EMR Adoption, Selection and Implementation Checklist, medical records

Claim Reimbursement — The Billing Scenario

by Nitin Chhoda PT, DPT | Aug 20, 2013 | Electronic Medical Records, Physical Therapy Billing, Physical Therapy Documentation

Building a clean claim is a concerted effort. It begins with the office staff that gathers demographic information and comes to fruition when the funds are deposited in the practice’s account.

Much can happen to a claim on its way to becoming a payment and in this informative article, Nitin Chhoda provides unique insights into the pitfalls that face even perfectly prepared claims and elements that affect payment.

Where’s the Claim?

Aside from coding errors, reimbursement claims can go awry in many ways. The insurance provider may not be known at the clearinghouse or the clearinghouse software may glitch and submit the claim to the wrong provider.

In some instances, the payer may not be using electronic medical records (EMRs) software necessitating submission of a paper claim.

Verifications

Practices that utilize EMR technology receive a report in real time when a claim has been submitted. These receipts provide billers with critical information in the event of a problem. Occasionally, a claim will appear to vanish into the ether.

Clearinghouse reports tell billers when the claim was received, its status and if any problems were identified. If payment isn’t received in a reasonable time or it doesn’t appear on the biller’s daily verification, that data be used to track down the claim and rectify any problems.

Reimbursement Amounts

The whole point of submitting claims is to get paid, but the amount charged can conflict with what the payer is willing to reimburse. When differences occur, billers can easily refer to the contract the clinician has with the payer to define the reimbursable amount.

CTP codes are assigned a relative value that determines reimbursement amounts, derived from the Resource Based Relative Value Scale (RBRVS). The value assigned is based on the work required, the cost of maintaining a practice and the malpractice/liability for which the practitioner is responsible.

A formula is then employed that takes into account geographical locations to calculate the reimbursement rate.

Prioritizing

Some contracts are RBRVS based, some aren’t, and the differences in each can be immense. Depending on how the contract is written, procedures may be paid based on RBRVS standards or discounts applied for secondary procedures done at the same time.

Some may be paid at a higher rate determined by prioritization, while others are billed according to expected payment. If the contact doesn’t state which procedure is prioritized, it’s up to the biller.

The Deciding Vote

The ultimate decision lies in the hands of the company that provides the patient’s healthcare insurance. Once the clearinghouse completes its search for errors, it forwards the claim to the payer. When reimbursements are less than expected, billers must refer to contract terms to obtain the maximum payment allowed.

Many hazards await claims, from submission to the wrong payer to glitches in clearinghouse software.

EMRs facilitate the process by submitting claims in real time and documenting receipts from the clearinghouse.

Billing specialists can help clinicians boost revenues by carefully monitoring claims and referring often to contract details. Practitioners must negotiate their contracts carefully to ensure their services are adequately reimbursed.

The Right EMR System Provides the Solution to the Physical Therapy Practice

by Nitin Chhoda PT, DPT | Aug 17, 2013 | Electronic Medical Records, Physical Therapy Documentation, Physical Therapy Management, Physical Therapy Software

Physical therapy clinics and providers should opt for the right EMR system that serves as the solution for improved management and better delivery of patient care. Nitin Chhoda reminds physical therapy practice owner to always choose the right EMR system to maximize its use and increase profitability.

Individuals in need of physical therapy services will always check on the expertise and capability of the clinic.

This will serve as the deciding factor in figuring out the physical therapy clinic or provider they will choose.

The same degree of professionalism and efficiency is also expected from the office solutions that are being utilized with electronic medical records for physical therapy services.

It is essential for any physical therapy clinic or provider to select the best EMR system or physical therapy documentation software.

Focus on What Your Practice Needs

Due to the wide selection of EMR system for physical therapy services, clinic owners and providers are having a difficult time sifting through the various features and functionality of every EMR system. Finding the right EMR system that fits perfectly with the practice’s needs and preferences are overwhelming.

The navigation and the user interface are the main features being focused on. The ideal EMR system can make the daily tasks a lot easier to handle while at the same time, make the office organized, thus, saving time and money for the practice.

User Interface

With many different EMR systems shown to practice owners, there are certain ways in which a user can interface in order to view and manage the documents online. The user interface is available in various forms.

The files are neatly categorized based on the chosen arrangement. This can greatly help in locating required files for a particular treatment as well as other important files such as the workflow items, insurance files, messages and many more.

Simplify Practice Flow

The right EMR system should involve the review of the workflow processes, particularly repetitive steps undertaken in the office.

EMR system for physical therapy services that meets the needs of physical therapy clinic can greatly help save time and money in the long run.

The EMR system that will be chosen will not only establish how the practice is organized, but also how well the patients are treated.

The professional image of your practice is also greatly affected. As the best solution for better management, workflow and delivering quality patient care, the ideal EMR system for physical therapy services must be chosen.

