Today's physical therapy practice is very different from those of the past. Treatment is more complex, technology has more horsepower, staff have increased responsibilities and insurances have gotten immensely more complex. A manual for your physical therapy practice can and make a huge difference in your practice in so many ways. This article will explore why you should have a manual, what it should include, and how you can tackle writing one.
There are several reasons that you need to have a manual. Here are the top 5:
Business continuity can come in different forms. One basic example is if a core staff member leaves your practice. If you have a office manager or biller who has been with your practice for years, could your practice withstand that person leaving? Continuity can also refer to day to day operations. If there is a problem at your practice, does everyone know how to react. For example, if the air conditioning fails one day - will everyone know how to react? Sure you can make do with some situations - but why not have a plan. Another example is preparing or being ready to sell your practice. You never know if/when a time may come when you wish to do so. Having your ducks in a row will be a huge asset (meaning more value to your business)!
You want your physical therapy patients to have a great experience. Having a work work flow is key to that goal. By having set procedures you can not only ensure that patients have a good experience but you can ensure that the experience is consistent across all patients and can be replicated. This is doubly true if you have more than one location.
Sadly, you can't just provide your services and expect to get paid. You've got work with tough insurance regulations often including the need for authorizations. Having a prescribed process will ensure that all patients have the authorizations needed and that everything is on file. That means when you get to the physical therapy billing portion of the patients life-cycle, you'll have greater success.
Many practices have responsibilities assigned more by habit and history than by in-depth thought. Writing a manual will give you the opportunity to develop workflows as described above but also give the opportunity to think carefully about who should do each step. Physical therapy practices of any size can benefit from thinking about this. It'll become a lot easier to tell if one person has too much responsibility or, frankly, not enough.
Compliance is a top concern and top priority for most practices. A manual that encompasses office and clinic procedure will be of immense help in creating and fostering an environment of compliance. This means HIPAA and patient confidentiality as well as complying with Medicare compliance rules as well as those of other insurances.
Totally and completely understanding your physical therapy practice is the key to making good decisions. Is it time to move to a bigger space? Is it time to hire another employee? Are employees producing as expected. It's certainly easily to pull a lot of data from your competent physical therapy software but you need a deep understanding of your business to use that data effectively.
If everything is documented well in your manual and you head out for vacation, you staff will be better equipped to deal with issues and less likely to have to pick up the phone and call you.
Here is a sample table of contents that you can use to build your manual:
Section 1: Basic Practice Information
This should include your full address, phone number, fax number and perhaps a print out of a map showing your practice
Section 2: Staff Information
You should have a staff directory with all staff name and contact information (phone and email) Section 3: List of all vendors
You should have a concise list of all vendors that you work with including the full name and contact (phone, e-mail, and website). Each vendor should have a brief description about what the vendor provides so it is clear
Section 4: Patient Workflow
You should devote a section to documenting the expected workflow from registration to discharge. For example, what sort of information will you collect during the initial phone call or through other intake means. Who and how will registration continue, who and how will you get authorizations, what will you do when the patient comes in for the first visit, etc.
Section 5: Dealing with certain scenarios
Have a protocol and procedure for certain scenarios. For example, what happens if the power goes out or the air conditioner isn't working. Will you cancel the rest of the day's visits? What about expected inclement weather? What about when a staff member is out, etc.
Section 6: Compliance+
Write up a section about expectations particularly with respect to HIPAA. Make it clear what your policies are. Simple example would include disposal of any paper. Hopefully you're scanning and uploading paperwork to your physical therapy software but there will always be instances when you have paper and you should ensure that the paperwork is appropriately tracked and ultimately destroyed.
Hopefully now convinced of the importance of a manual. Now, how to write one? First, you should not at all be afraid to delegate writing parts of the manual to your staff. Different staff will have different views and perspectives, all of which are very valuable. Even if you don't want to let others take a crack, you should absolutely take it to your staff once it is completed for review and for buy-in. The easiest and fastest thing to do is to start by writing what your current procedure is. Even if you've never written a manual, chances, you've established patterns just as a function of time. You should start by writing from this and you'll be amazed at how you'll start to think about how your practice is running. One last note, write as though you're talking to someone who knows NOTHING about your practice. The manual is most helpful if it is self-contained and self explanatory.
Once your manual is done:
Your practice, your way. By documenting your practice in a manual you can see improvement in almost every aspect of your practice and sleep better at night knowing that you're prepared for what might come next.
