Physical Therapy Billing

Physical Therapy Billing: Engineering the Ideal Physical Therapy Practice

by Nitin Chhoda PT, DPT | Jan 22, 2017 | Physical Therapy Billing, Physical Therapy Management

With the right information, strategy and coaching, it is possible to build a successful physical therapy private practice.

Nitin Chhoda explains how an automated physical therapy documentation and billing system can play an important role and help your practice succeed, allowing you to achieve the “ideal physical therapy practice” that drove you to start your practice in the first place.

Technology has changed the way that many industries and businesses work and succeed.

The benefit of implementing new physical therapy billing technology is that it allows us to make leaps and bounds forward, adjusting not just the little things but changing the way we work in a fundamental way.

It always helps to go back to the example of email because it is so stark.

Physical Therapy Billing — Before

Before email, all correspondence was sent on paper or communicated via telephone. Anything important had to be written down over and over again to ensure that the information was not lost.

Couriers bringing important physical therapy billing documents in a single day were the fastest way to exchange important documents, besides actually setting meetings and sitting down together.

Today, information travels instantly. Email has changed the way that every single business performs, bringing incredible efficiency and speed to even the most mundane jobs.

Physical Therapy Billing — Today

Physical therapy billing software has the potential to make that kind of dramatic change for physical therapy practices. Making the changes that are possible with physical therapy billing software will not be quick or simple. In fact, the more time you take and the more focused you can be, the better the results when you make the change.

But in the long term, there is no alternative for physical therapy billing and practice owners and management. Success in the future is going to depend on keeping up with the standards. Right now, you have the opportunity to set the standard and be ahead of the crowd.

The Ideal Practice

Start by imagining what the ideal physical therapy practice would look like if you could use physical therapy billing software that was fully integrated into the entire practice, from patient intake to treatment plans to patient discharge.

How would you implement a program if you could automate as much of the physical therapy billing process as possible? Can you imagine a system that is proactive rather than reactive?

There are many ways that an ideal physical therapy billing practice could function. Of course, the primary concern of every physical therapy manager or owner is to provide excellent care to all patients who walk through the door. Today, excellent care and streamlined technology are intertwined.

The Advantage of Having an Automated Physical Therapy Billing

If the therapist has all patient information at their fingertips, presented in a highly intuitive and efficient manner, the therapist can provide better care.

If the treatment plan is lined up and set in advance, with everyone on board, the patient knows what to expect.

And if the physical therapy billing staff can work together to ensure that the patient’s treatment plan is covered by their insurance company, the patient can relax and know that each time they visit your office, they are not risking a surprise bill in the mail a week or two later.

Technological physical therapy billing advances can be burdensome if the staff is not ready. But if you can imagine a better work environment for everyone, you can communicate the advantages to the staff. As a group, you can get excited about making big, positive changes. As a practice, success and growth will be realistic goals.

Physical Therapy Billing: How to Use Software To Minimize Physical Therapy and Medical Claim Denials

by Nitin Chhoda PT, DPT | Oct 10, 2016 | Physical Therapy Billing, Physical Therapy Documentation, Physical Therapy Management

There are many possible reasons for physical therapy and medical claims denial. Using physical therapy billing software, claim denials can be minimized, allowing you to improve cash flow and grow your practice.

Every physical therapy billing precaution can be taken and extensive documentation provided, but at some point, physical therapists will experience a denial for payment.

Claims are denied for any number of reasons, from incorrect physical therapy billing coding and services that aren’t covered to medications that were prescribed.

Patients may have exhausted a lifetime benefit cap on services or received what’s deemed as an experimental treatment by their insurance carrier.

Billing Affects Profitability

Navigating the labyrinth of rules and regulations of physical therapy billing each payer maintains can be extremely confusing, but it can also severely affect the profitability of a practice.

In an effort to cut costs, many insurance providers are requiring preauthorization for treatments and procedures that were never questioned in the past. Each insurer has their own appeal process, complete with deadlines and specific types of documentation that’s required.

EMR Advantage

One of the advantages of an EMR is being able to verify a patient’s insurance coverage long before they come to the office. The availability of time stamping provides documentation of when the treatment was received, who did the therapy, why a particular treatment was used and the patient’s response.

Physical therapy billing software also provides information about the referring physician and the client’s past history, which can play a critical part in contesting a denial.

Those who have implemented physical therapy billing software have an advantage. Therapists utilizing an EMR receive information and updates about denied claims in hours or days instead of weeks.

The same software system allows therapists to quickly submit required documentation, explanations or correct coding errors. EMRs offer billing and coding options and flexibility that actually reduces the number of denials.

