How to Mitigate the CMS 8% Reimbursement Cut

On August 1, 2019, Systems 4PT analyzed the CMS 2020 proposed rule and we discussed, “Notice of an 8% reduction of PT/OT reimbursements in 2021.”

The 2,475 page, 2020 final rule was released last week.

The Bad News

Of course, the bad news is that Medicare has finalized and adopted their intention to lower PT, OT, and SLP reimbursements by 8% in 2021. We all need to be aware that this advance notice increases the likelihood that commercial payers will do the same.

Making Good News Out of Bad News

There IS Good News

This is not what you’re expecting to hear, but the good news is that over the past several years, technologies have been developed that increase outpatient rehab collections by more than the 8% that payers will cut.

These new technologies leverage artificial intelligence, machine learning, real-time computer-to-human interaction, Medicare HardStop™ safeguards, advancements in database integration, and “Treatment Not Billable” lists, which quarantine the dirty claims that you’re billing out every day today.

We agree, the prior sentence is a mouthful of terms that don’t prove your collections will increase. So, let’s review some facts:

Analytics

Since 2004, Systems 4PT has measured “before and after” collections when we install new practices
- Our practices have always averaged 9.2% higher reimbursements when using Systems 4PT vs. their prior approach to billing
During 2019, Systems 4PT conducted this same before and after collections analysis with practices who previously billed with a familiar web-based PT EMR and their separate therapy billing software
- Systems 4PT practices averaged 9.6% higher reimbursements vs. collections when using the web-based PT EMR and non-integrated therapy billing software
And while other EMRs rationalize “Our software isn’t the reason your collecting less, everyone’s reimbursements are declining,” Systems 4PT’s collections per claim have been stable for the past four years

It’s important to point out that our practices deserve a lot of the credit for these stable collections. These practices have dramatically increased patient co-insurance and deductible collections during intake. Your EMR doesn’t communicate coinsurance and deductibles due during intake, which costs you 3% or 4% of revenue.

The good news is that billing technology exists TODAY that will increase your collections by more than the 8% reimbursement cut that’s headed our way.

You’re invited to take a look at Systems 4PT’s billing technology over lunch. There is no charge, no obligation, and we won’t chase you relentlessly after the webinar. If fact, if you never call us back, we won’t call you either.

Our conversation will not be meaningless generalizations like, “We’re the biggest, we’re the best,” or “We’re the most trusted.”

You will hear why you’re not being fully paid today, and what Systems 4PT has done to fix the problem. You’ll see the actual technologies and the workflows that increase our customers’ collections by over 9%.