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Do you need to know any insurance coding for patients?

#physicaltherapy

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Katrina’s Answer

Hi Dexter,

You do not have to be an expert by any means in insurance or coding, but it is something that you will do as a physical therapist but it also depends on your setting as to how involved you are. For example, in the hospital, the physician usually selects the code for the visit and that is automatically selected for me, in outpatient or rehab I may have to select my own codes.

There are some codes that are specific to physical therapists. We use those for billing, but again it depends on the setting as to how involved you are with billing. These ones get very repetitive and are easy to learn.

As for insurance, you will learn about the different types of programs in school, but when you are working in the field we often have in-services when there are changes.

And, if you make a mistake there are lots of other people there to help you catch it! I hope this helps.


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Justin’s Answer

Hey Dexter,

If you were to get into physical therapy you wouldn't have to be an expert on insurance or medical coding and billing. You'd want to understand how medical insurance works since many of your patients would be using insurance but the specifics around coding and billing would be handled by other individuals, possibly one's that you would hire to work with you.
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Emma’s Answer

Hi Dexter,

Yes, physical therapists should have knowledge of insurance coding and billing practices as it is crucial for effective patient care and reimbursement. Understanding insurance coding helps therapists accurately document the services provided during therapy sessions and submit claims for reimbursement to insurance providers. This ensures that patient records are complete, supports compliance with legal and ethical standards, and facilitates effective communication with insurance companies. While therapists may not handle insurance claims directly, their collaboration with administrative staff or billing specialists within a practice ensures proper coding and documentation, ultimately benefiting patients and managing healthcare costs effectively.
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