in-one software, StrataEMR, to reduce these costs and struggles for OTs and therapy clinics. StrataEMR provides you with free EMR software that combines billing and revenue cycle management (RCM) in one platform to help you achieve a reimbursement rate of higher than 99%. No other provider in this industry will make you more money. 

How StrataPT Makes OT Billing Easy

We created StrataEMR after experiencing the challenges of OT and PT billing first-hand. 

In this section, we show you how we built the software to help OTs, physical therapists, and other therapists reduce the costs of billing and get paid for everything they’re owed.

1. StrataEMR brings billing and clinical documentation together

One of the biggest mistakes clinics make is separating their EMR and billing. In fact, billing is often treated as an afterthought because conventional EMRs and outsourced billing services encourage clinics to think that way. 

As a result, you might treat patients, update your records, and issue plans of care—and only then see that the procedure codes are out of scope, or that there’s an error in your submission. Inevitably, that’ll lead to inaccurate claims and medical necessity denials.

That’s exactly why we built StrataEMR with billing at its core. 

With StrataEMR, clinicians see that any treatment options and examinations conform to payer rules (and/or your internal guidelines)—before they’re issued.

This way, you’ll benefit from:

  • Guardrails to ensure all treatment issued gets reimbursed. For example, if particular insurers stipulate limitations on care, clinicians are alerted to this prior to submitting documentation. As a result, you’ll be aware of all potential issues before submitting claims that will be denied. This is what we call the Billing Plan of Care

  • Automatically updated billing codes. Don’t waste time researching current procedural terminology (CPT) codes, or trying to understand the most recent rules from Medicare. Instead, you can rely on StrataEMR to keep you up to date on evaluation codes and rules on billable units. 

  • Templates for all different types of therapy. A common issue for occupational therapists using generic medical software is that typical documentation templates are often just not relevant to the needs of OT services. But with StrataEMR, you can use preset and customizable templates to ensure that your documentation makes sense for the type of therapy your patient needs. 

This applies to billing codes, protocols, and modifiers, too. For example, if a patient needs hand rehabilitation treatment, you’ll find all the L codes you need in the template. Or if you need to include therapeutic exercises, you can add those, too.

StrataEMR: Choose Your Responses and Edit Selections

StrataEMR puts billing at the heart of clinical documentation, to help you ensure all your claims are clean, complete, and accurate—so you get reimbursed for everything you’re owed.

2. StrataPT’s billing service chases all unpaid claims for you

Clinics that partner with StrataPT typically see that 85% of their claims are paid within 30 days without any need for them to be edited, submitted, or chased.

But for any claims that do get denied, we’ll do the hard work to make sure you get paid. We chase every single unpaid claim, no matter how small. This is how we help our clients achieve a >99% reimbursement rate. 

Here’s more of what you can expect with StrataEMR:

  • Faster payments. With StrataEMR, more than 95% of all billings are paid within 60 to 90 days. Bearing in mind that physical therapy practice benchmarks say PTs are doing well if they have less than 25% of accounts receivable in 120+ days, that’s big. One clinic we’ve worked with had 65% of their accounts receivable older than 90 days—adding up to over $200,000. Now, with StrataPT, less than 4% of their AR is older than 90 days.

  • 24-hour customer service. Whatever your query or concern, our US-based customer service team responds within an average of 22 minutes during business hours. 

  • A single fee for the software and billing service. Don’t pay for multiple softwares, tools, and services to handle the different parts of your practice. With StrataEMR, you won’t pay per-user fees and you won’t even pay for the software. Instead, you’ll pay a fixed rate on billings, while we ensure your reimbursement rate exceeds 99%.  

3. Strata Clarity ensures you have visibility over all your finances

While we take care of the hassle of chasing unpaid claims, you’ll want certainty over your practice’s performance. StrataEMR’s Clarity Panel provides exactly that reassurance, giving you key data on all aspects of your OT practice. 

  • Key billing metrics and financial data. Whether you want to check your accounts receivable, the average billed units per visit, or how your occupational therapy reimbursements compare to different therapy types, Strata Clarity puts all that information at your fingertips. 
Financial Metrics: Billed Visits and Billed Units, Billed Dollars, Average Units Per Visit, Insurance Payments, and Patient Payments
  • Data by insurer, clinician, and patient. See how individual therapists are doing or dig into your reimbursement rates for different insurers. You can also see claims made for each patient or payer, with a play-by-play record of every single transaction and treatment for each patient. 

    As an example, you can see how particular billing code combinations impact reimbursement rates, so you can adjust how your Billing Plan of Care is set up for certain healthcare insurers and patients.

  • Information on other parts of your practice. Get clarity on appointment cancellations, marketing campaigns, referral channels, patient satisfaction, and more. Using StrataEMR, you’ll have all your critical data under one roof, to improve practice management and grow your business.

4. Patient billing provides financial clarity to patients 

Alongside maximizing reimbursement rates for your clinic, StrataEMR also makes it easier for patients to use your services. 

All patients receive a personalized portal where they can access all the information and tools they need to enjoy a more streamlined experience with your practice. Here, they can manage their payments, complete questionnaires and intake forms, and sign and upload documents. 

  • Patient balances and payments. Patients can see how much they owe and simply pay by card. Many of the practices we work with tell us that they’ve dramatically increased their number of patient collections thanks to this feature. 

  • Easier onboarding and patient management. All you have to do is share documents through StrataEMR’s patient portal and they’ll be able to complete questionnaires, sign any documents, and return them to you. 
Example of Client View: Consent and Policies, Benefits Confirmation, Patient Registration Form, Health Questionnaire

Speak to an expert, and discover what StrataEMR can do

StrataEMR improves your reimbursement rate to higher than 99%, helping you make more money without having to pay extra software fees. With StrataEMR, you’ll be able to submit clean and complete claims, get paid faster, and track your financial performance.

Give clinicians back their time to focus on their patients and therapeutic procedures while improving your bottom line. Speak to an expert today to see how StrataPT can keep your OT billing up-to-date, clean, and compliant. 

Recommended reading:

  • 4 Must-Have Features of Occupational Therapy Software: If you’re offering outpatient occupational therapy services, you need to be sure all your interventions will be reimbursed—from your initial OT evaluation (whether low complexity, moderate complexity, or high complexity) to the therapeutic activities you employ. For this, you need OT software with some key features, which we reveal in this guide.

  • How to Do PT Billing and Get a >99% Reimbursement Rate: From Medicare’s 8-minute rule and time-based CPT codes to using untimed codes and following payer rules for manual therapy, getting PT documentation right is a big challenge. This impacts your billing and RCM. In this article, we show StrataEMR facilities clean claims by seamlessly integrating your documentation and billing processes.