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There are many reasons as to why someone would want to start their own business. If you are constantly at the office, or store, you will not have the time you would like to spend your time with your family. If you work from home, you can spend more time with your loved ones, pets, and a lot more, simply because you will be in your home office, just several feet away from your family. It will be very convenient during times when your child is at home unwell or when your child has to be picked up from school. Getting out of bed at 6am to get to work at 8am is not really for everybody; although the majority of people find a way to endure it. Whenever you work at home, you will have the freedom to work whenever you work best. Some people like to wake up at 4am and work for a few hours, catch a nap and get back to work. Working from home allows one to do these things, especially if your work is on the internet. This is one of the most favored motive for anyone wishing to work from home. Based on what the business owner's additional duties and income sources are, they can set their own home-based business workload to fit around them. The reasons to start a home-based business are plentiful, but what it amounts to for most of us is the opportunity to be totally free of the conventional job and everything that it involves. It is an undeniable fact that not everyone is able to work well together, and some clients will not be a good match for you and your specific services, which is completely natural. Whenever you work for someone else, that person can determine who your clients are going to be, however what doing work for yourself offers you is the liberty to determine who you would like to accept as a client. You will find that there are few work opportunities outside of home-based businesses that offer that level of freedom.
As far as Wendel knows, third-party credentialing only applies to the clinic that has a contract with that insurance company. “If you go out on your own, and you do not contract with any third-party payers, then you are not bound to any of that insurance company’s rules,” she says. However, she cautions that before doing anything, you should have an attorney review the contracts that you and/or your employer signed during your tenure at that practice. Should I check my new patients’ benefits for them to determine whether they need prior authorization? I didn’t think this type of legwork was required of a cash-based PT. Wendel has a form she provides to patients that they can use as a prompt to ask their insurance company the right questions about their out-of-network benefits. “As an out-of-network provider for third-party payers, you can charge whatever the market bears in your town/city,” Wendel says. “Patients are not required to submit for reimbursement,” Wendel says.
I’m starting a cash-based PT practice in a fitness studio, but we will be separate entities. I will provide the PT billing invoice, but the payment will go through the fitness studio (and, therefore, the patient will get a payment receipt from the studio). Will this be a problem when the patient then submits this to insurance for out-of-network reimbursement? I’m opening a cash-based health and wellness practice, and I’d like to get patients reimbursed through their insurance companies. Do you have documentation you provide your patients to help them obtain reimbursement? ” To determine whether a client is eligible to receive reimbursement for wellness services, you’d need to check with the insurance company—or ask the patient to do so. Wendel says that “some clients may be able to use their health savings account (HSA).” In fact, she’s used Square to process payment from a client’s HSA card. Can I accept payment from Medicare patients?
You may not accept payment from Medicare patients unless you are a non-participating provider, Wendel says. No relationship: PTs who have no relationship with Medicare may not provide covered services (e.g., physical therapy) to Medicare patients. However, they are able to provide non-covered services, including wellness services. Non-participating provider: PTs who are non-participating providers are allowed to accept self-payment at the time they provide service as long as they send the claim to Medicare so that Medicare may reimburse the patient directly. Participating provider: PTs who are participating providers accept and bill Medicare for patient visits. If a Medicare patient wants to pay cash for therapy and does not want to be reimbursed, is that not allowed? Unfortunately, that is not allowed; physical therapists may not opt out of Medicare. I’m a rehab therapist with a private practice, and I’m considering going cash-based. Where can I learn more about the specifics of billing Medicare for services rendered?
We recommend reading Jarod Carter’s three-part series (here, here, and here) on Medicare for cash-based practices. What have you found to be the most efficient method for providing patients with necessary documentation for their insurance in conjunction with receipts? Wendel created all of her own forms, which you can find here. Do cash-based providers need an EMR? Wendel uses WebPT’s EMR and Front Office Package: “I like having everything handled through WebPT,” she says. “It's pretty seamless. I use everything: scheduling tools, automatic appointment reminders—which are invaluable—and online evaluation and treatment note faxing. Do you document wellness services in WebPT for Medicare clients? If so, how do you handle the ICD-10 and CPT coding section? Wendel says that she “documents the visit in shortened form (not a SOAP note), and records the exercises and movements” she does during each session. I use the "Unknown" code for the ICD-10 section—it's just a place-holder—and four units of therapy exercise for the CPT code. I’m a fairly new physical therapist who works for a not-for-profit organization as a full-time PT. I’d like to open my own part-time cash-based clinic for after-work hours.