Questions & Answers
PTPN is committed to maximizing the private practitioner’s clinically effective and profitable participation in health care. By joining a prestigious rehabilitation network that positions you as the provider of choice in your community, you gain access to more patients than you would on their own, while advancing the work done in private practices.
Members gain quantifiable value from their PTPN membership. In many states, PTPN provides access to dozens of contracts with payers. Last year PTPN members generated more than $80 million in claims volume as a result of PTPN’s managed care contracts. In addition, PTPN’s consumer brand, Physiquality, lets people know that you are a premier provider of rehab, wellness and fitness services and builds consumer demand for the entire range of services you provide.
Members also receive such valuable services as discounts on supplies and services, information on regulatory compliance, discounts on seminars and materials, assistance in resolving billing problems, and political advocacy in Washington, D.C. Calculate your potential return on investment as a PTPN member here.
Through Physiquality, PTPN members are positioned as the providers of choice for consumers seeking help from among the broad spectrum of services that private practitioners may offer — from traditional insurance-reimbursed therapy to cash-pay health and wellness programs. Physiquality also gives you access to a range of cash-pay programs ready to be integrated into their practices. These programs have features available exclusively to PTPN members, including custom content and better pricing. Also, PTPN’s practice marketing resources will help raise your visibility and build revenue.
PTPN charges its providers a flat annual fee that varies by state. In some states, this fee may be related to business volume. Contact us for more information on your area.
No. PTPN has strict membership standards, including ownership standards, continuing education, Medicare certification, ratio of aides and assistants to therapists, and, in some states, geographic requirements. Only after meeting PTPN’s unique criteria, and passing both an on-site review and primary source verifications, do providers become PTPN members.
Here is the list of credentialing documents and other materials required in your application for PTPN membership. For the complete application and for more information about PTPN’s proprietary credentialing policies and procedures, contact your local PTPN office.
PTPN’s geographic requirements are generally based on the population per member office in a given service area. The greater the population, the closer you can be to another member; the smaller the population, the farther away you must be. Distance is calculated as the crow flies. We also have targets for offices offering hand, pediatric, speech and occupational therapy.
In measuring the efficiency of all of our clinics, the PTPN Outcomes Program helps us to deliver better services to and improve our relationships with payers while offering a better alternative to other medical management systems. The mandatory program will also make your office more competitive by giving you information to improve and market your practice. And, finally, as the movement for “pay for performance” evolves into “pay for outcomes,” the PTPN Outcomes Program is already putting members first in line to receive incentive payments from payers who recognize the benefits of such programs.
No. PTPN offers its members the option to reject fee-for-service contracts. However, the vast majority of our members do participate in nearly all of our contracts.
We train your office in how to identify and bill for PTPN patients and then give you a Master Contract Details List, which should have all the information you need. Or you can always call your local PTPN office for assistance.
When you become a member, you agree to participate in PTPN’s Quality Assurance Program. To do this, we need your claims data. With that data, we can report back to you — and the payers — on the value of PTPN membership. You can send your original paper PTPN claims to us, we will keep them for one day, and then send them to the payer, who pays you directly. The money does not go through PTPN. We also have many options for sending us electronic copies of your claims, with your office sending the originals directly to the payer.
*Applicable in certain states only. Contact us to learn more.