by Nitin Chhoda PT, DPT | Jun 1, 2015 | Physical Therapy Billing, Physical Therapy Documentation, Physical Therapy Management
There are times when new practices are unable to enroll with major insurance companies. In this article, Nitin Chhoda provides some valuable tips on how to simplify the complicated process of enrollment and get your practice in-network with the payers you wish to work with.
Although physical therapy billing is complicated by the various billing requirements of insurance companies and government programs, some private practices are finding ways to simplify the process.
In fact, physical therapy billing is being redefined by physical therapy documentation software and EMRs.
The changes that are being make streamline the process, improve claims acceptance from insurance companies, and improve the patient experience.
Applications to Insurance Companies
For each insurance company that a physical therapy practice would like to bill, an application process must be completed and even certification may be required. Insurance companies have a lot of power in this regard and the process can be time consuming and costly.
These physical therapy billing applications cannot be taken lightly, and the terms of the final contract with each insurance company should be carefully reviewed.
The contract terms will determine just what you can bill for and what the limits are for each insurance company. Not only will this inform what the physical therapy billing staff does, but it should also be used to instruct physical therapists on how to work with patients to get the most benefit from the limits imposed by the insurance companies.
The Most Efficient Way to Enroll
There are now services that offer to apply on behalf of your practice for a fee. In many cases, this can be worthwhile, as the time and energy it takes to complete this kind of application takes physical therapy billing or management staff away from other duties.
Hiring a specialist to do this temporary work may be the most efficient way to enroll with a number of insurance companies as well as government programs like Medicare and Medicaid.
But this still involves a great deal of attention, at least from physical therapy billing and management. You may want to start by determining exactly which companies you want to enroll with.
Not every insurance company will be worth working with, especially if the limits are particularly low or they have a particularly high rate of rejection and denial of claims. Once you have drafted a list of potential companies and programs, you can work with an application company to get enrolled more quickly and efficiently.
Integrating Insurance Requirements into an EMR
A fully integrated and flexible physical therapy EMR can provide clinicians with the correct weighted procedures and treatment options so that when the information is transferred to the physical therapy billing staff, the billing process can be seamless and smooth.
A physical therapy billing and documentation software solution can help make enrollment smoother for physical therapy billing staff as well as for management. Once the terms are set, the specific can be entered into your EMR.
Without wasting time looking up the details of each insurance contract, the physical therapy billing staff can fill out the necessary claims and submit them more quickly and accurately than ever before. If the requirements are integrated into the EMR, everyone benefits including the practice as a whole.
by Nitin Chhoda PT, DPT | Apr 29, 2015 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation, Physical Therapy Management, Physical Therapy Marketing, Physical Therapy Software
Accounts receivable is one of the biggest problems for private practices. Across the nation, there’s millions of dollars that practices are still waiting to collect from insurance companies. The problem is twofold. Practices aren’t using integrated software that performs automatic functions and many billers are being forced to enter each bit of data manually. That leaves them less time to concentrate on collecting from payers.
To remain financially secure, clinicians must do everything they can to shorten the revenue cycle for each patient and get paid faster. That means streamlining the biller’s job with software that contains automation and one-touch functionalities, along with scrubbing and editing abilities. Next to the clinician, a biller is the most important person in a practice. They’re highly trained professionals that keep revenue flowing into the practice.
Accelerated Submissions
In Touch EMR™ and In Touch Biller PRO are the two most advanced software systems available. The integrated systems work together to provide billers with tools that facilitate the entire billing process from start to finish. Efficiency is extremely important in today’s economic climate and In Touch EMR™ allows practitioners to create a claim and submit it to the biller by the time the patient leaves the office.
The system contains essential time-saving features that notify billers of potential problems that could delay the claim, such as incompatible CPT codes. If an inconsistency exists, billers can edit the claim as needed. The claim is automatically optimized, batched and sent the same day. The biller doesn’t have to manually load and send.
Where’s The Claim?
A critical part of the biller’s job is to track, monitor and follow up on submitted claims. In Touch Biller PRO enables billers to track each claim at every stage of the process. The software tells billers exactly where the claim is and its status, an ability that’s missing in most systems, but one that allows billers to track and process claims seamlessly.
The system automatically posts ERAs to patient accounts without the need for billers to do the task manually. That one ability alone provides an enormous time savings that can add up to $1,200 or more per month and thousands each year.
Next t to the clinician, the biller is the most important person in a practice. Any opportunity to streamline his/her job with automation should be implemented. In Touch EMR™ and In Touch Biller PRO makes the biller’s job easier, shortens the revenue cycle and allows practitioners to get paid faster.
by Nitin Chhoda PT, DPT | May 28, 2014 | Medical Billing, Physical Therapy Billing
Quick and efficient billing is a necessity in today’s economic climate. Reduced reimbursements and changes brought about by Obamacare are forcing practices to work smarter and more efficiently to collect the revenues they’re due. The best way to accomplish that goal is through integrated software systems with automatic features.