Claims Procedure

Claims for reimbursement go through a rigorous physical therapy billing documentation process before payers approve or deny a claim.

In some instances, a particular procedure may be used to treat more than one type of complaint and the payer will automatically deny a request for reimbursement unless the therapist can prove it was medically necessary.

Therapists must be prepared with appropriate physical therapy billing documentation if they’re to receive reimbursement and provide the patient with needed care.

An insurer may also question a curative treatment versus a palliative one. One of the great mysteries in healthcare is why one insurer is willing to pay for months or even years of palliative treatment without a “cure,” while others are more likely to approve curative remedies.

Once treatment has commenced, physical therapy billing insurers expect the therapist to continue, even if a denial has been issued. These expectations raise serious questions about reimbursement for the practice owner.

Therapists can continue to submit claims for the patient during the time the request is being contested, but ultimately, there’s no guarantee that they will be paid.

Physical Therapy Software

Physical therapy billing software offers clear and concise documentation to help therapists reduce and minimize reimbursement denials, and contest them when they occur. While denials can arise for a number of reasons, most can be traced to errors in the manner the claim was submitted or the coding used.

EMRs are a therapist’s best friend, offering extensive documentation, time stamping and copious amounts of information, all of which can be submitted electronically to quickly and efficiently address reimbursement denials.

Physical Therapy Billing: Using Revenue Cycle Management Software to Boost Revenue in Your Practice

by Nitin Chhoda PT, DPT | Oct 3, 2016 | Physical Therapy Billing, Physical Therapy Documentation, Physical Therapy Management

Discover how real-time software can instantly determine the patients’ insurance coverage and eligibility. This helps you get paid for your services. Discover the importance of eligibility verification function in your EMR.

Revenue cycle management should be a top priority of any physical therapy business. Simply putting it as taking the necessary physical therapy billing steps to ensure therapists are paid for their services and that they’re compensated in a timely manner.

Where Revenue Cycle Starts

A revenue cycle is attached to every client. It begins the moment the patient calls the office for an appointment and ends when their balance is zero.

It’s essential during that initial contact to gather patient data that includes their name, phone number and information about their insurance provider.

Typically, data is provided by the patient when they arrive for their appointment, a time consuming endeavor that involves numerous pages of written documentation that can be streamlined and simplified with physical therapy billing software.

Some clinics gather basic information when a client calls to schedule an appointment, but neglect to ascertain insurance information, an oversight that can cost the practice dearly.

Insurance Coverage and Eligibility Should Be Verified Immediately

Verifying insurance coverage and eligibility for services saves time and physical therapy billing headaches for the clinic in the future. If problems arise, it’s an easy matter to contact the patient or their insurance provider for further details, or reschedule the client if necessary.

Reimbursement denials can be significantly reduced with the use of an EMR that provides electronic billing, coding and submission capabilities. Physical therapy billing software offers flexibility and multiple coding options to reduce rejections and denials significantly.

It’s estimated that it costs approximately $25 per claim to manage each denial. An EMR reduces those costs, while drastically cutting the time needed to provide additional information or challenge denials. The value of an EMR can’t be overstated in the management of revenue cycles.

Patient portals provided by physical therapy billing software allows therapists to capture a wide variety of client data ranging from names, phone numbers and insurance providers to email addresses, mobile device information and complete health histories.

EMR Advantages

The advantages of an EMR doesn’t stop with the initial intake physical therapy billing documentation. They offer powerful tools that can be used to track claims, file disputes and provide additional information when a denial occurs. Claims can be submitted individually or batch filed for greater efficiency and they can be automated.

EMRs allow therapists to clear up questions in hours or days instead of weeks or months.

Therapists that harness the power of an EMR have the needed physical therapy billing tools for patients to make convenient one-time or recurring payments, notify clients when they have an outstanding balance and obtain critical insurance information for verification of eligibility.

EMRs also provide practice owners with multiple ways of contacting patients for any number of reasons using text and voice messaging, phone and email. Using revenue cycle management software provides clinic owners with essential tools to track client accounts for better profitability.

Enhanced physical therapy billing and coding options, combined with electronic submissions, facilitates the reimbursement process from self-pay patients and claims that go through individual insurance companies and clearinghouses. Physical therapy billing software works for therapists to reduce denials and clear up claim problems when they arise.

EMR and EHR – The Difference

by Nitin Chhoda PT, DPT | Sep 28, 2016 | Electronic Medical Records, Physical Therapy Billing, Physical Therapy Documentation

EMR and EHR are two different terms that are often used interchangeably. Nitin Chhoda discusses the difference between EMR and EHR and why this is important for your practice.

