Physical Therapy Billing

Physical Therapy Billing: On-Site Patient Credit Card Processing

by Nitin Chhoda PT, DPT | Aug 8, 2016 | Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

The ability to accept credit or debit cards as a form of payment for physical therapy services rendered can boost practice revenue.

Presenting patients with simple, convenient ways to make payments and recurring payments if necessary is a way for a practice to minimize accounts receivables and increase cashflow, according to Nitin Chhoda

Credit and debit cards represent one of the most convenient and easy way for patients to pay their bills, while providing practices with a point-of-purchase solution to collect funds before the client exits the clinic.

Physical therapy billing allows patients to make one time and recurring payments at the office and online to boost revenues. Patients are much more likely to relinquish co-pays and fund their healthcare costs if all they must do is provide their credit or debit card information.

Ease of Access

Convenience is the keyword for the 21st century clinic. Today’s population is busy and mobile, with little time left after meeting, work, and family obligations. Few clients carry cash with them nowadays, but virtually everyone has a credit, debit or pre-paid card.

It’s a trend that therapists can utilize to their physical therapy billing advantage. For those who want to move into the electronic age of physical therapy billing,coding and collections, an EMR is the first step. Financial institutions have offered online payment options as a courtesy for their members for years.

EMRs provide the same service through patient portals where clients can make a one-time or recurring payment without the need to enter extensive billing information.

Payments Made Simple With the Help of EMR

EMRs allow patients to make physical therapy billing payments from home or from their mobile devices, and funds can be transferred into the clinic’s account in as little as 48 hours. Practice owners can offer a variety of incentives to patients who pay with their cards, from special discounts to membership programs.

Many credit card issuers offer their own incentives, and when combined with offers from a practice, it provides additional motivation to pay early and often. A physical therapy practice is a business and clinic owners must look at every available avenue to collect for their services.

Therapists can immediately determine if funds from physical therapy billing are available so as to initiate a transfer if payments are made at the office.

An EMR with a patient portal allows individuals to pay their bills and manage their financial obligations to the practice more effectively.

The ability to accept credit and debit cards can increase revenue by as much as 23 percent. Instead of waiting up to 90 days for a check to clear, funds can be deposited directly into the clinic’s account for better cash flow. Credit card processing becomes an automatic physical therapy billing process for savings in time and effort.

The Convenience of Using Credit Card

Accepting credit cards via an EMR is an environmentally desirable solution that saves natural resources and cuts costs for practices. The ability to accept credit cards provides a speedy, flexible and convenient means of delivering a superior level of customer service.

Clinics also gain credibility from established and potential patients. Therapists utilizing physical therapy billing software contained within an EMR are perceived as the most modern and desired therapists. An EMR with physical therapy billing capabilities provides convenience for patients and increased cash flow for clinics.

Credit and debit card processing for one time and recurring payments enables practices to collect quickly for their physical therapy billing services and are perceived better by patients, leading to clients who enthusiastically recommend the practice to family, friends and co-workers. Combined with real time, automatic claim submissions, therapists can significantly boost their cash flow, even in a vexing economic climate.

Physical Therapy Billing: Real Time, Automatic Claim Submission to Boost Cash Flow Reiterated

by Nitin Chhoda PT, DPT | Aug 1, 2016 | Medical Billing, Physical Therapy Billing, Physical Therapy Documentation, Physical Therapy Management

Paper-based physical therapy billing not only consumes a lot of time but is also prone to claim submission errors that will affect the practice’s revenue.

Nitin Chhoda shares how an integrated physical therapy EMR can produced automated claim submissions and boost cash flow for your business.

A steady cash flow is a primary concern for any physical therapy practice and it’s one of the most difficult aspects for clinic owners to predict.

Coding errors, claim denials and time spent exchanging correspondence via the postal service reduce the turnaround time on physical therapy billing reimbursements and can quickly place a clinic in the red.

Billing with EMR

The future for physical therapy practices of all sizes is good physical therapy billing through the utilization of an EMR.

They offer superior coding options to reduce denials and errors, while providing paperless electronic claim submissions that reach their destination almost instantly.

Submissions can be transmitted individually as clients are seen or set for a batch submission at the end of the day.

One of the biggest problems facing practices is the need for proper coding and documentation in the claims process to ensure clinics receive the reimbursements to which they’re entitled. Information management is a hallmark of automatic claim submissions, providing crucial physical therapy billing and documentation to facilitate and accelerate the reimbursement process.

Paper Submissions are Reduced

Electronic submissions reduce the need for paper physical therapy billing and invoicing for significant savings and can reduce associated costs by up to 15 percent over traditional methods. Electronic submissions are environmentally friendly, highly efficient and enable therapists to collect for their services in hours instead of weeks.

