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What Does Legacy Software Really Cost Your PT Practice?

The real cost of legacy software in PT

For physical therapists and practice owners, sticking with an existing software can seem like the path of least resistance, both practically and financially—because “that’s just what we’ve always used.” But costs run so much deeper than the surface, or simply what you might read on a price tag. Physical therapy businesses may end up deep in the hole after months or years of using outdated EMR and practice management technology, burning the candle at both ends by driving up operational costs and missing out on revenue. Not to mention burning out your employees.

So what does the status quo actually cost your PT business? In this article, we’ll list some of the main reasons why the path of least resistance can actually be harming your bottom line, slowing growth, and potentially putting your business at risk.

Underbooked and canceled visits

For outpatient rehab teams, keeping schedules full is the cornerstone of your revenue. Empty visit slots, especially with how much costs are rising, are not something most clinics can afford. And with limited or disjointed technology, this can result from any number of things: overlooked details, miscommunication between the front desk and providers, a difficult or confusing scheduling experience for patients, a poorly managed waitlist (or the total lack of one). And many of the “legacy systems” in PT can contribute to most or all of these problems.

Missed, canceled, or unfilled visits can add up quickly. And difficulty with scheduling appointments can create a poor experience for patients in need of care—which can also lead to negative word of mouth. Because of these challenges and unpredictable costs alone, a modern system can pay for itself in helping get patients booked out and getting empty slots filled—without your front desk staff having to scramble with making calls. Based on industry averages, filling one empty slot per day can equal out to around $25,000 per year per therapist.

Prompt’s all-in-one platform joins together provider schedules, front office communications, waitlist automation, and patient online scheduling so more visits are booked and cancellations are filled faster. When patients have the option to book visits online, it not only increases the chance they’ll make an appointment, it also lowers the overall cancellation rate. This improves providers’ daily revenue from two directions. And with help from automated waitlist management, patients are notified whenever something opens up and they can grab these open slots with the push of a button. That helps fill slots faster, and alleviates the strain on your front desk to call each person on your waitlist at a moment’s notice.

Inaccurate and expensive billing practices 

Healthcare billing is an obstacle course that gets more complicated by the day. Proper billing at a physical therapy clinic is a nonstop hunt for accurate medical codes, insurance details, up-to-date-patient information, and more—with so much room for error that can lead to underpaid claims or denials. Because older EMR systems don’t offer much in the way of support, billing teams have to spend hours manually searching for the right codes, tracking down info, and scrubbing insurance claims for accuracy. And this all still leaves so much room for error. These headaches will often lead to practices outsourcing their billing at a huge added cost.

Optimized PT billing, with help from modern tools, can also help your team find data points to capture more revenue as well as identify any unnecessary expenses across your practice. This benefits your clinic’s financial health from multiple angles. Leveraging the right solutions will also allow you to identify poor billing practices in general, which can help improve overall efficiency and allow them to focus on value added work, rather than putting out fires and working on tedious claim audits. All this combined can save your team so much time, frustration, and—most importantly—save your business a lot of money in the long run.

Authorization denials and front desk headaches 

As physical therapy EMR software has gotten more advanced, so has its ability to spot potential claims issues. Older platforms widely used in the industry often lack these features, leaving clinic teams to find out the hard way when visit authorizations are denied by insurance payers. 

Not only can this impact your forecasting and revenue cycle—and put your billing team in an uncomfortable position trying to correct the issues—but it can also create conflict with patients, leading to billing disputes and difficult conversations for your front desk. This is a major way in which “sticking with your existing system” can be harming your business, creating unforeseen risks, and doing a disservice to your patients.

Overworked providers without enough support

Legacy EMR software leaves providers with far more manual work than is necessary. This is a huge contributor to PT burnout, and also takes precious time away from patients during their visits. Because of these slowdowns, PTs are not able to take as many visits, which means less revenue for them and your practice. And in some cases the patient experience will leave something to be desired, sending those patients elsewhere for their care.

Along with that, the inefficiency of older systems will create gaps in how much front desk staff can keep up with the providers’ needs, from patient communication and scheduling to documentation reviews and entry. This will either leave providers with too much work, or cause a need for fewer patients or visits in order to keep up, which translates to underbooked schedules. With improved software and the increasing number of automations that are available, each front office staffer can now support twice as many clinicians. You shouldn’t need additional hires to do the job that your existing team can likely do if they were given the best tools for the job.


If your practice still operates using old software tools, even if just as a resource for data, it’s likely that you’re holding your company back from its potential, both efficiency-wise and profit-wise. There’s a lot more to “costs” than the initial price tag, or the savings you think you’re getting by not updating to a more advanced system. Consider the ways here that your outdated technology might actually be slowing your team down, creating risks, and causing you to miss out on potential revenue. You should talk with your team to better understand their needs—as well as their frustrations with the tools they’re using—and demo a modern platform that can help them thrive so your business (and patients) can thrive as well.

Prompt Staff

Prompt Therapy Solutions builds practice management software for physical therapy clinics ranging from single provider practices and startups, to large enterprise organizations.

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