Proven Tips on EMR Implementation Provides Physical Therapy Clinics with an Advantage

by Nitin Chhoda PT, DPT | Aug 14, 2013 | Electronic Medical Records, Physical Therapy Documentation, Physical Therapy Software

Physical therapy clinics will gain an advantage by utilizing the proven tips on the implementation of the EMR for physical therapy services which Nitin Chhoda keeps on sharing to the practitioners.

The decision to integrate EMR for physical therapy services is the best choice due to the remarkable shift in the management of the patient files and the workflow.

The EMR system was specifically created in order to improve the accuracy for better patient care and management.

The implementation of the EMR system is important as well as the type of EMR system that was selected.

Certain aspects that range from the government standards up to the training of personnel must be carefully planned out during the implementation of the EMR so that the best results can be achieved.

EMRs Main Purpose

With the main objective of the EMR systems to reform the health care system as well as improve quality of health care, patient safety and efficiency, practitioners can achieve a better workflow and even provide the best patient care.

Today, physical therapy clinics that concentrated on providing superior care to their clients while at the same time managing the daily practice efficiently with the help of the EMR system, has a better stand in gaining monetary incentives in the long run.

Physical Therapy Staff Involvement

The involvement of the personnel in the implementation process will result in a highly efficient and effective EMR system that can greatly improve the workflow. During the implementation of the new EMR for physical therapy services, important personnel can voice out their own perspectives, which can help improve the patient care.

Staff should also receive training on operating the EMR system in order to make the implementation successful and highly effective.

Creating Plans for Implementing EMR

Implementing EMR for physical therapy service should require a plan B just to be prepared for unexpected surprises during the implementation process.

Doing so will help save a lot of hassle in the future. Even opting for a secondary electronic medical records system can help maintain the functionality while certain issues are dealt with to recover the main system.

Proper implementation of EMR for physical therapy services can greatly help out the practice in achieving better management, workflow and even the patient care they provided.

There should be adequate planning as well as working with the personnel involved to achieve a successful implementation.

Physical Therapy Software Benefits to Physical Therapy Practices

by Nitin Chhoda PT, DPT | Aug 11, 2013 | Electronic Medical Records, Physical Therapy Documentation, Physical Therapy Management, Physical Therapy Software

The management of healthcare can be a tedious task due to the various divisions involved. Nitin Chhoda shares how using physical therapy software or EMR (electronic medical record) can provide several benefits to any healthcare facility, especially in physical therapy businesses all over the world.

Both large-scale and small-scale physical therapy centers will gain an advantage if a physical therapy software is utilized. Physical therapy software offers a number of features that can comply with the different aspects on physical therapy practice.

Reporting Capabilities of the Physical Therapy Software

Proper physical therapy software management is not considered complete without the reporting capabilities offered by the physical therapy EMR. As long as the reporting feature is utilized optimally, the average number of visits for each patient can be monitored easily.

This figure can be linked with referral indicators. Any problems or inadequacies can be recognized in which patients are more likely to self-discharge. Previously, this kind of exhaustive reporting takes a lot of time to gather. With the help of the physical therapy software, needed reports are made in just a matter of minutes.

It is a known fact that medical billing can be a burden together with insurance companies who pay approximately half on all the claims that were submitted. With the help of the EMR physical therapy software, submissions are improved.

Additionally, it eliminate errors, boost the efficiency of the overall process, as well as make the identification process on claims a lot easier. The physical therapy software allows the medical billing staff to access all the required tools to track the insurance companies that deny or reject claims on a regular basis.

Physical Therapy Scheduling Process

Inefficient therapy scheduling process in any physical therapy practice also causes money loss. There are instances that one of the patients might cancel without notice. Some cancelled appointments can be rearranged. But there are patients who do not show up, incurring losses.

Physical therapy software can also provide solutions that deal with physical therapy scheduling issues.

With the benefits offered by an EMR, physical therapy practices will become more efficient in terms of providing services as well as with its management.

A private practice that utilizes physical therapy software is considered more efficient, has an improved insurance claim acceptance rates and can deal with problems that might arise easily.

EMR – Electronic Data Interchange 101

by Nitin Chhoda PT, DPT | Aug 8, 2013 | Electronic Medical Records, Physical Therapy Documentation, Physical Therapy Software

When the Affordable Health Care Act goes into effect, electronic data exchange (EDI) will be the standard for submitting billing, communicating with medical facilities, and staying in contact with patients.

In this informative article, electronic medical record (EMR) expert, Nitin Chhoda, explains the basics and how an EMR can be used to accomplish all those tasks.

Reimbursement Claims

Perhaps the most important facet of an EMR for physicians is its ability to let billers submit claims to clearinghouses in real time.

Billers receive confirmation of the claim’s arrival and can track any reimbursement request as it makes its way through the payment system.

The communication is conducted in real time, eliminating long waits and allowing clinicians to collect payments in as little as 10 days.

Another advantage of an EMR is its ability to identify potential problems with claims. Any inconsistencies can be remedied quickly before reimbursement requests are sent. Clean claims are processed quickly and practitioners collect their funds quicker.