There’s been a lot of confusion about the difference in an electronic medical record (EMR) and an electronic health record (EHR), with some using the terms interchangeable.

An electronic medal record is an integrated software system that allows therapists to interact with patients and submit billing claims online, and increase the productivity of the clinic.

An EHR is a collection of data that includes a client’s medical history, personal statistics, billing information and demographics.

The two are very different and many researchers and vendors are still struggling to define each, though both groups tend to agree that EMRs will revolutionize the way medical professionals conduct business, deliver patient care and boost the prosperity of a practice.

EMR is the New Technology

As the debate rages on, one fact remains. Therapists must implement an EMR by 2014 as per The Affordable Care Act. There are dozens of available EMRs, most of which were designed with hospitals, physicians and critical care facilities in mind. They’re generally expensive to purchase and require huge monthly fees.

The good news is that there are very affordable options available that are designed specifically for physical therapy practices. Clinicians should exercise due diligence when researching an EMR and not install the first system they explore, thinking any system is better than none.

The goals of The Affordable Care Act were many and lofty. Some facets of the act were designed to lower healthcare costs, enhance patient care and provide improved access to healthcare services. EMRs will definitely be a cost saver for insurance providers, but they also have distinct advantages for physical therapy practices.

EMR and EHR

With an EMR, therapists can access a patient’s EHR to discover what tests and procedures have been ordered, prescriptions being taken and how the client responded to treatment. There’s no need to rely on a client’s memory for crucial medical information.

It’s all there in the EHR and can be accessed via an EMR by multiple healthcare professionals. Therapists can begin treatment sooner, without the need for duplicating costly tests. Access to the information in an EHR saves time for both clients and therapists.

The documentation in an EMR is stored electronically and can be submitted online for quicker turnarounds on reimbursements.

Denials can be addressed in a fraction of the time offered by traditional paper methods and postal service, and there’s no need to wait days or weeks to obtain patient information.

An EMR also offers a convenient means of communication between therapists and patients to send payment and appointment reminders, post test results, request prescription refills and verify insurance coverage.

Healthcare providers can consult and collaborate through the medium of an EMR for more effective patient care.

In contrast, an EHR is a document representing a collection of data rather than a software solution. EHRs provide a complete record of a patient’s illnesses, ailments, allergies, prescriptions and immunizations.

It offers in-depth information about the client’s health history that can be instantly updated and accessed by multiple healthcare providers through an EMR. Along with health information, it encompasses valuable demographic data that therapists can utilize to market their practice and track referrals.

Multiple Tools

The 21st century method of record keeping has arrived with EMRs and they offer therapists multiple tools to create better patient care outcomes, market their clinics, and save enormous amounts of time, effort and money. While many continue to use the terms EMR and EHR interchangeably, therapists need to understand the difference for the good of their business.

EMR Adoption, Selection and Implementation Checklist

by Nitin Chhoda PT, DPT | Aug 22, 2016 | Electronic Medical Records, Physical Therapy Billing, Physical Therapy Documentation

If you are switching from one EMR system to another, you need to consider several factors including portability, integration and security.

Nitin Chhoda provides a detailed checklist to help you make the transition to an EMR system that will help you prepare for the future, streamline and automate your practice.

The selection of electronic medical records system is one of the most important decisions a practice owner will make over the next two years. It will affect every aspect of the clinic, from communicating with patients to submitting reimbursement claims.

With hundreds of available EMR options available, selecting a documentation software system can be an exhausting and confusing process without a well-thought action plan and clear expectations of what the system will accomplish. Look for the following features in an EMR.

Evaluation – Decide what the EMR is expected to accomplish within the clinic.
Teamwork – Form a team to evaluate the different EMRs and report back to the final decision makers.
Specialization – Choose a documentation system specifically designed for physical therapy practices.
Privacy and security – To maintain HIPAA compliance, therapists must ensure their EMR meets stringent requirements to safeguard personal health information. Practice owners that fail to do so will find themselves faced with costly fines, along with civil and criminal charges.
Customization – Physical therapy practices have unique need and an EMR should allow clinicians to create custom documents and templates.
Web-based – Select a web-based system that stores information in the cloud to eliminate the dangers of fires, floods, natural disasters and identify theft.
Workflow integration – Some therapists are attached to their existing systems and don’t want to give them up.

Choose an EMR that integrates any existing office software and offers the ability to remove old systems easily should they no longer be wanted or needed.

