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November 14
2025
Be efficient without overdoing it: Spending wisely in rehab (Part 2)
By John Wallace, PT, MS, FAPTA, Chief Compliance Officer, WebPT.
weight: 400;”>Being efficient doesn’t mean cutting all costs. In rehabilitation, this means understanding where lean systems are adequate and where targeted investments can pay off. Many practice owners pride themselves on their resourcefulness, but avoiding necessary expenses can be just as damaging as overspending. True effectiveness requires insight, not deprivation.
Invest in prevention, not just cleanup
weight: 400;”>Many compliance challenges are preventable and often come down to education. Annual CPT coding reviews, documentation training, and payer-specific updates help teams avoid the most common reasons for denials. Fortunately, these resources are widely available and affordable.
weight: 400;”>Associations such as APTA, AOTA, and ASHA offer defensible documentation checklists at low or no cost. Some EMRs also include built-in CPT code training modules that therapists can complete on-demand. Even an annual training session can prevent dozens of costly mistakes and appeals.
weight: 400;”>Spending wisely on education can avoid costly cleanup later.
Understand the limitations of in-house repair
weight: 400;”>Internal reviews, peer reviews, and checklists can resolve most routine issues. But when review rejection rates spike, especially above 50%, it’s time to reconsider the DIY approach.
weight: 400;”>If you’ve already submitted your records and received a wave of denials, don’t rush into filing an appeal without backup. Hire someone who can review your submission, flag weaknesses, and ensure the complete story of the document is told. Even one missing element that is overlooked can disrupt an otherwise appropriate course of care.
weight: 400;”>Waiting too long to get help can turn a manageable problem into a financial crisis.
Reevaluate your payer strategy
weight: 400;”>Some of the most expensive mistakes rehab practices make come not from what is in the documentation, but from who they contract with. New owners often accept every payer agreement, assuming that more plans mean more patients. But each payer adds administrative costs. If reimbursement does not offset the documentation burden, rejection, and audit risk, the contract may be a liability rather than an asset.
weight: 400;”>There are some large commercial payers known for aggressive recycling audits. Talk to peers, evaluate models, and think critically about which payers are worth the effort.
weight: 400;”>Out-of-network models, while not suitable for everyone, can provide more control and less regulatory friction. They require more patient communication and claims support but protect clinical autonomy and reimbursement consistency in the long term.
When you really need help, get the right help
weight: 400;”>Not all challenges require external support, but some absolutely do. If a payer is demanding multi-year clawbacks, or you are considering potential legal action, you need a health care attorney, not a business attorney who helps set up an LLC. These legal experts specialize in payer appeals and regulatory defense, often working with compliance counsel to prepare defensible document reviews.
weight: 400;”>Start your search through a professional association, peer group, or online recovery treatment community. Platforms such as Facebook and LinkedIn host active forums where practice owners regularly recommend experienced advisors and lawyers.
weight: 400;”>This isn’t about hiring an expensive expert for every little problem. It’s about knowing who to call when the stakes are high and taking action early to protect your practice.
Efficiency and Intent
weight: 400;”>Starting a low-cost practice doesn’t mean cutting corners or taking on all the responsibility yourself. The most resilient clinics are strategic clinics whose leaders intentionally structure their budgets, prioritize staff training, protect themselves from risk, and avoid contracts that are not in their best interests.
weight: 400;”>Lean doesn’t mean minimal. It means strategically. Knowing when to ask for help or get out of the way is one of the smartest moves a clinic owner can make.