Security

Patient information is confidential. Data transmitted electronically through an EMR meets HIPAA’s stringent security requirements.

Communication

Practitioners have the ability to communicate with other physicians, medical facilities, labs and pharmacies. Referrals can be made, medications ordered and tests scheduled right from the office.

Electronic medical records provide enhanced communication with patients to remind them of appointments and any debt they owe. With an integrated EMR, medical providers can post test results in a client’s secure account and communicate with them through mail, phone, email, and text and voice messages.

Patient Care

EDI benefits patients by providing continuity of care. Client records can be accessed by authorized personnel from virtually anywhere in the world through EMR. In the event that an individual is unable to supply needed data, medical providers can access records through EDI to avoid treatment errors, learn about any health issues or allergies, and eliminate redundant testing.

Records are also available in the cloud in the event of a natural disaster

Portability

EMR technology can be employed on laptops and tablets, providing practice owners with new opportunities for revenues. The systems can be accessed anywhere there’s an Internet connection, allowing clinicians to offer services away from the office. Corporate wellness programs, senior centers, home care programs and spas are just some of the opportunities available with a portable system.

Savings

An electronic data exchange system saves practices time and money. There’s no need to maintain a room of file cabinets full of folders filled with paper records.

Patient information is maintained in the cloud for convenience and quick retrieval. Vendors are responsible for maintaining HIPAA compliance and security, and EMR systems can quickly notify other medical providers if there’s ever a security issue.

Before purchasing any EMR, clinicians should conduct sufficient research and examine several systems. All EMRs aren’t the same – practitioners should choose one specifically designed for the type of practice they have.

Selected EMR systems have low monthly fees, 24/7 support from vendors and updates, along functionalities to assist in marketing. Electronic data interchange represents the future of how those in the medical field communicate with clearinghouses, medical facilities and providers to offer a superior level of patient care.

Web-Based Billing and EMR – The Cutting Edge

by Nitin Chhoda PT, DPT | Aug 5, 2013 | Electronic Medical Records, Medical Billing, Physical Therapy Billing

Electronic medical record (EMR) systems have changed billing standards with cutting edge technology. EMR systems allow for cloud-based billing that’s quick, efficient and clinicians can receive payment in as little as 10 days.

In this insightful article, Nitin Chhoda explains how an EMR facilitates the reimbursement process.

The use of an EMR allows practices to conduct business in the cloud, also known as web-based billing. It eliminates the need for files full of paperwork and the space to maintain them.

With web-based billing software, claims can be filed, payments delivered and records accessed any time of the day or night for greater productivity. It’s an environmentally friendly solution.

Identifying Problems and ICD-10 Codes

Perhaps one of the biggest advantages of a web-based billing EMR is its ability to identify mistakes and potential problems. It’s a simple matter to make the appropriate corrections, ensuring clean claims that progress quickly through the system. An EMR can assist providers with up to a 91 percent payment rate the first time claims are submitted.

When a claim is questioned, an EMR makes it easy to address the problem online. The transition to ICD-10 codes can cause significant problems for practices that aren’t using an EMR. The web-based billing software system is capable of handling all the new codes with clarity and ease.

Equipment Costs and Savings

Practitioners save money and eliminate costs associated with web-based billing software, equipment and the need for upgrades. There are excellent EMR programs available for free that provide medical practices with a full service billing and management system. They keep monthly fees low, offer 24/7 customer support and online training for staff.

The vendor is responsible for all facets of the infrastructure.

Digital Delivery

Every medical practice is familiar with clearinghouses. They check claims for errors and forward them to the patient’s healthcare insurance carrier. A web-based billing EMRs transmit reimbursement claims electronically in real time and maintain an ongoing record of each claim, its details and current status in the chain of reimbursement.

An EMR is crucial for medical providers who want to work with government-sponsored healthcare insurance plans. They require claims to be submitted electronically and prefer to pay via electronic fund transfer. Submissions can be sent individually or as a batch. Real time adjudication and notice of denials or acceptance are received in moments when a web-based billing system is at hand.

Portability and New Venues

Integrated and web-based billing EMR software can be implemented on laptops and tablets. It provides practitioners with portability and the opportunity to forge trails into new venues for new revenue streams. Web-based billing software can be submitted from any location an Internet connection is available and remain in compliance with HIPAA security standards.

Other Services

Electronic medical records facilitate the payment process with cloud-based billing, but they offer a comprehensive variety of other advantages. They store information in a secure environment and allow staff to verify insurance coverage prior to treatment.

Electronic patient statements can be sent, payments made and clients can complete a variety of essential information online. Patients can be contacted by multiple methods, test results can be posted for clients and medications can be requested.

Web-based billing offers clinicians the ability to receive payments quicker, opportunities to extend their circle of revenues and submit bills in real time.

The web-based billing software systems represent the future for medical practices and billing procedures. Practitioners without an EMR face a loss of efficiency, productivity and revenues.