Rehabbing Your Revenue Cycle

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick is joined by Chad Madden, Founder of Madden & Gilbert Physical Therapy and Co-Founder of Breakthrough, a physical therapy practice marketing company. Chad shares his journey from a physical therapy startup to a large practice with six offices and over 10,000 visits a month.

Chad had a deep understanding of patient care but needed an education in owning a practice. He discusses how developing standardized systems and controls based on data helped him scale successfully. Chad discusses how it was critical to understand the financial aspects of being a business owner and credits Robert with helping him understand and implement many revenue cycle based metrics. Chad explains how he used marketing strategies, such as reactivation emails and professional referrals, to generate demand and fill patient schedules.

His story shows how physical therapy practice owners can use the right data and optimized systems to grow their business, improve financial outcomes, and create a scalable operation despite industry challenges. Chad mastered improving the elements of his practice that ultimately determine practice valuations, and after successfully scaling, Chad had a successful exit from his practice, selling to a large national PT consolidator. Chad and Robert’s business journeys share many similarities.

Expect to Learn

-How Chad grew his physical therapy practice from 48 visits a week to over 2,800 visits a week.

-Why building systems and understanding financials are key to scaling a successful practice.

-How marketing strategies like reactivation emails and professional referrals can drive patient demand and fill schedules.

-How revenue cycle systems and process optimization founded on great data are essential to overall profitability and scalability.

-Why having the right data to manage clinician performance and patient conversion is also essential for growth.

-How aligning marketing and revenue cycle strategies can help practice owners build a scalable and sustainable business.

Timestamps

[00:00:00] - Teaser

[00:01:38] - Introduction & Purpose of the Conversation

[00:04:05] - Defining Scaling and Chad’s Early Journey

[00:11:46] - The Five Ways to Acquire New PT Patients

[00:17:04] - Why EMR Marketing Tools Don’t Cut It

[00:23:43] - Budgeting for Growth: The 10% Rule

[00:30:36] - Market-Message-Media Match in Rural vs. Urban Areas

[00:34:03] - Connecting Revenue Cycle to Marketing Investments

[00:38:29] - Graduation Rate as the New NPS

[00:50:30] - Using Data to Optimise Therapist Performance

[00:58:57] - Targeting High-Value Patients with Smart Marketing

[01:08:51] - Financial Systems and Therapist Engagement

[01:10:06] - Final Thoughts

Follow Chad Madden on:

👉 LinkedIn - https://www.linkedin.com/in/chadmadden

👉 Instagram - https://www.instagram.com/chad.madden/

👉 Facebook - https://www.facebook.com/chadmaddenpt/

👉 X - https://x.com/maddenpt

Websites:

👉 Breakthrough - https://maddengilbertphysicaltherapy.com/

👉 Madden and Gilbert Physical Therapy - https://getbreakthrough.com/

Company LinkedIn:

👉 Breakthrough - https://www.linkedin.com/company/getbreakthrough

👉 Madden and Gilbert Physical Therapy - https://www.linkedin.com/company/madden-pt

Follow Robert Kowalick on:

👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/

👉 Company Website - https://ascendsolutionsllc.com/

Follow Rehabbing Your Revenue Cycle Podcast:

👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle

👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/

👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick sits down with Debbie Powell, Co-Founder and Owner, and Jean Weatherly, Director of Administration, at HealthActions Physical Therapy and Fitness, to discuss one of the most common revenue leaks in private practices today: patient cost shares. Together, they share how their clinic successfully improved cash flow by optimizing their patient financial responsibility policies and processes. Even though patient payments account for over 18% of HealthActions revenue, patient AR accounts for less than 1% of their total AR. Once armed with proper data, Debbie and Jean strategically updated policies and implemented best practices that focused on staff training, patient communications, systems integrations and consistent execution in each of their 11 offices to collect millions from patients per year with no patient AR over 30 days old! Debbie and Jean have created a more profitable and streamlined business, even in the face of rising patient cost shares and industry challenges.

With decades of experience in physical therapy private practice, Robert was able to help HealthActions identify opportunities to improve the financial outcomes of their business. Patient financial responsibility policies and processes are one of the most common under performing revenue cycle functions in a practice. Debbie and Jean are living proof that better data opens the door to better processes, better outcomes and a better business. Their commitment to creating efficient systems and a strong team culture has helped their practice grow, resulting in greater financial stability and long-term success.

-How Debbie and Jean improved their practice's financial performance through better data, better processes and better revenue cycle outcomes.

-Why training the entire staff, front office, back office and clinicians is key to collecting patient cost shares at the time of service and eliminating patient accounts receivable.

- Why using data to track the impacts of policy and procedure changes is critical to optimization efforts.

-Why effective patient financial responsibility policy and process have a huge impact on reducing revenue cycle complexity and billing time demand.

