What to Expect When You're Expecting a New PT

Congratulations on your practice’s new addition! Bringing on a new PT can be a lot of work, but it’s also highly rewarding. There’s a lot to consider when you make such a big decision, and if you don’t cross all your t’s and dot all your i’s, the road ahead is certain to be bumpy. So, to ensure your nest is all ready for your little bundle of joy—uh, I mean, your new therapist—be sure to take the following considerations into account:

Licensing and Credentialing

Probably the most important—and time-consuming—part of hiring a brand-new PT is making sure he or she has met all applicable state and payer requirements before his or her first day on the job. You literally cannot afford to overlook this step, because a provider who lacks proper credentials can throw a major wrench into your billing process. So, do the following to ensure smooth sailing:

Verify the new therapist’s credentials. 

This may seem like a no-brainer, but it’s worth mentioning. Aside from ensuring your PT has the appropriate knowledge and skill set for the job, double-checking that he or she has met all the necessary licensing and education requirements will keep your practice out of legal hot water. Here’s a list of key licensure and certification to-dos a PT must check off prior to starting employment (as adapted from this article from Monster.com):

• Graduating from an accredited PT program 
• Passing the National Physical Therapy Examination 
• Obtaining PT specialist certifications (preferred, but not required)
• Satisfying continuing education requirements

Furthermore, you’ll want to confirm the insurance payers your new hire is credentialed with, as this will affect the manner in which you can bill for the services he or she provides. Medicare, for example, will allow a non-credentialed therapist to treat Medicare beneficiaries under certain conditions. As we explain here, “A therapist can begin treating patients—even if he or she is not yet officially Medicare credentialed—as long as the Medicare credentialing paperwork is pending CMS’s approval. However, the practice must hold all billing claims for that therapist (up to one year from the date of service, per timely filing rules) until the credentialing approval comes through.” Additionally, “Medicare won’t allow credentialed therapists to cosign claims for non-credentialed employees, so the uncredentialed therapist should reassign his or her individual Provider Transaction Access Number (PTAN) to the practice, and that practice should hold all the claims until he or she is fully credentialed.” 

That being said, as WebPT Chief Compliance Officer Veda Collmer, OTR, JD, explained during this Medicare compliance webinar, the rules often differ from payer to payer. The above-mentioned resource goes on to note that several “non-Medicare insurance companies allow a credentialed therapist to cosign a non-credentialed therapist’s note if the cosigning therapist supervises the treatment. Similar to the rules governing billing for PTA services, the credentialed therapist must provide direct onsite supervision and be immediately available to intervene if necessary.” That said, this should only be a temporary fix while you wait for the new therapist to become credentialed—not a permanent solution.

Update name changes and address changes.

Big life changes happen all the time, so it’s important to verify that the information on a therapist’s credentials is up to date. As Meredith Castin, PT, DPT, founder of The Non-Clinical PT, mentions here, “If a therapist has been working under one name for a while, but then goes through a marriage or divorce (and a subsequent name change), then you’ll need to update that therapist’s name with every insurance company you work with.” If you fail to do so, you put yourself at risk of receiving claim rejections.

Get an early start.

If your new PT is not yet credentialed with payers, it’s best to jump on that ASAP, as the process can take anywhere from 90 to 150 days—usually closer to 150 if the therapist is a fresh graduate. Here are a few considerations when it comes to getting your brand-new PT credentialed: 

• Make sure you already have a group NPI. This will ensure the credentialing process goes quickly whenever you hire a new therapist.
• Use the CAQH ProView™ provider database, which will eliminate the need to fill out the same paperwork over and over again.
• Be prepared to encounter closed networks, as some insurance panels don’t always accept new providers.

New-Hire Onboarding

There will always be a learning curve for new therapists—whether they’re new grads or seasoned veterans. Newly minted PTs will have a lot to learn about being on the clinic floor—even after completing their clinical rotations. After all, being behind the wheel is a lot different than riding in the passenger seat. And for experienced therapists, there will still be a period of adjustment as they get to know your clinic’s unique operational workflow and culture. (Things will go a lot smoother if you hire for cultural fit, though.) 

Be proactive.

Make sure everything is ready to go for your new PT when he or she arrives. That way, he or she can hit the ground running ASAP. Here are a few things to do before the therapist’s first day (as adapted from this article):

• Send a welcome email to the therapist to let him or her know what he or she should bring to the clinic on the first day (e.g., tools or documents for HR), where and to whom he or she should report, and how he or she can access your employee handbook.
• Clean and prep the therapist’s workstation.
• Put together an onboarding agenda he or she can reference as needed.
• Let your current team know about the new hire, and encourage them to introduce themselves.

Create a warm welcome.

To help ensure a consistently positive new hire experience, put together some kind of “welcome kit” or develop a structured employee onboarding process. At WebPT, for example, we have all new employees go through a “culture cruise” during which they learn about the company’s history, core values, expectations, and goals. Seek feedback—and get buy-in—from your current team as you establish this process. That way, they can take ownership of it—and hold fellow team members accountable for upholding it.

Assign a mentor. 

If you have a formal mentorship program, you may find this to be an effective tool for attracting new talent. As this resource from My PT Solutions explains, “After a new therapist’s one on one training period has ended, assign an experienced therapist as a mentor, even if you don’t offer a structured program. This mentor can answer questions as they come up, and prevent problems before they start.” By having a single point of contact, your new therapist will have a reliable resource for timely guidance and answers to any questions that arise. 

Check in at designated intervals.

Finally, make sure your onboarding process doesn’t end after the first week. Be sure to check in with your new hire at regular intervals. We suggest scheduling a one-on-one review at the 30-day, 90-day, and one-year marks. Not only will this ensure your therapist is comfortable and confident in their role, but it’ll also help you suss out opportunities to enhance your onboarding process.

Bringing in a new addition to your clinic family is exciting—but it can also be stressful if you’re not properly prepared. So, get to nesting—and if you have any questions, let us know in the comment section below.