In Touch Biller PRO has advanced features that allow billers to submit claims that are far less likely to incur a rejection and to submit those claims quicker. In Touch Biller PRO is a completely integrated scheduling, documentation, billing and marketing system available in a single product to shorten the revenue cycle.
Sophisticated Functions
With an integrated system, scheduling and documentation should work with the billing software with no need for a separate system. In Touch Biller PRO is designed to communicate with other systems for a seamless solution that carries data through to wherever it’s required. The biller is the most important person in a practice after the clinician and In Touch Biller PRO allows the biller to do his/her job more efficiently to keep funds flowing into the practice. Making the biller’s job easier means more revenue.
Automatic Data Entry & Tracking
In Touch Biller PRO eliminates manual entry of patient data that’s time consuming and robs billers of valuable time that can be better spent tracking and monitoring payments and claims. The software detects potential problems and inconsistencies and allows billers to edit claims before they’re submitted, a feature that’s lacking in other systems. Claims are scrubbed and optimized before they ever leave for the clearinghouse.
Customized Reports
The ability to generate sophisticated reports is an essential means of increasing income and determining the health of a practice. In Touch Biller PRO can produce customized reports whenever needed, based on a comprehensive array of criteria. Reports can be generated according to accounts receivable, ICD and CPT codes, payers, providers and referral sources.
To keep revenues high, practitioners require a system with seamless integration, the ability to edit claims, and generate sophisticated reports using multiple criteria. In Touch Biller PRO provides billers with essential tools to shorten the revenue cycle and offers clinicians multiple ways to diagnose the health of their practice.
by Nitin Chhoda PT, DPT | Mar 29, 2014 | Healthcare Practice Management, ICD 10, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation
The transition to ICD-10 codes comes with a revised CMS form to facilitate reporting. The National Uniform Claim Committee (NUCC) approved the use of the revised CMS- 1500 Claim Form in February 2012. The new CMS-1500 form will be printed with 02/12 in the lower right hand corner to indicate it’s the replacement for the 08/05 version.
The CMS-1500 must be used when billing Medicare and other federal payers for services. Clinicians must indicate when submitting claims on CMS-1500 if they’re using ICD-9 codes or if they’ve already made the transition to ICD-10. It’s essential that clinicians maintain communication with their payers and clearinghouses and conduct testing to ensure submissions are being transmitted and received correctly.
Medicare began accepting the revised version of claim form CMS-1500 on Jan. 6, 2014 and all submissions after March 31, 2014 must be done with the revised CMS-1500.
For those who have received a waiver for electronic transmission, Medicare will continue to accept paper claims, but only on the revised form. Medicare will deny any claim submitted on the old CMS form on and after April 1, 2014.
The new CMS-1500 was required to correctly report and document the thousands of new ICD-10 codes and the alpha-numeric system that will be used. Use of the new form is mandatory when billing any federal payer. Many of the line-by-line item changes were relatively small, such as changes in wording. For example, TRICARE CHAMPUS has been shortened to TRICARE and the Social Security number is now referred to as an ID number.
Other line items with which clinicians were familiar were eliminated entirely, since the information will now be reported elsewhere on the form or not at all. A number of lines now read “Reserved For NUCC Use” and data that includes employer’s name, school and balance due that wasn’t reported on 837P weren’t deemed necessary and aren’t required on CMS-1500.
An enhancement on the form allows clinicians to list up to 12 diagnosis codes per patient. CMS-1500 has a number of open fields, but they can’t be utilized to report additional data. Practitioners now have qualifiers to identify them as a referring, ordering or supervising provider and diagnosis codes that were labeled 1-4 now have an A-L designation.
The ICD-10 codes are more specific and the CMS-1500 reflects that. The new form has a QR Code that can be scanned with a smartphone. The QR Code takes users to the NUCC website. The revised CMS-1500 also underwent changes that would provide practitioners with the ability to add extra qualifiers when needed.
Any reimbursement claims filed prior to implementation of the revised CMS-1500 that must be resubmitted for any reason should be transmitted utilizing the revised form. This is true even if the previous claim was submitted on the earlier form.
A copy of the form can be downloaded for examination purposes, but it can’t be utilized to submit claims. CMS-1500 uses exact red ink match technology and much of the embedded information will remain invisible when it’s scanned with an Optical Character Recognition (OCR) device. Clinicians should be aware that payers can opt not to process claims that are submitted in black ink and doesn’t use the red ink match technology.
