Shouldn't Physical Medicine providers get reimbursed fairly for helping injured workers get back on the job?
PTPN CompDirect thinks so.
As you are well aware, the workers’ comp business has changed dramatically over the last several years. We’ve seen the Physical Medicine segment of the market become dominated by large Rebilling Vendors that offer employers and other payers small discounts off the workers’ comp fee schedule, pay providers very low rates, and keep the difference.
PTPN CompDirect changes all of that. Our workers’ comp Physical Medicine program offers more services to payers and generates more business for our member providers – at fair reimbursement rates. And unlike Rebilling Vendors, PTPN will not direct patients based on the lowest contracted rate.
We’re accomplishing that by introducing something that neither providers nor workers’ comp payers can currently get from Rebilling Vendors: transparency and accountability. In PTPN CompDirect, payers pay providers directly. There’s no middleman billing the payer and paying only a fraction of the payment to the provider, which slows down payment, frustrates providers, and jeopardizes the injured workers’ experience.
This program has been developed in response to what both providers and payers have been saying: The Rebilling Vendors are wreaking havoc in workers’ comp. You have been asking for ways to get reimbursed fairly and to recover workers’ comp patient volume that has been taken away; payers have been increasingly dissatisfied with the level of service and quality of care they’re receiving.
How are providers paid?
Unlike with Physical Medicine Rebilling Vendors, in PTPN CompDirect providers are paid directly by the payer. In addition, providers will be reimbursed fairly, at rates higher than Rebilling Vendors typically pay, after they take their cut.
Do certain providers get priority status when it comes to patient referrals?
Priority for patient referrals will be given to providers who qualify for Tier 1 of PTPN CompDirect. This qualification is based on criteria like participation in a benchmarked outcomes program and passing an on-site credentialing visit. Unlike Rebilling Vendors, PTPN CompDirect does not direct patients based on a provider’s contracted rate.
What are the benefits of joining PTPN?
PTPN is the nation’s premier network of independent private practitioners of physical therapy, occupational therapy, and speech language pathology. The hundreds of private practices and thousands of therapists who belong to PTPN enjoy many benefits, including:
Access to more patients and more revenue through PTPN’s contracts with payers, including our PTPN CompDirect clients and nearly 100 other workers' compensation, health plan and medical group contracts. Last year, PTPN members generated more than $85 million in claims volume as a result of participating in PTPN contracts.
- Higher fee schedules with some health plans in some states for top performers in the PTPN Outcomes Program.
Discounts on brand-name supplies and services — from liability insurance to gym equipment to EMR software — through the PTPN Preferred Vendor Program.
Increased exposure through our consumer brand, Physiquality, which positions PTPN members as the providers of choice for both cash-pay health/wellness programs and traditional therapy services. PTPN members have access to a range of cash-pay education and tools, as well as programs and products ready to be integrated into their practices at discounted pricing.
Active legislative and regulatory advocacy on behalf of private practice, including our own consultant in Washington, D.C., and an online Political Action Center that lets you easily contact your federal representatives on important issues when we alert you.
Practice marketing tools, training, and support to help you increase patient/client volume and participate in emerging payment models, such as Medicare's bundled payment system.
Access to PTPN's experts for answers to your questions about Medicare billing and compliance, documentation, practice management, reimbursement troubleshooting, and many other topics.
Contact us today to learn more about becoming a member of PTPN!
Contact us today to find out about joining PTPN, as well as other ways to maximize your participation in PTPN CompDirect!