EMR Adoption, Selection and Implementation Checklist, medical records

EMR Software System — Transforming Patients into Referral Sources

by Nitin Chhoda PT, DPT | Jan 21, 2014 | Electronic Medical Records, Physical Therapy Documentation, Physical Therapy Software

It’s important for physical therapists to keep in touch with their patients throughout the year and not just when they make an appointment. Nitin Chhoda elaborates on how electronic medical record (EMR) software provides the tools to build and maintain an ongoing relationship with patients and transform them into a primary source of referrals.

Familiarity Breeds Referrals

Patients want to know that their business is appreciated. They’re busy and have dozens of options available when choosing a healthcare professional.

They want to feel that they’re more than just an insurance card or a paycheck. Clinicians must reach out to them.

An electronic medical record makes it easy, simple and streamlines the process.

Practitioners must strive to create an improved relationship with patients to increase the chances of referrals. They have to like, trust and be familiar with the therapist before they feel comfortable enough to refer them to friends and family.

Practitioners must keep their names in front of patients and an EMR provides the means to do that.

Modern Communications

An integrated solution, such as the In Touch EMR™, offers multiple methods of connecting with patients in traditional and modern ways to form and maintain long-term relationships. Practitioners can use the abilities of an EMR to provide patients with gentle reminders without being invasive.

Communication is the key to creating a long-term relationship between patients and practitioners.

Note: An EMR contains multiple mechanisms to communicate with patients.

When patient information is entered into an EMR, it provides clinicians with eight pieces of data that can be used to inform, educate and connect with their clientele.

Therapists should automatically collect the needed patient information, including their email address and cell phone number. Practitioners can take advantage of the built-in abilities and data residing in the EMR to send clients offers, announcements and eBooks, along with voice and text messages. Patients must give permission for the contact, with the option of ending the communication when they desire.

An EMR Facilitates Communication in a Variety of Ways

Clinicians can keep in touch with patients through mail, email, phone and cell phones, and voice and text messages.

All those methods can be used to mark the client’s anniversary with the practice, the patient’s birthday, and send a variety of patient reminders.

Most text messages are read within five minutes of receipt, making them a reliable vehicle of communication.

Electronic medical records provide practice owners with automated options that can be used to deliver newsletters, greeting cards and special offers. Clinicians should endeavor to use at least two or three of the available communication options. With the metrics contained in an EMR, practitioners can also track patients who make a large number of referrals.

Integrated EMRs will soon be the standard in private practices, hospitals, labs and pharmacies across the nation. They streamline all facets of the office and reimbursement process, and provide automated methods of connecting with patients to build relationships that generate referrals.

EMRs have the necessary tools to help practitioners expand their reach and transform patients into an ongoing source of referrals.

Flow Sheet and EMRs Increase Reimbursements

by Nitin Chhoda PT, DPT | Jan 19, 2014 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

Flow sheet helps clinicians track what they did for a patient on previous and current visits, but they’re much more than a means of patient management. They hold the key to obtaining reimbursements.

Claim denials and delays result in fiscal hardships for practices and in a time of shrinking healthcare payments, and in this article, Nitin Chhoda explains how the flow sheet is a critical element in the reimbursement process.

Flow Sheet and its Important Role to Claim Reimbursements

The flow sheet has to justify the billing amount and should be designed to reflect the CPT code in the reimbursement claim.

It forms the basis of the billing, streamlines the reimbursement process and supports medical necessity.

A properly designed flow sheet provides all the information needed for billing and supports each prior step.

The flow sheet provides a permanent record of care, supplies and products dispensed that are eligible for reimbursement. They’re essential for patient care and management, reimbursements, and can be used for research and quality improvement.

A flow sheet offers a birds-eye view and summary of changing factors that includes vital signs, diseases, treatments, medications and test results.

It’s used to document findings for each patient encounter, allowing practitioners to tell at a glance if the patient is being seen for a new condition or something that has occurred in the past.

No matter what type of practice is being operated, the flow sheet is one of the greatest assets available to determine when patients are due for check-ups and tests, and facilitates moving patients through the office in a timely manner.

–> Clinicians don’t have to start from scratch when working with established patients.

