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Scott Jones, PT, has spent 25 years in physical therapy, most of it as an Air Force physical therapist with a background in orthopedic manual therapy.
About a year and a half ago, he opened his own practice, Peak Health and Performance, built around a goal he had carried for years: create a clinic where clinicians could finish their notes during the workday and avoid the high-volume mill model that so often stalls patient progress.
The clinical side came together. The billing was a different story.
"20% denial rate. That's what we were up against. Not because we were not conscientious or thorough or lazy, but because we're a new clinic and we didn't understand what we didn't understand," Scott said.
Scott's team was thorough and committed, but denials kept coming and revenue kept slipping, and no one could pinpoint why. Working with Prompt Business Coaching (formerly OTPI), the practice changed how it communicated with payers, and the financial turnaround followed in under 3 months.
Since working with Prompt Business Coaching, the practice has seen:
- Nearly 50% increase in the amount billed
- 16% increase in revenue collected
- 2/3 reduction in claim denials
Before Prompt Business Coaching: working hard, but stuck
The practice was new, the team was conscientious, and the denials kept coming anyway.
"We knew that we were leaving revenue on the table. We knew that our denial rate was much higher than it should be," Scott said.
The hardest part was not knowing why. The team spent what Scott calls a "truly inordinate amount of time" on the phone with insurance payers, and the answers rarely lined up.
Every call to insurance seemed to produce a different response, and his team had optimized as far as it could on its own, but they kept hitting the same wall.
"It really became a matter of do we want to spend our time talking to the payer representatives, or do we want to spend our time with our clients?" Scott said.
The team wanted to move the practice forward, not spend their days correcting mistakes in the rearview mirror. After weighing their options, they engaged Prompt Business Coaching to make the jump.
"We wanted to spend time moving the clinic and our processes forward, and we were stuck. Looking around, weighing our options, [Prompt Business Coaching] seemed like the best option to help us make that jump," Scott said.
Speaking the payer's language
The Prompt Business Coaching team focused on something Scott hadn't expected. Rather than overhauling clinical care, they zeroed in on how the practice communicated with payers, and on being explicit about the clinical intent behind each code.
They provided clarity on just how important it is to communicate effectively with the payers using the payer's language.
The financials turned around quickly, and without touching patient care. By cleaning up how the practice communicated coding intent, the numbers moved across the board.
"There was almost a 50% increase in the amount that we billed, and there was very quickly a 16% increase in the revenue that we collected," Scott said. "All without changing anything other than simply expressing our intent to the payer."
Getting intake right
The Prompt Business Coaching team guided them in focusing on 2 operational fixes. The first was a daily review of the sub-tabs of the billing module, where teams can review the categories of notes and claims that need to be cleared each morning before they turn into denials.
As Scott put it, "We weren't doing it at all, and we didn't even know [those categories] existed." Clearing the backlog and building a daily habit eliminated 30 to 40% of claim denials on its own.
The second was intake. Prompt Business Coaching, led by consultants Chris and Megan, kept returning to where denials actually originate.
"Chris and Megan did a great job of early on really hammering away at this idea of, 'look, if you automate everything that you can and get the intake process right, and as much as possible eliminate the potential for error with intakes, you will eliminate 2/3 of your claim denials,'" Scott said.
The result matched the promise almost exactly. "That was 100% true, and it was almost exactly 2/3 of our denials went away just by implementing that," he said.
A turnaround in under 3 months
What surprised Scott most was the speed. Within 2.5 months of working with the Business Coaching team, Scott saw increases across total billed, total revenue, average gross revenue, average net collections per visit, and days to payment.
It was less than 3 months, and all those numbers went up fairly dramatically.
Focused on what moves the practice forward
For a new practice, the gap between working hard and working effectively can be expensive and invisible at the same time. Scott's team was thorough and committed, but they were missing information they could not have found alone.
Prompt Business Coaching closed that gap by changing how the practice communicated with payers, not how it cared for patients.
It's just [now] we're communicating effectively, and we're reaping the rewards of that.