-Why patient payments that average almost 20% of practice revenue is the lowest hanging fruit to capture when searching for ways to improve practice financial performance.

-How teamwork across all roles in a practice as measured by common revenue cycle objectives is essential for improving revenue cycle outcomes and building greater financial stability.

[00:00] – Teaser

[00:59] – Introduction

[04:11] – The Journey of Change

[08:58] – Revenue Trends in Physical Therapy

[15:43] – Building Effective Systems

[18:24] – Benchmarking Success with Data

[22:23] – Collecting at the Front Desk

[29:21] – The Role of Patient Experience

[31:01] – Credit Card on File & Post-Discharge Balances

[34:05] – Documentation, Auditing & Incentives

[37:05] – Closing Thoughts

Follow HealthActions Physical Therapy on:

👉 LinkedIn - https://www.linkedin.com/company/healthactionspa/

👉 Website - https://healthactionspt.com/

👉 Facebook - https://www.facebook.com/HealthActions/#

Follow Robert Kowalick on:

👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/

👉 Company Website - https://revenuecyclesolutionsllc.com/

Follow Rehabbing Your Revenue Cycle Podcast:

👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle 

👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/

👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick sits down with Petra Pirc, Owner of Physical Therapy Plus, an outpatient physical therapy practice with locations in New Mexico. Petra shares her journey from being a staff therapist to taking over the long-established PT clinic she worked in just before the COVID-19 pandemic. She explains how partnering with Revenue Cycle Solutions (“RCS”) helped solve her financial struggles by improving her revenue cycle outcomes. Her evolution started with having access to the data she needed to understand her present condition and what was reducing revenue and increasing costs. The RCS data identified root causes of claims issues and opportunities to improve clinician coding and the practice payer mix. Once armed with better data, Petra was able to optimize processes internal to her practice and improve her financial outcomes. Petra's story highlights how practice owners can use data to increase revenue per visit, reduce billing complexity, and build a more stable and scalable business despite today’s industry challenges.

With more than two decades of experience as a physical therapist, Petra Pirc had a deep understanding of patient care but needed more expertise as a business owner. After taking over Physical Therapy Plus in late 2019, Petra quickly faced the challenges of running a practice during the COVID-19 pandemic. Through her partnership with RCS, Petra was able to focus on becoming a more knowledgeable and effective practice owner. Using the RCS approach of better data, facilitating better processes and outcomes, Petra was able to gain better control over the things that determined her financial outcomes. Her hands-on approach and commitment to using data to optimize her practice operations have helped her boost revenue per visit by $32, reduce days in AR, and create excess cash flow that could be used to be more competitive as an employer and ultimately strengthen the long-term success of her practice.

-How Petra transitioned from staff therapist to practice owner and navigated the challenges of COVID-19.

-Why obtaining the right data is the most important first step in improving practice financial outcomes

-How the right data enables optimization of CPT coding and payer mix, which can significantly raise revenue per visit

-How reducing revenue cycle complexity results in stronger and faster conversion of provider time into cash, prevents leaving money on the table, and reduces the cost of getting paid

-Why the right revenue cycle data is key to identifying revenue risks and making smarter strategic decisions

-How collaboration between all the roles in a practice around common revenue cycle goals can create a more stable and scalable business

[00:00] – Teaser

[02:21] – Buying the Clinic Just Before COVID Hit

[04:33] – Surviving COVID and Securing PPP Loan

[08:14] – In-House Billing Struggles and Learning by Doing

[11:14] – Data, CPT Coding, and Rebuilding After the Pandemic

[15:21] – Looking at Petra’s Data Over the Past Three Years

[20:59] – Optimizing Revenue Cycle and Payer Mix

[28:44] – Payer Mix Optimization and Dropping Low-Paying Plans

[34:19] – Billing Time Demand vs Time Supply Explained

[36:16] – Reducing Claim Errors and Improving Efficiency

[01:00:56] – Petra’s Advice to Practice Owners

Follow Petra Pirc, on:

👉 LinkedIn - https://www.linkedin.com/in/ptplusnm/ 

Company LinkedIn:

👉 Physical Therapy Plus - https://www.linkedin.com/company/ptpinc/ 

Company Website:

👉 Physical Therapy Plus - https://ptplusnm.com/ 

Follow Robert Kowalick on:

👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/

👉 Company Website - https://revenuecyclesolutionsllc.com/

Follow Rehabbing Your Revenue Cycle Podcast:

👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle 

👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/

👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick, Founder & CEO of Revenue Cycle Solutions, LLC and Ascend Solutions, LLC, explores what he calls the "Revenue Cycle Complexity Black Hole." He explains how and why healthcare revenue cycles are experiencing a pandemic of preventable complexities, weakening the financial health of healthcare organizations. Robert explains the many causes of Revenue Cycle Complexity (RCC) and how to quantify them while providing objective proof that reducing RCC improves every objective RCM outcome measure. Listeners will learn how it is the RCC within the claims volume that determines Billing Time Demand, not the volume itself. RCC can inflate the most critical billing task times by as much as 4000%! Listeners will learn why reducing RCC should be the #1 focus of every revenue cycle management system, process, and function. Robert explains how to transform any billing team from back office task doers into powerful revenue cycle intelligence data generators providing the insights needed to reduce even the largest and most damaging Revenue Cycle Complexity Black Holes. With years of data coming from millions of claims, Robert explains how individual errors and omissions across systems, administrative workflows, and payer processes feed the RCC Black Hole so it can consume your time and financial resources while reducing RCM effectiveness. Like any problem worth solving, Robert shares why understanding and measuring RCC is the first step to reducing it. Using clear examples and real client case studies, Robert shows how reducing complexity can lead to reductions in AR, faster payments, improved revenue, improved billing efficiency, lower billing costs, and ultimately a more valuable business. Stay tuned for future episodes that will identify must-have RCM metrics that break down the sources of complexity and quantify your RCC Black Hole and how to reduce its damaging impact on your healthcare business.

-Why revenue cycle complexity is the biggest hidden challenge in healthcare revenue cycles

-How quantifying RCC and its impact on billing time demand reveals staffing shortfalls at the task level, which causes outcomes to suffer

-Why converting the medical biller’s daily experience into RCC data is the most effective way to improve RCM outcomes

-Why fixed billing time supply models fail, and why aligning billing time supply with billing time demand is required to create better cash flow, faster payments, and lower costs

-Why reducing RCC is the most effective strategy for creating a more financially stable, more scalable, more efficient, and more profitable healthcare business

[00:00] – Teaser

[00:01:02] – Defining Revenue Cycle Complexity as a Black Hole

[00:09:31] – How Billing Time Demand Is Shaped by Every Function

[00:11:32] – Matching Billing Time Supply to Time Demand

[00:24:34] – Why ADO Score Is the Key Outcome Metric

[00:30:18] – Using the Biller's Tasks to Create Useful Data

[00:56:50] – The True Cost of High Complexity on Billing Time

[00:58:24] – Comparing Low vs High Complexity Billing Outcomes

[01:03:04] – Real Practice Case Study: PT Plus

[01:06:24] – Real Practice Case Study: Summit Physical Therapy

[01:11:08] – What’s Coming Next

Company LinkedIn:

👉 Revenue Cycle Solutions, LLC - https://www.linkedin.com/company/revenue-cycle-solutionsllc/

👉 Ascend Solutions, LLC - https://www.linkedin.com/company/ascend-solutions-llc-co/ 

Company Website:

👉 Revenue Cycle Solutions, LLC - https://revenuecyclesolutionsllc.com/ 

👉 Ascend Solutions, LLC - https://ascendsolutionsllc.com/

Follow Robert Kowalick on:

👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/

Follow Rehabbing Your Revenue Cycle Podcast:

👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle 

👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/

👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/

If you missed it, check out Part 1, then continue with Part 2 of this episode of Rehabbing Your Revenue Cycle, where host Robert Kowalick, Managing Member & CEO of Revenue Cycle Solutions, LLC and Ascend Solutions, LLC, shares his journey from hospital-based physical therapist to building a multi-location practice and launching a data-driven billing company. Drawing from more than 20 years in healthcare, Robert explains why many revenue cycles fail and how focusing on billing time demand, complexity, and outcomes can lead to better financial results. He introduces the core ideas behind his unique approach to revenue cycle management and outlines how turning billers into data sources helps fix problems at the root. This episode sets the foundation for healthcare providers who want to grow stronger, more efficient, and more valuable businesses.

With a background in physical therapy and a strong focus on solving business problems, Robert Kowalick brings years of hands-on experience to revenue cycle management. After starting his career in a hospital system, he launched and grew a successful seven-location practice before selling it and turning his in-house billing team into a full-service company. Motivated by the need to improve billing outcomes for other providers, Robert developed a data platform that tracks billing time and complexity to uncover root causes of poor performance. His mission is to help healthcare practices improve revenue, reduce waste, and build more scalable and profitable businesses through better use of data.

-Why most healthcare practice revenue cycle outcomes are broken and how they impact provider income underperform expectations.

-Why quantifying revenue cycle complexities and their impact on understanding billing time demand, billing process efficiency, and effectiveness, and time supply is the most important missing information in a healthcare practice that can improve cash flow and efficiency.

-How and why converting the biller’s experience into billing intelligence data identifies all opportunities for revenue cycle process optimization helps reveal hidden problems in the revenue cycle.