The Value of an EMR in Creating Flow Sheet

Maintaining flow sheets to expedite reimbursements is much easier with an electronic medical record (EMR) system.

The In Touch EMR, which is also integrated with billing software called, In Touch Biller Pro, is an example of an “intelligent” EMR that advises and prompts users when information is entered to ensure each element of the reimbursement claim matches and all the necessary components support each other.

EMRs offer portability to help clinicians provide a superior level of care, while allowing practitioners to see more patients within the day.

Clinicians can move easily through the office without the need to find and retrieve paper records before patients can be seen. They also support the creation of custom forms and templates.

The systems encompass built in calendars, calculators and treatment reminders. Clinicians can pull up photos, videos and print information for patients to take with them.

It ensures patients have data from a reputable source instead of letting them surf the web and obtain erroneous information.

An EMR can be implemented on tablet technology, allowing practitioners to diversify the practices services. The systems can be updated by multiple healthcare professionals and utilizes electronic communication to save time, money and resources.

Data can be retrieved whenever needed, for printed reimbursement claims, RAC audits or litigation. Errors due to illegible handwriting are eliminated.

To file reimbursement claims that are paid quickly, the flow sheet must reflect the CPT codes used and all the documentation must support the billable expenses. EMRs are an essential component of the process, with prompts to ensure each step supports the next, for clean claims that are paid quickly.

Billing: The Importance of Keeping Records in Your MIB Business

by Nitin Chhoda PT, DPT | Jan 15, 2014 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Software

Documentation is the backbone of a medical insurance billing (MIB) business. It’s essential to file claims for clients and interacting with the IRS at tax time. In this informative article, Nitin Chhoda reveals the many reasons for maintaining proper documentation within an MIB business.

Tools of the Trade

Billing software is designed to handle virtually any billing related task an MIB chooses to offer, but MIBs should consider the option of employing electronic medical record (EMR) technology in their business.

Fully functional EMR software is available for free and only requires a modest monthly user fee.

EMRs are in compliance with HIPAA privacy standards and submit claims electronically. They have the ability to maintain multiple databases for any number of patients, providers and payers. The billing software maintains a comprehensive array of information digitally or in the cloud, eliminating the need for paper medical records.

Avoiding the Litigation

Perhaps the greatest need for documentation in a biller’s arsenal is to avoid running afoul of litigation on behalf of their clients. It offers protection against accusations of billing for services and procedures that weren’t provided, altering or falsifying claims, misrepresentation, and billing for non-covered services.

Daily Documentation

Armed with a medical provider’s day sheet, MIBs are tasked with submitting a client’s current claims, complete with the necessary patient data. Documentation must be kept that supports the medical provider’s diagnosis, treatment and procedures performed when claims for billing are sent.

It’s a simple matter to import written records into an EMR for storage and easy retrieval should a claim be denied, rejected or need correction.

Billing software provides a running account for each client that documents which claims have been paid, patent balances owed and payments posted to a clinician’s practice. Billers can quickly refer to their software when dealing with clearinghouses, payers or recalcitrant patients.

Patient IDs and Coverage

A patient must provide a photo ID and a copy of their insurance card for a claim to be filed. All that information can be kept securely within billing software, allowing billers to update the data as needed. Copies of all those insurance cards provide billers with necessary information to submit claims that get paid in a timely manner.

The billing documentation provides essential information about the client’s medical coverage, insurance exclusions, co-insurance, deductibles and co-pays, and who is covered, along with any financial maximums or caps. The documentation contained within the software allows billers to ascertain if the patient’s coverage requires pre-approvals or referrals.

Contracts and Databases

To deal with clearinghouses with authority, billers need a copy of the contract between clients and their clearinghouse. Digital documentation puts the necessary information at their fingertips.

Multiple databases can also be created to provide an array of information that billers have agreed to track for their clients, from referral sources and revenues to the number of procedures performed each month.

Operating Costs

Documentation and receipts are critical for billers at tax time. The data allows MIBs to claim the cost of operating expenses, from equipment replacement and depreciation to loan payments, office supplies and coding updates. Don’t forget to document income.

With the elimination of paper forms, digital documentation becomes a critical element in business, especially in the medical billing industry. Billers who want an affordable full management system that will grow with their business should consider an EMR for comprehensive documentation, storage and retrieval.

