Close Server: KOPWWW05 | Not logged in

Welcome to Health Care POV | sign in | join
Life of a PTA

Billing Rapport

Published August 8, 2014 4:31 PM by Allison Young

In a typical therapy session, I attempt to fit in the most important tasks I feel the patient needs to focus on for that day. Therapeutic exercise, gait training and pain management modality -- it can be challenging to fit the session goals into the allotted 45 minutes to an hour. Then there are times when the patient is so weak and ill, bed-level exercises and bed mobility are the only options for therapy. In these cases, extensive rest breaks due to increased fatigue and education regarding importance of movement with healing can be filled during the treatment time -- which is duly documented.

One documentation "gray area" I find when working with a patient, particularly one who is new to my schedule, is billing for the time where I'm "building rapport." There are many instances where, after introducing myself to a patient, I'll attempt to engage the person in a topic of interest. Any discussion of family/job/dog/sports/music (etc.) can and usually help relax the patient and begins to build our therapist-patient relationship. These "chats" can last up to 10 minutes or more before any skilled therapy begins.

Throughout the session, I find having irrelevant conversations off topic of the patient's medical condition can lead to an overall more productive treatment. In some cases, the amount of activity is lower but the quality and effort are increased because the patient is less stressed. When I finally sit down to document for that session, I'll chart that extensive rest breaks were taken and encouragement was provided. Personally, I don't actually state that a portion of the treatment time was dedicated to "building rapport," but I've read notes where those exact words were used by other clinicians.

I'm not about to stop engaging my patients in discussions that bring them comfort and some enjoyment, but it definitely can be a balancing act. Keeping a person focused on the therapy session just as much as the talk of his favorite NFL team, it can be challenging but necessary. As well, appropriately billing for therapy treatment is my responsibility as the patient's PTA.

You Might Also Like...

Empowering Efficiency

The right practice management software can improve workflow and streamline business operations.


Great post! Building rapport is so important. Getting to know a person is what helps us make sure we are establishing patient focused goals.

I am going to share this with my Geriatric OT, PT, SLP Collaborative Group on FB.

Rachel Wynn, SLP August 10, 2014 9:01 AM
Boulder CO

leave a comment

To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Enter the security code below:


About this Blog

Keep Me Updated