It will take some time for clinicians to familiarize themselves with the revised CMS-1500 form and the new ICD-10 codes, but the form is now an accomplished fact. The new codes and forms are a reality of the healthcare environment and clinicians must use them or risk not receiving reimbursements.
by Nitin Chhoda PT, DPT | Mar 21, 2014 | Electronic Medical Records, Healthcare Practice Management, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation
Patients are usually the last to pay their part of the bill for services they received. To encourage patients to pay their bill, practitioners must make it as easy as possible for them to do so. That means implementing a variety of online payment options. Practices that offer that service are more likely to collect from clients without the need for multiple billings and reminders.
Multiple Payment Methods
In Touch EMR™ allows patients to pay with multiple methods that include cash, check, money orders, and credit and debit cards. Older clients are less trusting of technology and are less likely to utilize payment methods that require them to divulge personal information online, or they may not have access to a computer. For those patients, checks and cash are typically the preferred method of payment.
The In Touch EMR™ is the most sophisticated system in the world, providing a convenient way to pay that’s available to clients 24/7. It’s safe, secure and boosts revenues. The company assists therapists in setting up a merchant account that enables payments to be deposited directly into the clinic’s account, usually in as little as seven days.
Recurring Payments
With the In Touch EMR™, patients also have the ability to make recurring payments. When faced with a large bill, many clients panic and don’t pay anything instead of making smaller but steady payments. In Touch EMR™ solves that problem. Client amounts are broken down into convenient and manageable payments that they can make over time. Clinicians can offer discounts for cash payments and balances paid within a specific amount of time to encourage remittance.
Convenience, security And Eco-Friendly
There’s no need to store sensitive data on-site with In Touch EMR™. The software maintains data in the cloud for added security. The software is HIPAA compliant and adheres to the protocols set forth by the Payment Card Industry Data Standard. The cost of collections is significantly reduced and billers can focus more on claim submissions.
The integrated software is an environmentally friendly method that virtually eliminates paper bills and statements. There may be times when a paper document is required and In Touch EMR™ provides the ability to print one when necessary. When an online payment is made, the data goes to the biller for posting.
Convenience for clients is an essential concept for clinicians that want to increase revenue collection. Online options utilize methods with which most patients are familiar. Practices with online payment options are perceived as more progressive and desirable. An added benefit of offering online payment options is that patients are more likely to recommend the practitioner to others, providing valuable word-of-mouth marketing.
by Nitin Chhoda PT, DPT | Mar 17, 2014 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation, Physical Therapy Software
Efficiency is the key for every facet of a practice’s workflow. EMR and billing software should be integrated, offer one-touch functionalities and complete many tasks automatically. Technology can make a practice infinitely more efficient and thereby more profitable. It makes the biller’s job easier, allowing income to be generated more quickly. From one-touch functionality to voice recognition documentation, In Touch EMR™ and In Touch Biller PRO software is specifically designed for efficiency and better profitability.
Bring In The Patient
In Touch EMR™ has the ability to schedule patients, communicate with them through multiple methods, and create automatic patient files. When the client arrives for their appointment, In Touch EMR™ has the built in ability to quickly validate patient insurance eligibility online with hundreds of payers, and more can be added as needed.
The In Touch EMR™ is the only EMR with an iPad app. Patients can take a photo of themselves for identification purposes, photograph their insurance card and complete patient data with the iPad. The Web-based system maintains information in the cloud for security and HIPAA compliance. When the required information is obtained, the front desk can hit a single button to automatically create a patient file. The client is now in the system and the file is available to the clinician.
Claiming Revenues
The integrated In Touch EMR™ works with In Touch Biller PRO to create a simple, yet efficient workflow. In Touch Biller PRO scrubs claims and allows for changes to be made when needed. It identifies potential problems and prompts billers for modifiers and other data to ensure each claim is clean for submission. The system enables billers to review all claims, no matter what their status
Reporting Statistics
Sophisticated reports can be generated with In Touch EMR™ to keep clinicians advised of the most profitable procedures and payers, where most referrals are originating, and the most productive staff members. Reports can be generated based on a comprehensive array of user defined parameters to monitor every facet of the practice.
Clinicians can utilize features that include the advanced flow sheet, voice recognition for documentation, automatic creation of patient files and automatic claim submission. The In Touch EMR™ is designed to create and enhance an efficient workflow that allows practices to become more profitable, while making it easier for clinicians to do their job.
In an era of dwindling reimbursements and increased regulatory requirements, clinicians must use every resource at their disposal to make their office efficient and profitable. In Touch EMR™ and In Touch Biller PRO work in tandem to accomplish those goals with technology designed for the way clinicians work.