Portability – iPad compatibility is essential for portability throughout the office, at home and other venues where the clinic offers services.
Electronic billing – An EMR equipped with electronic billing reduces the turnaround time on reimbursement claims and allows for the quick submission of documentation and resolution of denials.
Communication – Interacting with clients can be automated to deliver appointment and billing reminders. Communications can be sent via email, phone, and text and voice messaging.
Patient portal – Clients can schedule an appointment, view test results, complete health histories and provide insurance information with a patient portal. Therapists can easily verify insurer information and contact patients if there’s a problem.
Prescriptions – The ability to submit medication orders to a wide variety of pharmacies saves time for therapists and patients.
Interconnectivity – Tests, x-rays and lab work from outside facilities can all be ordered from the office with an EMR. Therapists should ensure their EMR is compatible with other facilities in the area. Results can easily be returned to the office electronically and posted through a patient portal where clients can view them.

Importation capabilities – EMRs are designed to eliminate voluminous paper files, but the information contained within existing documents must find its way into the documentation software. It’s essential that the EMR offer the ability to import notes, documents and test results for a complete electronic solution.
Online training – Staff must be trained in the use of an EMR, but training provided by vendors often results in an overload for staff. Online training can be accessed multiple times and whenever it’s needed to reduce the learning curve and assist staff in retaining more information.
Customer service – Choose an EMR that provides automatic updates, 24/7 support, regular back-ups, and the ability to upgrade and add new modules as needed.

The idea of implementing an EMR can be a scary thought and has led many professionals to delay the process.

An electronic documentation system must be in place by 2014 and therapists need to initiate the search for a suitable EMR as soon as possible to ensure sufficient learning and shake down time before the deadline.

Physical Therapy Documentation: Productivity Benchmarks in Your Documentation System

by Nitin Chhoda PT, DPT | Aug 16, 2016 | Physical Therapy Billing, Physical Therapy Documentation, Physical Therapy Management

If your practice is still using pen and paper, the thought of electronic medical records can be daunting.

Nitin Chhoda explains how to boost productivity using a web-based documentation system to make life easy for the practice owner, the staff and the biller.

Productivity is a key element in all facets of a physical therapy practice, from obtaining vital patient information to receiving reimbursements.

For a struggling clinic, an increase in productivity can mean the difference between eliminating positions to hiring new staff that can help the practice grow.

Physical therapy documentation software provides automation of tasks for increased productivity for every member of a clinic’s team.

As new treatments become available and reimbursement regulations escalate, an EMR provides better and more elaborate coding and physical therapy documentation options to satisfy third-party payer provisions.

Physical Therapy Documentation

Every therapist has experienced the time consuming process of recording, rebilling and providing explanations to insurance companies, Medicare and Medicaid. EMRs offer multiple coding abilities for practices working with an extensive array of providers to ensure therapists are adequately paid and clients receive ongoing care.

Employee wages constitute one of the largest expenses for a physical therapy practice. Clinic owners can utilize their physical therapy documentation software to ascertain where the abilities of staff members can best be allocated. An EMR helps therapists ascertain if they’re overstaffed, identify time wasters, and where positions can be eliminated for greater overall productivity.

Patient Scheduling

A full patient schedule is one of the goals of a productive practice and a physical therapy documentation system provides essential information therapists can use to market their clinic successfully. Referrals can be monitored and marketing efforts tracked to ascertain methods that work best based on a variety of demographics.

An EMR provides improved patient management, eliminating duplication of testing, prescriptions and treatments. Lost charts and missing information is never a problem with physical therapy documentation software.

A secure patient record is created that can be accessed by numerous medical professionals and quickly updated as surgeries, procedures, prescriptions and treatments are implemented.

Patient care can begin immediately instead of waiting for essential records to be transported by the postal service.

The Advantage of a Physical Therapy Documentation Software

Those in the medical professions have notoriously bad handwriting that’s eliminated with an EMR. Personal notes can be added with no loss of legibility.

Therapists work with a wide variety of incidental documents that includes work and school excuses, referral letters and requests for records. Physical therapy documentation software allows therapists to produce and transmit those and a myriad of other documents with just a few clicks.

There’s no need to maintain copious amounts of physical therapy documentation paper-based records, space to house them, or engage staff in the time consuming task of finding them with an EMR.

‘Patient information is available at a moment’s notice anywhere an Internet connection is available, reducing the time needed to implement a course of treatment. EMRs speak for a patient in an emergency, preventing errors or inappropriate treatment.

Clients like the convenience of patient portals with physical therapy documentation software, but patient portals save significant time and effort for therapists. Insurance information can be validated prior to services and a complete health history can be submitted, allowing practice owners to familiarize themselves with the client’s data and formulate possible options.

The highest level of productivity is necessary for clinics to survive and thrive and EMRs provide practices with the tools to achieve that, along with tools to analyze trends and the productivity of their entire business operation.