healthcare and insurance

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.

Healthcare Management and Medical Billing Relationship

by Nitin Chhoda PT, DPT | Jan 4, 2016 | Healthcare Practice Management, Physical Therapy Documentation, Physical Therapy Management

Medical billing and healthcare management are interconnected. The success of the practice relies on these two factors having a good relationship.

Nitin Chhoda explains the correlation between billing and management, and the role it plays in a successful healthcare practice so that the owner will value its importance and avoid recklessness.

Therapists walk a thin line when reconciling the healthcare management of their patients and medical billing.

The process of accurately coding and billing of healthcare practice management can sometimes be at odds with the client’s welfare and their insurance coverage.

Therapists are often dealing with a narrow description of a complicated problem and it’s essential to provide the exact billing codes that describe the diagnosis, symptoms and corrective measures that were taken.

Patients can differ widely in their responses to treatment, making it imperative that therapists provide in-depth documentation to support their actions and conclusions.

Accurate physical therapy billing ensures clients to receive the best possible care and the clinic to reimburse at the highest available level for the services provided.

Healthcare Management and Billing

Billing and healthcare management is a closely interwoven process and it’s the responsibility of clinicians to educate themselves on the intricacies of the two. The result is better billing and coding, expedited reimbursement claims, and staff members that aren’t overwhelmed.

Next to treating patients, billing is the most important position in a practice. A clinic’s profitability rides on the billing professional submitting claims in a timely manner, conducting follow-ups and ensuring payments are received.

Physical therapy billing is complicated and time consuming, and smaller practices often have a designated biller that has a variety of additional tasks.

The day-to-day workflow doesn’t remain the same and it’s easy for billers to get behind without the appropriate healthcare management support and sufficient time to perform their responsibilities.

An EMR facilitates the process, allowing billers to submit claims quickly, efficiently, and with a lower denial rate.

Billing With EMR

EMRs provide clinic owners with the tools to track reimbursement claims, monitor denials, and identify potential and existing problems. On average, claims are denied approximately 50 percent of the time.

This is due to a variety of factors, from incorrect coding to improperly submitted claims. The burgeoning number of healthcare claims and limitations on services has been the impetus for insurers to scrutinize reimbursements more closely than ever.

Therapists with an EMR for healthcare management can utilize its many capabilities to identify denial rates, ascertain why claims was rejected and discover any patterns that might exist.

Problems may lie with incorrect coding, inefficient healthcare management or time restrictions placed on the biller. Once the cause has been determined, clinicians can work toward a solution that better utilizes the biller’s time.

Revenue Loss Factors

Another factor in revenue loss is the number of old and unpaid accounts the practice is carrying. One of a biller’s priorities is to track payments and ensure they’re deposited in the clinic’s account. Billers must review accounts on a regular basis to ensure payments have been made and make inquiries into their status if needed. Billing and healthcare management requires an individual who is detail oriented, with an agile mind and specialized knowledge.

The financial health of a physical therapy practice hinges on the efforts of its coding and billing expert. A large part of effective healthcare management is ensuring the biller has the time and support needed to maintain a steady cash to the clinic.

Ensuring the individual has superior training and sufficient time to perform the necessary and sometimes redundant tasks of billing will boost the clinic’s revenues and allow clinicians to pursue additional streams of revenue.

How to Solve the Problem of Patient Payments

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.

Outline of a Simple, Efficient Workflow

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.

What to Expect From Your Biller

by Nitin Chhoda PT, DPT | Mar 5, 2014 | Healthcare Practice Management, Medical Billing, Physical Therapy Billing, Physical Therapy Software

The biller is the most important person in the practice other than the clinician. It’s time that clinicians stopped accepting inefficiencies in their billing department by automating many of the biller’s tasks. The right software can help billers work better and faster, submit claims that are less likely to be denied, and increase the overall efficiency of the billing department.

