Understanding Physiotherapist Insurance
Your practice as a physiotherapist demands the correct business insurance. Your practice’s wellbeing depends not only on what you offer your clientele, you will also need to consider what can go wrong as you move forward in your practice. In this blog post, we go over how the insurance coverage offered can naturally mitigate not only your corporate risk but also your individual risk as a physiotherapist.
What are the Risks of Running a Physiotherapy Clinic?
Due to the nature of physiotherapy and rehabilitation, physiotherapists are subjected to more liability risks than their peers in other healthcare careers. While performing therapy, they have a high risk of misdiagnosing or exacerbating an injury. There might be events where a physiotherapist may be liable for accidental injury while providing therapy, an office staff member hurting themself on the job or a slip-and-fall of anyone on the premises of the clinic. Remember these potential exposures can add up rapidly even if they have merit or not.
Types of Insurance Coverages Available
As a sole physiotherapist practitioner, you may still be found liable for any unintentional error or mistake made in the performance of your professional services. This includes coverage for patient injuries. Perhaps during therapy, a patient over works a body part that is being rehabilitated and they are not only set back in progress but in a lot of pain. You may expect a lawsuit from the patient alleging malpractice which will require legal defense and payment of court awarded judgements. As you can imagine these costs could bankrupt you if you don’t have the proper insurance.
Clinic Professional Liability Insurance Coverage
Liability protection for the medical clinic extends as far as the limit of liability. This assures protection in case of malpractice liability claims against doctors or medical assistants. Professional Liability Insurance coverage for the clinic is based on the limits purchased, annual revenue and number of licensed professionals.
Commercial General Liability
Coverage for property damage liability and bodily injury liability to a patient, supplier or visitor is handled by the general liability coverage. Think of accidents, like an assistant spilling something on patient’s belongings or someone trips on a ripped carpet breaking a bone. General liability provides premises liability for things that go wrong at your office and product liability for any health products you may sell.
A single package containing a combination of Property and Liability insurance for an individual practitioner or a large practice, is a necessity.
Property insurance, for example: In your office, a burst pipe results in the destruction of your furniture, flooring, woodwork, equipment and client files. The policy will pay for the replacement cost for your building and contents. If your clinic is closed due to covered damage to the building and the reconstruction will take a long period of time, you will be relieved that you have the included business interruption and extra expense coverage. This will pay you for the insured loss of income suffered during the shutdown and the extra expense to assist you in setting up a new temporary or permanent place of business.
Worker’s Compensation is mandated in almost all states, depending on the number of staff that you employ. Worker’s Compensation policy covers a percentage of lost wages, medical care expenses incurred because an employee is injured on the job. There is a death benefit provided for an employee’s family if death results from a workplace injury.
Cyberattacks affect businesses of all sizes—large businesses are susceptible because of their sprawling digital footprints and numerous staff, but small and medium-sized businesses are often made vulnerable by their lack of cybersecurity resources.
There are many different types of coverage within a cyber policy. Coverage is included or can be added to a cyber policy for the following:
- Computer Crime
- Computer Fraud
- Privacy Notification and Crisis Management Expense
- Information Security and Privacy Liability
- Payment Card Industry Data Security Standards fines or penalties
- Regulatory Defense and Penalties Coverage
Accepting Health Insurance
As a physiotherapist, you have to make a number of decisions. Will you only treat patients in your network, or will you expand your practice to non-affiliated facilities as well? Helping you answer these and similar questions, here are some things to keep in mind.
According to the American Physical Therapy Association, third-party insurance is still the most prevalent source of medical revenue for physical therapists irrespective of where they work or how they practice.
If a therapist desires to become in-network, he or she will have to pass the credentialing and contracting processes. You may be wondering whether your credentialing is permanent, like your NPI. Credentialing is not permanent for the life of your payer contract. Each provider must be recredentialed on a schedule determined by the terms of your contract and laws of the state in which the contract is based.
The Credentialing process involves verifying the qualifications of the therapist’s:
- Training history
Business Owner’s Policy or BOP
This is a combination of general liability, property, business interruption, and extra expense coverage. In particular, prefer this cost-effective policy.
Insurance companies use this information to verify that a therapist is a potential candidate to work with individuals covered by a specific insurance carrier. Once a therapist has completed credentialing, they must then endure the contracting process with the insurance company.
You can make sure that your payment negotiations result in favorable finances by demonstrating your value to the payers, learning the language used in contracts, and preparing yourself to discuss figures. Insurance contracts are one of the most difficult and time-consuming parts of your business to deal with, but it is an essential component of your business. In order to prepare for this task properly, you need to take into consideration these five points.
- educate yourself
- set your price
- set reasonable and realistic goals
- watch for pitfalls
- be willing to walk away
Out of Network (or Cash-Pay)
If you make your mind up to bypass the insurance maze, it may be a good choice for you if you decide your demographic area can support an out-of-network practice that does not take insurance. If you opt to go into the out-of-network medical billing arena, you must identify any potential legal consequences and consult with a financial expert and accountant.
Cash-pay is often a good alternative, but remember some patients cannot or decide not to pay for services out-of-pocket. Also it's important to remember that if a patient can get the same value or same service from an in-network provider with no out-of-pocket cost, he or she will likely choose to stay in-network.
Best of both worlds
Don’t abstain from cash-pay services just because you don't feel ready to take the leap to solely cash. Try to get the best of both worlds by becoming an in-network provider who offers cash-pay services as well.