Self-Pay Patient Best Practices

Let’s review some common questions about self-pay patients and how to handle them in the WebPT EMR. We’ve also included information on the downstream implications for your WebPT billing applications. 

Creating the Patient Case

When creating self-pay patients, use the system default Self Pay insurance as the patient’s primary insurance on the case.

Billing Solution

• Therabill: Sessions created for patients with the Self Pay insurance will default to Initially Bill To Client. This automatically sends those sessions into the Bill Client Client Balance Statement section, allowing you to invoice your clients. 
• WebPT Billing: Charges for patients with this insurance will default as billable to the patient and will be included on the next available statement run less any patient payments collected. 

Collecting Patient Payments

When collecting patient payments for self-pay patients, you can use whichever Charge Type you prefer. Often, Members will use Wellness. You can also use the Description field to indicate Self-Pay.

Billing Solutions

• Therabill: The Description field flows into Therabill with the payment, so you can use this for reporting, as needed.
• WebPT Billing: Ensure the Charge Type chosen has also been enabled on your Clinic Settings or it won’t flow into Billing.

Billing for Services

Which CPT Codes you use really depends on how you want to bill patients for the visit. If you’d like to charge a flat fee or discounted rate, we recommend using a Custom CPT Code. Alternatively, you can use standard CPT codes and adjust the charge amount in your billing system manually. 

Billing Solutions

• Therabill: Ensure Custom CPT Codes are added to your Fee Schedule in Therabill. Tip: These codes must match exactly between the EMR and Therabill, including using the same capitalization. If the code is not entered in the EMR as it appears in the Therabill Fee Schedule, the code will flow in with a $0 charge. If this occurs, edit the session and add the correct value.  
• WebPT Billing: Ensure Custom CPT Codes are added to your Procedure Codes in Billing. 
  • RevServe and RevEquip: To add a new code, email updates@webpt.com and provide the code and associated charge amount. 
  • Self-Service: Add the code following these instructions.
  • Tip: These codes must match exactly between the EMR and Billing, including using the same capitalization. If the code is not entered in the EMR as it appears in the Billing, the charge will be placed on Delayed Claims with the reason Charges for the Newly Imported and won't pull onto the patient's statement for billing.   

RevServe: Alternative Self-Pay Billing Pathway

For RevServe Members who do not want their RCM Services team to handle their self-pay patient invoices, make the following adjustments to the process. This ensures that neither charges for that patient nor the patient's payments will flow into WebPT Billing.

1. Collect Patient Payments using a Charge Type that has not been selected to integrate with WebPT Billing. If you select Internal Payment as the Charge Type, then the patient payment will not flow into WebPT Billing.
2. Use the NORCM code on all patient notes to prevent those visits from flowing into WebPT Billing.