Funds are automatically deposited in the practice’s account. Coding errors are the bane of a physical therapy clinic and electronic claim submissions offers a wide variety of options to accommodate physical therapy billing by the session, services rendered or treatment setting.

Electronic claim submissions via EMRs are secure and HIPAA-compliant. Claims can be sent virtually to any agency or payer with which therapists work, from private insurance, Workers’ Compensation and TRICARE for veterans to Medicare, Medicaid and clearinghouses.

Software for Physical Therapy Billing

Physical therapy billing software can virtually eliminate coding errors and drastically reduces the number of denials, post-payment audits and requests for clarification.

When an instance does occur, disputes can be handled quickly and efficiently through electronic methods.

EMR documentation software provides a clear record of the patient’s visit so therapists don’t inadvertently submit claims that contradict coding and billing rules or lack specific billing codes.

Electronic claim submission capabilities allow clinic owners to file for reimbursement from any location with Internet access. The system enables payers to deliver crucial correspondence and responses through the same claim submission system.

Automated Physical Therapy Billing

An automatic physical therapy billing record is created of what was filed and when, along with the current status of the claim. Ceilings on payments and reduced benefits for employee insurance programs are costing practices dearly.

Physical therapy billing software enables clinic staff to verify a patient’s insurance eligibility and range of coverage before they arrive at the office. Therapists can utilize that information to develop a treatment plan that falls within the constraints of the client’s available coverage.

Automatic claim submissions provide enhanced coding options to boost reimbursement levels. Submissions can be set to send individually, or as a batch at the end of the day for added convenience.

Physical therapy billing allows therapists to receive payments in hours or a matter of days instead of weeks for better overall cash flow. Superior speed and documentation significantly reduces errors, denials and audits, while placing more cash in clinic coffers where it can do the most good for the practice and patients.

Medical Coding and Its Trends

by Nitin Chhoda PT, DPT | Jul 25, 2016 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

Medical coding can be done by a skilled professional or by a trained physical therapy billing staff. It is important that who ever is assigned this task is knowledgeable and detail oriented because it affects the billing and revenue cycle for the practice.

Nitin Chhoda shares the latest trends in medical coding and the role of ICD-10 codes to the medical practices.

Incorrect medical coding costs small practices thousands in revenues each year. Medical coding can be a tricky process and requires the expertise of a trained professional, even with an EMR.

Physical therapy billing software will significantly reduce the number of errors and denials, but with upcoming changes in billing codes, clinic owners may want to consider hiring a certified medical coder.

Medical Coding and Billing

Medical coding is a complex and demanding environment requiring someone with special knowledge and expertise, and who is detail oriented. Some practices combine their billing and coding departments under the guidance of a single person.

A good physical therapy documentation system will include billing and coding functionalities that makes a coder’s job easier, but then clinicians must decide if they’re going to hire a certified medical coder or train one themselves.

Even with a top of the line EMR, nothing can replace the expertise that comes with an experienced and certified medical coder. They undergo extensive education and training, build upon their expertise with on-going re-certification courses, and are fully able to navigate changes and updates in the coding system as they occur.

They command more money for their medical coding services, but trying to train a new coder is time consuming and can cost the practice thousands of dollars while they learn.

The Coding Process

The introduction of EMRs adds another level of difficulty to the billing and medical coding process.

An EMR greatly facilitates the job of a professional coder, allowing them to maintain a constant rate of concurrent billing and coding procedures, reducing the ebb and flow of payments that can severely interrupt a practice’s financial health.

A factor that will radically affect the billing and medical coding process is the switch from ICD-9 to ICD-10 codes in October 2013 that will introduce 100,000 new codes into the existing system of 13,600.

medical coding trends Correct coding is difficult enough – the on-going educational requirements for professional coders will make it easy for them to handle the many changes and updates.

The medical coding changes will affect every medical provider in the country and represents the first comprehensive update since 1977.

The coding changes take into account new diseases that have been discovered, a better understanding of old ailments, new medications and vaccines, and the effectiveness of those medications in treatment.

With mutating viruses and diseases that can be communicated among species, the coding change is long overdue. Global travel and journeys to under-developed countries sets the perfect stage for pandemics.

Switching to ICD-10 Codes

The switch to ICD-10 codes will help all practices provide medical coding that more accurately reflect treatments and procedures. The result is better patient care, quicker reimbursements and fewer denials.

The future is bright for professional medical coders. Their extensive medical coding training is a distinct advantage for practice owners who benefit from their expertise. Better medical coding means better and faster reimbursements, fewer denials, mistakes and errors, and issues can be dealt with quickly and efficiently. EMRs will help medical coders accomplish those goals in an expeditious manner.

EMRs will soon be a fact for every physical therapy practice. Clinic owners who implement an EMR system with correct medical coding will be ahead of the game when the coding changes take effect. Professional coders will play a major role in ensuring that clinicians are compensated for their time and services.

