Selection of Physical Therapy Providers

Doctors Usually Refer Employees to Physical Therapist

An area often overlooked by employers and the workers compensation insurance adjusters is the proper selection of the physical therapist and office. Normally the orthopedic doctor tells the employee physical therapy is needed to avoid surgery or to recover from surgery.

The employee says “Okay, who shall I see?” The doctor promptly refers the employee to the physical therapist (PT) in an office down the street or, to the office where the doctor has a financial interest.

There are better ways to handle the selection of a physical therapist.

How to Select a Good Physical Therapist

In states where the employer is allowed to join a medical provider network, the selection of the physical therapist is handled by the network. In states where the employer can select the medical provider, both employer and insurer go a step further and control the selection of the physical therapist.

The question then becomes: “How do you select a good physical therapist company?” As almost all states regulate physical therapists, the designation of “PT” (licensed physical therapist) after a therapist’s name only means one is a licensed professional who completed training for certification.

In workers compensation claims, almost all referrals to physical therapy involve injuries to the musculoskeletal system, making the most often needed physical therapist an OCS (Orthopedic Certified Specialist). The NCS (Neurologic Certified Specialist) is also seen from time to time on billing from a physical therapy office.

If you see a physical therapist with other designations, don’t be alarmed. Physical therapists use an alphabet soup of designations such as: PCS (Pediatric Certified Specialist); GCS (Geriatric Certified Specialist); WCS (Women’s Health Certified Specialist); CHT (Certified Hand Specialist).

As the employer or insurer paying the physical therapy bills you want to choose someone whose area of knowledge relates to the treatment of your injured employee – particularly in the workers compensation field.

Employees suffering from work related injuries to muscles, ligaments, tendons or bones benefit best from treatment provided by an OCS; i.e, a physical therapist specializing in orthopedics. An OCS often works with post-operative joints, ligament tears and even every day sprains and strains.

Physical Therapy Designations

1. OCS: Orthopedic Certified Specialist
2. NCS: Neurologic Certified Specialist
3. PT: Licensed Physical Therapist
4. PCS: Pediatric Certified Specialist
5. GCS: Geriatric Certified Specialist
6. WCS: Women’s Health Certified Specialist
7. CHT: Certified Hand Specialist

Advanced Physical Therapy Designations

1. APTA: Member of the American Physical Therapy Association
2. FAPTA: Fellow of the American Physical Therapy Association. Most FAPTAs have advanced degrees in the science, education and practice of physical therapy.
3. NARA: National Association of Rehabilitation Providers but these are rare and may not see patients.
4. FAAOMPT: Fellow of American Academy of Manual Physical Therapists — a good choice for workers comp PT needs.
5. FSBPT: Federation of State Boards of Physical Therapy promotes stringent compliance with the rules and regulations governing the licensing of physical therapists. Their purpose is to promote high standards in physical therapy by requiring all new physical therapists to pass a national physical therapy examination.

Physical Therapy offices pre-screened and recognized by the Centers for Medicare and Medicaid Services as a CRA (Certified Rehabilitation Agency) will have several GSC designated physical therapists on staff. Be sure to ask the PT office if they have OCS and NCS physical therapists to handle your employees’ workers comp claims. Also ask if the physical therapy office is a United States General Services Administration contractor providing services to the Veterans Administration. If so, the provider is generally thought to be good quality.

Other characteristics of the physical therapist office to consider are:

• Their proximity to the medical provider’s office and distance from the employer’s office and area where most employees live.
• The size of their office. It is best to have an office with several therapist who can work with the employee if the primary therapist assigned to the employee is unavailable.
• Their ability to use a wide variety of treatment methods rather than relying primarily on one approach.
• Their ability to use electric nerve stimulation when other pain management procedures are not working.
• You want a physical therapy office who will adopt an evidence-based approach to complement the physical therapy treatments.

Learn From Peers

If you are a member of RIMS (Risk and Insurance Management Society) or another professional organization, ask other risk managers, claim managers and insurance professionals about physical therapy offices where they have had good results. By learning from the experience of others, you can eliminate the worry about the alphabet soup of titles and designations.