Back in Action Therapy optimized CPT coding by 60%, while boosting compliance by 20%

"The data talks without us (the management) having to. This kind of automation and insight is a huge advantage and significant time savings in data gathering and delivery.”

Overview

Back In Action Therapy, a growing physical therapy practice with 11 skilled therapists, has been on the leading edge of integrating technology into their workflow. Spearheaded by owner Derek Halladay and his co-owner Matt Hoyt, the practice decided to implement PredictionHealth's Practice Intel platform after hearing from colleagues in the industry about their successes with the platform.

In only a few months after adopting PredictionHealth, Back In Action witnessed their company compliance score soar from 69 to an impressive 83/100. Additionally, the practice experienced a 17% decrease in Therapeutic Exercise (TE) usage paired with a remarkable 60% increase in Therapeutic Activity (TA) usage in a mere two months.

Room to Improve

At the time Derek and team jumped on board with PredictionHealth - February 2023 - Derek felt there was room to improve in three key areas:

• 1. Therapists’ Access to Objective Metrics: Previously, the assessment of therapists' performance relied largely on input from Derek and Matt, rather than data-driven insights. This took time away from the management team and limited bandwidth to focus on other key areas of the business. It also made the process of transferring actionable data to therapists relatively clunky. 
• 2. Coding Inefficiencies: Newer therapists to the group were often unacquainted with best practices in CPT coding, posing a risk for potential Medicare audits and leaving revenue on the table. As a result, management made a practice of investing dozens of hours of coaching for all new hires, to help get them on the right track. 
• 3. Documentation Compliance: Documentation practices of the group weren’t necessarily a significant problem, but Derek knew there was definitely room for improvement in both compliance and efficiency of daily documentation.

Data-Driven Objectivity

The Practice Intel platform empowered therapists to directly view their objective performance data, both in Documentation Compliance and also coding diversification and efficiency. This transparency boosted the credibility of data, given that it was not filtered through a managerial lens. "The data talks without us (the management) having to," said Derek. “This kind of automation and insight is a huge advantage and significant time savings in data gathering and delivery.”

Gamified Improvement - Without More Work!

PredictionHealth's design enables therapists to consume all necessary data within a matter of minutes. “When you bring something like this into the workflow, an initial concern can be that it will introduce ‘more work’,” said Derek. “However with PredictionHealth that is not the case and for some it is actually helping therapists to do less work through the ‘Over-documentation’ tracking”. 

Derek explained, “Furthermore, the gamification of the program brings encouragement and excitement rather than deflation or extra burden. The Documentation Compliance audit scoring has been instrumental in driving change in the therapists’ documentation practices. For instance, if a therapist has a score of 73 and then improves next month to a 78, the visible progress becomes a morale booster and encourages therapists to continuously refine their documentation practices toward improvement.”

Derek’s clinics experienced immediate results. Back in Action’s overall company compliance score was an average of 69/100 over the months before starting with PredictionHealth, indicating a "Significant Risk of Audit Failure" risk status per PredictionHealth standards. Upon implementing PredictionHealth in February 2023, Back in Action’s scores quickly rose to 74 in February, reached 79 in March, and climbed to 83 (a “Good” risk status) by June 2023, showing a marked improvement in mitigating the risk of audit failure.

Improved Coding Practices 

PredictionHealth's CPT coding and coding efficiency analysis tools have played a critical role in educating newer therapists about best practices which has led to improved coding diversification and increased revenue. 

“Therapists typically are not receiving quality guidance in PT school regarding best practices in billing/coding efficiency.” said Derek. “They may utilize 4 units of Therapeutic Exercise or 4 units of Therapeutic Activity in a visit, instead of diversifying the coding. Poor diversification can lead to undesirable reimbursement, but it can also become a red flag for Medicare to select that provider for an audit.”

After focusing on Documentation Compliance over the first two months on the platform (February and March 2023), Back in Action prioritized looking into CPT coding starting in April - specifically the company’s overall use of Therapeutic Exercise (TE) versus Therapeutic Activity (TA). Back in Action averaged 42.8% TE and 14.2% TA from November 2022 to March 2023. Then after doubling down on examining PredictionHealth’s coding analytics in April, from April to June 2023 Back in Action averaged 35.7% TE and 22.8% TA. This represents a 17% reduction in TE use and a 60% increase in TA use.  

Conclusion

For Derek Halladay and his team at Back In Action Therapy, PredictionHealth's Practice Intel platform has proven to be more than just a software solution. It has become an integral part of their practice management strategy, empowering therapists and significantly reducing administrative burdens. Through objective data analysis, efficient information consumption, and continuous performance improvement, Practice Intel has redefined what it means to be a data-driven physical therapy practice.

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