Medical Billing Mistakes to Avoid

by Nitin Chhoda PT, DPT | Jul 18, 2016 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

In this article, Nitin Chhoda reveals the common mistakes in medical billing and coding that can quickly impact the cash flow of a private practice.

Some of the mistakes such as illegible handwriting, use of language and incorrect details can be avoided by using an automated physical therapy documentation system.

Medical billing and coding errors, mistakes, oversights and insufficient coding represent the most costly problems that physical therapy practices face, resulting in the loss of thousands of dollars in revenue each year.

The busier the clinic, the more likely it is that the problem will occur. An EMR will help eliminate denials and late payments, but practice owners must make medical billing and coding a priority.

Insurance providers are scrutinizing reimbursement claims more closely than ever before, making it imperative that the person responsible for billing and coding be trained and knowledgeable in the specialized language of the profession and familiar with EMR practices.

Sometimes it’s the simplest codes that create denials and a professional medical billing coder can make a tremendous difference in the revenues collected.

Details

The little things in medical billing and coding can wreak real havoc on revenues and result in denials. Identifying a male client as female, dates that don’t match, using outdated codes and not coding for a multiple diagnosis are just some of the ways therapists slow down their cash flow and generate denials. Illegible handwriting is always a problem and if the writing can’t be read, it can be deemed unbillable. Utilizing an EMR will eliminate such problems.

Language

Coders rely on therapists for the information needed to correctly code claims. The language and terms taught and learned in school aren’t necessarily those used in a real world practice.

It’s important for the therapist to include notes to ensure coders have enough information to bill at the highest acceptable level. Therapists should also impress upon medical billing coders the need to look at the explanation of procedures.

Services

Physical therapists offer a wide range of services and products, but in a busy practice, some may go unnoticed when it’s time for billing. Failure to bill for ancillary services such as, medications and supplies dispensed in the office, along with x-rays and lab work that was performed, are just some of the ways that therapists rob themselves of essential income. Clinicians need to make a conscious effort to ensure that each service, appliance and aid is documented for medical billing purposes.

Documentation

If the service, treatment or procedure isn’t documented, it can’t be billed. Coders can only work with the information provided, even with a technologically advanced EMR. Relying on the coder to “know” that a specific service was provided is pure folly. Document everything in detail and be clear about the type of service offered, including referrals and consultations. It may take a few extra seconds, but the extra time will pay off in greater revenues even in your medical billing.

Up- and down-coding

Medical billing for services at a higher level than documentation supports is embarrassing in the extreme. Many clinicians choose to down-code, hoping to avoid the specter of an audit, and only succeed in cheating themselves of valuable reimbursements.

Insurance Providers

Insurance providers aren’t infallible and it’s up to the practice owner to carefully oversee the explanation of benefits to catch medical billing mistakes when they occur. There’s a tendency to think once the reimbursement claim has been submitted, that’s the end of the process.

In truth, it’s simply the beginning. Insurance companies can lose or misplace claims, or never receive them at all. Therapists who don’t conduct regular audits on the state of their claims stand to lose significant amounts of money.

In the new economy, it’s essential that physical therapists code correctly to ensure they’re reimbursed for their time, services and supplies. Every precaution must be taken to provide clear and concise documentation. The implementation of a correct medical billing EMR will greatly reduce the number of errors, mistakes and denials for the financial health of any clinic.

Medical Billing and Coding – In-House or Outsourced?

by Nitin Chhoda PT, DPT | Feb 15, 2016 | Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

In-house or outsourced medical billing and coding have their own advantages and disadvantages depending on the size and the needs of the physical therapy practice.

Nitin Chhoda elaborates the differences between these two methods, and how to maximize the billing and coding process for your business.

Medical billing and coding are one of the most important tasks for practice owners to consider.

However, many are unsure whether to maintain a billing and coding department on-site or outsource the entire operation to a specialty firm.

In-House or Outsourced?

Both methods have their own set of advantages, but many therapists are finding they have the same set of tools available in their EMR as those offered by medical and billing companies.

Therapists have always had the option of outsourcing their medical billing and coding tasks, but it’s a major expense that may not be necessary with the implementation of an EMR. Physical therapy documentation software allows clinicians to submit bills electronically themselves, but they may still want to consider hiring a professional coder to work with the EMR.

Outsourcing Options and Benefits

Outsourcing medical billing and coding needs provide practices with a one-stop solution that takes the reimbursement process out of the office and places it in the hands of companies that employ trained coders who handle all the submissions and details. Such firms can verify insurance information and authorizations, reconcile accounts, and provide code checking and analysis services.

The same firms can conduct audits to help clinics operate more efficiently and provide training for staff on medical billing and coding-related issues.

They eliminate the need for purchasing and establishing hardware and software infrastructure.

Outsourcing also negates the need to hire a professional coder and the associated expenses of a salary, insurance and benefits.