-How reducing revenue cycle complexities from any source across systems, payers, and processes leads to better revenue cycle business outcomes.

-How better revenue cycle data and metrics drive optimizations that allow you to build. Why treating your billing team like a data source is key to building a more scalable and profitable practice.

[00:00] – Recap of Part 1

[00:37] – The Starting Point & The Billing Time Puzzle

[02:57] – Defining Revenue Cycle Functions and Their Impact

[05:21] – Turning Billers into Data Generators

[07:55] – The Daily Reality and Frustrations of Billers

[10:58] – The Need to Control Revenue Cycle Complexity

[12:11] – The Goal: Balance Time Demand & Supply

[16:31] – Quantifying Complexity with Data

[18:02] – 78% of Problems Originate Outside Billing

[23:40] – The 40x Time Variance in Denial Management

[26:11] – Upcoming Episodes and Topics

[32:38] – Case Study: Transforming Practice Value in 9 Years

[36:11] – Who This Model Can Help

Company LinkedIn:

👉 Revenue Cycle Solutions, LLC - https://www.linkedin.com/company/revenue-cycle-solutionsllc/

👉 Ascend Solutions, LLC - https://www.linkedin.com/company/ascend-solutions-llc-co/

Company Website:

👉 Revenue Cycle Solutions, LLC - https://revenuecyclesolutionsllc.com/

👉 Ascend Solutions, LLC - https://ascendsolutionsllc.com/

Follow Robert Kowalick on:

👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/

Follow Rehabbing Your Revenue Cycle Podcast:

👉 Website: https://revenuecyclesolutionsllc.com/

👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle

In this launch episode of Rehabbing Your Revenue Cycle, host Robert Kowalick, Managing Member & CEO of Revenue Cycle Solutions, LLC and Ascend Solutions, LLC, introduces the purpose and vision behind the show. Robert shares his journey from running a successful seven-location physical therapy practice to building a data-driven revenue cycle management company. He explains how years of working with thousands of providers revealed a common issue in healthcare: broken revenue cycles. This episode covers how understanding billing time demand, reducing complexity, and using better data can help providers improve cash flow, increase efficiency, and grow their business with confidence.

With a background as a licensed physical therapist and over 20 years in healthcare, Robert Kowalick brings deep experience in both patient care and business operations. He began his career in a hospital system before starting and growing his own multi-location physical therapy practice. After selling that business, Robert turned his focus to revenue cycle management, building a company that helps other providers improve billing results through better data and time analytics. Stay tuned for part 2, where we’ll cover how most revenue cycles are broken and why solving billing complexity is key to creating a stronger, more profitable healthcare business.

Why most healthcare practice revenue cycle outcomes underperform expectations

Why quantifying revenue cycle complexities and their impact on billing time demand, billing process efficiency, and effectiveness is the most important missing information in a healthcare practice.

How capturing the biller’s experience into billing intelligence data identifies all opportunities for revenue cycle process optimization.

How reducing revenue cycle complexities from any source leads to better revenue cycle outcomes.

How better revenue cycle data and metrics drive optimizations that allow you to build a more scalable and profitable practice.

[00:00] – Teaser

[01:06] – Why This Podcast Exists and What to Expect

[04:50] – Root Causes of Billing Problems in Healthcare

[09:13] – Why Helping Other Practices Is Harder Than Expected

[17:10] – What Revenue Cycle Really Means for Providers

[19:55] – The Balance Between Time Demand and Time Supply

[26:02] – Applying the Physical Therapy Mindset to Business

[35:04] – Creating a Billing Model That Prioritizes Outcomes

Company LinkedIn:

👉 Revenue Cycle Solutions, LLC - https://www.linkedin.com/company/revenue-cycle-solutionsllc/

👉 Ascend Solutions, LLC - https://www.linkedin.com/company/ascend-solutions-llc-co/

Company Website:

👉 Revenue Cycle Solutions, LLC - https://revenuecyclesolutionsllc.com/

👉 Ascend Solutions, LLC - https://ascendsolutionsllc.com/

Follow Robert Kowalick on:

👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/

Follow Rehabbing Your Revenue Cycle Podcast:

👉 Website: https://revenuecyclesolutionsllc.com/

👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle

Is your billing process healthy, or is it holding your practice back?

Introducing Rehabbing Your Revenue Cycle, the new podcast for PT and OT owners ready to turn data into dollars.

Join host Robert Kowalick, founder of Ascend Solutions, as he moves beyond the "billing service" mindset to introduce Billing Intelligence. Each episode reveals how to use time-based data to slash payment delays, eliminate operational risks, and maximize a practice's total value.

It’s time to stop guessing and start growing.

Rehabbing Your Revenue Cycle. Coming soon to all major podcast platforms.