Services Rendered: The Options to Offer as a Medical Insurance Billers

by Nitin Chhoda PT, DPT | Jan 13, 2014 | Electronic Medical Records, Medical Billing, Physical Therapy Billing

The future of medical billing is as bright and busy as billers want to make it. As various portions of the Affordable Health Care Act take effect, professionals and health care facilities will be serving an influx of new patients, requiring a variety of billing related services.

In this informative article, physical therapist and electronic medical record (EMR) specialist, Nitin Chhoda, examines services offered by medical insurance billers (MIB).

Certified medical insurance billers provide a variety of services, from coding and transmitting reimbursement claims to accounting and tracking accounts, along with full practice management services.

Much depends upon the work environment. Those who work in medical practices and facilities may be tasked with simply coding and transmitting claims electronically.

Medical insurance billers working from home may choose to offer a la carte services to meet the specific needs of the client. Tracking accounts receivable and payable, and pursuing unpaid amounts owed by insurance companies and individuals are also part of a biller’s duties.

Who Are The Clients?

Most medical insurance billers think exclusively of medical practices when offering services, but any healthcare provider or facility is a potential client, from small clinics to practices with multiple clinicians. Hospitals, nursing homes and mental health professionals offer other options. Often overlooked sources of clients include dentists, pharmacies and social workers. Services can be adapted to meet individual requirements.

Customized Services and Specialties

Certified medical insurance billers always seek to bill accurately and quickly to increase the cash flow for their clients. They may also take on a multitude of other duties, including making referrals and recommendations within the field. Some medical insurance billers have taken their prior experience in marketing and other professions and applied it to billing to assist practitioners promote their products and services.

Medical insurance billers have their finger on the financial pulse of practices. They can determine when a client’s finances are faltering and offer consulting services. Some medical insurance billers specialize in services to physicians just starting out who can’t afford an in-house biller, as well as medical professionals who are closing out their practice.

Others have found their niche by working with rural providers who don’t have access to medical billing services or by handling non-insured patients.

EMRs and Portability

EMRs are an essential element for medical insurance billers, allowing them to perform their tasks quickly and efficiently, with clean claims that approved the first time. Built-in functionalities meet HIPAA security standards and EMRs provide alerts if claims contain potential problems or if a security issue is present.

An EMR also provides medical insurance billers with portability, allowing them to offer services from multiple locations and take the job to the client.

The software systems are capable of producing graphs, reports and charts to keep practitioners informed of how they fare financially.

Multiple opportunities exist for medical insurance billers and those who are willing to offer specialized, customized services are indispensable. Billers who offer the little “extras” are in high demand, but medical insurance billers should never lose sight of their most important goal – quick and accurate billing that produces a steady monetary flow for clients.

Understanding the RAC Audit Process

by Nitin Chhoda PT, DPT | Jan 11, 2014 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Software

One of the greatest challenges facing practitioners is a potential investigation by a Medicare Recovery Audit Contractor (RAC). Medicare estimates that there is a sixty two percent error rate among reimbursement claims in which documentation doesn’t match the billed expenses.

Private practice marketing expert, Nitin Chhoda, says that when services, fees and documentation don’t match, it increases the possibility of a RAC audit. The good news is that there are concrete steps clinicians can take to reduce the risk. And he shares that information in this article.

Even with the best coders and billers, errors can occur and it’s ultimately the responsibility of the practitioner to ensure that records match.

Knowing how the RAC process works allows clinicians to develop measures and install appropriate software systems to minimize risk factors that lead to an audit.

Medicare RAC auditors examine reimbursement claims after payment has been made, using methods similar to those employed by commercial healthcare insurance carriers.

The practice is known as pay and chase among industry officials. They look for inconsistencies in the billable services and submitted documentation.

RAC auditors utilize methods that comply with the Centers for Medicare and Medicaid Services (CMS) rules and regulations.

Determining the Two types of Audits

There are two types of audits – automatic and complex.

An automatic audit seeks easily identifiable errors in payments, but doesn’t require human intervention or medical records to determine a problem exists.
A complex audit addresses improper payments through a manual evaluation and a request for extensive supporting documentation. Medical providers have strict and definite timelines in which to request an extension, comply with producing the appropriate records, and make appeals.