Coding and billing firms are HIPAA compliant and feature a rapid turnaround time for reimbursements.

They reduce the work associated with billing, providing therapists with more time to see clients. For some clinics, it’s an ideal situation. For smaller practices, it may be an added expense that the clinician simply can’t afford.

In-House EMR Advantages

Therapists using an EMR can send reimbursement claims individually or via batch filing. Therapists must implement an EMR by 2014 and EMRs contain their own medical billing and coding abilities.

It just makes sense to utilize the technology to handle a task that affects the financial stability and security of a practice. Since therapists must implement an EMR anyway, there’s no good financial reason to spend additional funds contracting with an outside firm.

An EMR provides therapists with all the services offered by a medical billing and coding firm, along with updated ICD-10 coding changes. Electronic submissions allow therapists to collect their fees quicker and they can be automatically deposited in the clinic’s account. EMRs are HIPAA compliant for security and safety, and enables users to conduct audits on the state of the practice.

EMRs offer the ability to verify client insurance information and eligibility, collect one-time and recurring payments from patients, and send balance reminders to clients in the form of email, text and voice messages.Clinicians can conduct medical billing and coding tasks themselves, or hire a certified professional versed in the intricacies of the EMR, new codes and EMR documentation systems.

Balance Cost and Convenience

In the final examination, all therapists must balance cost and convenience. Outsourcing to a medical billing and coding firm eliminates the need for an on-site coder and facilitates a quick turnaround on reimbursements, but the cost may be prohibitive.

EMRs are designed with the ability to manage patient accounts, submit claims electronically, and collect from patients online. Therapists must implement an EMR by 2014 and many are discovering that they don’t need to outsource medical billing and coding when they can accomplish the same tasks with their EMR.

CPT Codes Defined

by Nitin Chhoda PT, DPT | Feb 8, 2016 | Electronic Medical Records, Physical Therapy Billing

Along with ICD-10 is another term called CPT codes. Nitin Chhoda defines and differentiates these two terms, and explains the impact they will have on the whole physical therapy documentation process.

Practitioners must become familiar with the codes in order to minimize errors upon claim submissions.

While owners of physical therapy practices are contending with the switch to ICD-10 coding, another term with which clinicians must be familiar with is current procedural terminology (CPT) codes.

CPT Codes

Every procedure, task, service, device and surgery a patient receives is associated with a specific numerical code. Insurance companies utilize CPT codes to determine the amount healthcare providers will be paid and CPT codes must be linked by medical necessity.

The American Medical Association (AMA) develops and copyrights CPT codes. They’re responsible for changing, revising, updating and discarding those that become obsolete as new technology and treatments become available. They encompass thousands of individual codes that are updated annually.

CPT codes, even when used in physical therapy documentation purposes, are uniform and apply to all clients except those with Medicare coverage. Medicare utilizes the Healthcare Common Procedure Coding System (HCPCS) that encompasses three levels of coding.

HCPS Levels

HCPCS Level I is maintained by the AMA and Level II consists of alphanumeric codes. Level III codes were abolished in 2003 and were state-developed for Medicaid and Medicare contractors. Therapists should be aware that the reimbursement amount for each code varies widely among insurers and assigning the correct code to the appropriate treatment is a complex endeavor.

An EMR facilitates the process, but clinic owners will want to ensure their coding and billing expert has the best possible training to manage CPT codes and the upcoming ICD-10 changes, along with a thorough knowledge and understanding of medical terminology. Entering the wrong codes will result in denials and delays in reimbursements.

It’s imperative that physical therapists use the code that most accurately reflects the service or treatment that was provided. It should match the current ICD coding and therapists must provide sufficient documentation to support the CPT code that was entered to avoid denials, audits and requests for more information.

CPT Codes Standard

CPT codes allow for two-digit modifiers should they be required, but they must conform to standard definitions. Incorrect coding costs valuable clinical time, interrupts cash flow and can delay essential services to clients.

CPT codes provide the means for healthcare providers to communicate effectively with insurance companies about the services, treatments and procedures rendered to any given patient.

Using correct coding is essential if clinicians are to be adequately reimbursed for their expertise and ensures payments reach the clinic in a timely manner.

There is no uniform payment for specific procedures. Each insurance provider has its own fee schedule and reimburses according to the company’s guidelines. Proper coding ensures therapists are reimbursed at the highest possible level.

An EMR provides clinic owners with tools to monitor and track agencies that provide the best reimbursements, allowing them to make informed decisions about the best payers with which to contract.

The use of CPT codes in conjunction with ICD codes directly affects the profitability of practices. It’s a complex system that requires knowledgeable staff, careful attention to detail, and stringent documentation to support every diagnosis, treatment and procedure. An EMR makes the coding and billing process easier, and provides practice owners with the tools to track the best payers for increased revenues.