Q: Why would I want to contract with PTPN?

A: PTPN was founded in the belief that the professional expertise and personal commitment of the private practitioner deliver the best value and the highest level of service to both patients and payers. Our financial incentives are aligned for your benefit because we don’t have conflicts of interest in our ownership (such as corporate or physician ownership) that would drive up costs and utilization. PTPN member offices must be owned and operated by private practitioners. 

Q: What services does PTPN provide? 

A: PTPN contracts with managed care organizations on behalf of independent physical and occupational therapists and speech/language pathologists.

Q: Is there a cost to access PTPN’s providers?
 
A: There are no PTPN access fees. PTPN revenue is derived from annual provider dues.

Q: Does PTPN take a percentage of the reimbursement dollar?
 
A: No, PTPN charges its providers a flat annual fee. In some states this fee may be related to business volume. PTPN contractors pay our providers directly, so that the money does not pass through our office.

Q: Can I choose the service area I want?
 
A: Absolutely. You can contract with PTPN locally, regionally, or nationally.

Q: Can I delegate credentialing to PTPN?
 
A: Yes! PTPN has an NCQA-level credentialing program that has passed every on-site audit. PTPN is delegated credentialing for 98% of its payers nationally.

Q: Does PTPN have quality assurance, utilization management or case management programs?
 
A: Yes. We have a comprehensive quality assurance program developed and refined since 1985. 

Q: What is the PTPN Outcomes Program and how does it help me?
 
A: The PTPN Outcomes Program lets you compare the performance of PTPN providers to national benchmarks, giving you the data you need to monitor network quality.

Q: Does PTPN accept any willing provider?
 
A: No. PTPN has strict membership standards such as independent ownership, continuing education, Medicare certification, ratio of aides and assistants to therapists, and geographic requirements. Only after meeting PTPN’s unique criteria, and passing both an on-site review and primary source verifications, do we enroll new providers.

Q: Can PTPN contract for workers’ compensation programs?
 
A: Absolutely. Approximately one-third of our business nationally is in managed workers’ compensation.

Q: Once I am contracted, will you come and speak to my claims adjusters, case managers, etc. about PTPN?
 
A: We are happy to do a PTPN in-service. It usually takes no more than 30 minutes. Call your PTPN contact for more information.

Q: Does PTPN perform any ombudsman functions?
 
A: Certainly! PTPN often acts as the intermediary between providers and payers on claims issues, being listed as a preferred provider, quality issues and more.

Q: How does PTPN keep us updated on provider changes?
 
A: PTPN sends out notifications to contractors on new providers, terminated providers, address changes, etc.