The process doesn’t stop there. Practitioners singled out for a RAC will be reported to CMS for potential fraud. If the RAC determines the problem is a potential quality issue, they report the provider to the state’s Quality Improvement Organization.

Initiate Self-Audits in order to Minimize RAC Interventions

Conducting self-audits will help minimize RAC interventions, but the best way clinicians have of avoiding an audit is to ensure their flow sheet, plan of care and billed expenses all match. If they don’t, it’s a problem and the responsibility of the practitioner.

Integrated electronic medical record (EMR) software is a critical element and provides the first line of defense toward that goal of avoiding an audit.

Each EMR differs slightly, but systems such as the In Touch EMR, and In Touch Biller Pro, have capabilities specifically designed to assist coders and billers.

When data is entered, it prompts and advises the user for information and data to ensure all the components match and support each other.

It’s a crucial feature that offers a greater level of compliance and minimizes the probability of an audit.

Knowing how and why a RAC audit is conducted provides clinicians with the necessary information to help them avoid the experience. Confirming that the flow sheet, plan of treatment and documentation are all in agreement is the first step. The second is implementation of an “intelligent” integrated EMR physical therapy software system.

An audit isn’t desirable, but instead of living in dread practitioners should look upon a RAC audit as an additional way to maintain compliance.

What Lies Ahead With Medicare Payments?

by Nitin Chhoda PT, DPT | Jan 9, 2014 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

The Affordable Health Care Act changed the healthcare landscape and it’s evolving further through new Medicare decisions. The only way for practitioners to financially survive the uncertainty is through diversification. To help practitioners prepare for the future, Nitin Chhoda addressed Medicare payments and diversification.

In a forced Medicare economy, clinicians need to diversify their practice to prepare for the loss of income that will come through the Affordable Health Care Act and the reduction in Medicare payments.

Practitioners need to implement cash paying services they can add to create additional revenue streams.

What Statistics Say …

Multiple payment reduction (PPR) now places limitations on payments. Medicare currently pays seventy five percent for PPR visits and it applies to clinicians in single or group practices.

Clinicians have seen a six percent reduction in payments on the low end and twenty percent on the high end.

Physicians have already seen the impact in the physician quality reporting system (PQRS). So far in 2013, practitioners have seen the incentive program go from voluntary participation to one that will be mandatory for eligible providers in 2015. Payments in PQRS are steadily being reduced.

Beginning in 2015, the program assesses penalties for providers that are “poor” reporters.

Many providers are concerned that Medicare could theoretically use PQRS data collected at eighty nine locations throughout the nation to set payments by geographical area. Apprehension also exists that Medicare might establish caps on the number of visits a patient can have to be considered “well.”

So What Are We Going to Do?

Will we be looking at patients as human beings or at the number of visits they’re allowed? Do we discharge them even if they’re not well because we won’t get paid?

Medicare may never increase – do we drop these patients? I would hope not, but I believe we’ll see commercial carriers doing the same things as Medicare.

The solution is a two-step process. Clinicians must be more efficient in the time they spend with patients, the types of codes they use, and the units billed when dealing with Medicare. An EMR is essential to plan, implement and market diversification efforts.

Systems such as In Touch EMR and In Touch Biller Pro, contain the functionalities needed to handle the undertaking, along with sophisticated training and strategies.

Diversify Payments and Create Cash-Paying Programs

Practitioners must also identify cash paying programs to make up for the loss in revenues. They can add the following to their practice:

Cash paying services such as products and services paid at the time they are received.
Accepting payments through cash, checks, debit and credit cards.
Selling supplements, medical products and durable medical supplies to serve the patient better.
Other cash paying options include weight loss clinics, massage therapy and personal training.
Diversifying into multi-faceted practices with alternative medicine, nutritional information, aquatic therapy, acupressure and corporate wellness programs.

Electronic medical records provide mobility for increased opportunities.

Changes in Medicare, combined with the Affordable Health Care Act, are changing the way clinicians operate their practice. Faced with very real financial deficits in reimbursements, clinicians must utilize cash paying programs and use their time more efficiently to ensure Medicare patients receive care and practices continue to flourish.