Stop Manual Input

There’s no need for billers to manually enter every scrap if information. In Touch EMR™ and In Touch Biller PRO are both integrated software systems that feature one-touch functionalities to input information and even send batch claims. That ability increases the biller’s efficiency, allowing them to spend more time following up on claims.

One-Touch Posting

A lot of information comes through the billing department, from claims and communications from payers to ERAs. In Touch EMR™ provides billers with one-touch posting of ERAs to patient accounts. A wide variety of information can be securely sent to patient files with a simple click of a button. Manual posting is one of the most time consuming tasks for billers and the software makes their job quicker, while assisting in quicker returns on claims.

Reporting Techniques

Billers should be able to provide clinicians with sophisticated reports about any facet of the practice. In Touch EMR™ and In Touch Biller PRO both provide billers with the ability to generate reports by payer, provider and patient, along with location, ICD and CPT code, and by referral sources. Reports can be created by accounts receivable, payments made and by clinic.

In Touch EMR™ provides a depth of diagnosis that most EMR systems can’t. The software includes diagnosis pointers that allow users to produce reports that correlate CPT and related ICD codes. Reporting is available that demonstrates income by ICD code, allowing clinicians to determine which types of procedures pay the most, and which insurance companies offer the best reimbursement rates.

When billers are more efficient, so is the practice. Clinicians deserve all the help and advantages they can get and software makes the job easier for them and their billers. With In Touch EMR™ and In Touch Biller PRO, billers can spend more time following through on claims and getting clinicians the money to which they’re entitled.

Cost Savings with Your EMR and Billing Software

by Nitin Chhoda PT, DPT | Mar 1, 2014 | Electronic Medical Records, Healthcare Practice Management, Medical Billing, Physical Therapy Billing, Physical Therapy Software

Imagine an EMR system that verifies patient eligibility, documents and provides prompts for billers to get the most out of each patient visit. That system is now available in the In Touch EMR™. In a two-physician practice that sees 100 patients per week, In Touch EMR™ can add up to more than $50,000 in savings each year.

Front Desk Savings

With In Touch EMR™, the front desk can check insurance eligibility online in seconds. The front desk can create a patient chart automatically and another click of a button schedules an appointment that automatically appears in the EMR program.

There’s no need to call insurance companies or enter information manually, for savings of at least 10 minutes per patient. If front desk staff is making $15 per hour, that’s a savings of $300-$400 per week for a two-physician practice.

Documentation Savings

In Touch EMR™ already has the patient information in the system, ready for the clinician when the client arrives for their appointment, allowing physicians to immediately begin an assessment. In Touch EMR™ has voice recognition capabilities for documentation that will save five minutes per patient. That adds up to 16-18 hours per week for a minimum savings of $300 per week.

The In Touch EMR™ allows clinicians to make custom templates that conform to the way they work, not the other way around. In Touch EMR™ is also the only EMR system with iPad compatibility that enables patients to complete much of the intake work themselves that provides further savings.

Billing Savings

When the patient visit is completed, a single button click sends the claim directly to billing. The information doesn’t have to be re-entered and billers can review, edit, add modifiers and provide secondary documentation if needed. In Touch EMR™ has an automated scrubber, provides billers with prompts for a variety of information, and notifies them of potential problems.

A single click of a button automatically creates the claim and submits it at the end of the day. No manual batching of claims is needed. ERAs are automatically sent to the patient’s record with one-click functionality and statements generated.

In Touch EMR™ prompts for notes and when certifications are about to expire. All this saves 10 minutes per patient for savings of up to $300 per week.

In Touch EMR™ is a merger between theory and practice. Clinicians know they need every minute they can get and the software is quick, easy and compliant. The In Touch EMR™ is like having another full-time employee and results aren’t linear, they’re exponential.

The savings that can be attained in a two-physician office seeing 100 patients per week amounts to $52,000 a year. That’s a significant addition to the bottom line of any practice.