John Wallace
BMS Reimbursement Management, Claremont, Calif, has been focusing on the billing needs of rehabilitation providers since 1988. The company was cofounded by Chief Executive Officer John Wallace, PT, OCS, who learned about the challenges facing rehabilitation centers, first hand, when he owned and operated Peachwood Physical Therapy Corporation for 14 years. Rehab Management recently had the opportunity to ask Wallace about his company and how it has evolved over the years in the ever-fluctuating reimbursement marketplace.
Q: How is BMS different from its competitors?
A: We are far more than a billing company. We provide compliance services to our clients at no extra cost. This focuses on Medicare, but also includes workers’ compensation compliance in the 33 states in which we service clients. In 2005, we billed more than a million visits. We are the largest company of our kind in the country serving independently owned rehabilitation practice. We service PTs, OTs, and SLPs, but more than 90% of our clients are PTs. Also, all checks go directly to the client—they do not come to us. We don’t get paid before our clients do.
Q: How has billing and collection changed since your business started in 1988?
A: In 1988, electronic claims submission was in its infancy. Now, 60% of our claims go electronically. As HIPAA changes filter down to individual state WC systems, this number will grow dramatically. Electronic remittance and automated claims posting is coming quickly—many Medicare carriers will no longer provide paper Explanations of Benefits. We have become a quasi-technology company with three developer/programmers on our staff.
Q: How have the new Medicare coding regulations affected you business?
A: Medicare is always changing so we have a number of systems in place to track these changes and provide updates and education to our clients. The most significant coming change is the expiration moratorium of the therapy caps. These are going back in place in January. We’ll be providing our clients tools to track the cap on their patients, as well as working with them to develop effective strategies to help their patients.
Q: What sort of financial impact do BMS customers usually experience after implementing the company’s program?
A: Our typical client enjoys a 10% to 20% increase in their payment per visit, and a decrease in A/R days (days sales outstanding) of 22 days.
A: That depends on the payer community, but I expect that in 10 years most claims and payments will be automated. This will require significant technology upgrades for therapists in their bill/collect operations. We are preparing ourselves for this by constantly upgrading our software and hardware systems to take advantage of these things as they develop.
— S. Krcmar
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