Physical Therapy Billing: How Real Time, Automatic Claim Submission Can Boost Cash Flow in Your Practice

Physical Therapy Billing: How Real Time, Automatic Claim Submission Can Boost Cash Flow in Your Practice

There was a time when claim submission was an ardous, manual process. With the emergence of electronic claim submission, a claim can be submitted in seconds.

Nitin Chhoda describes the technology of real-time, automatic claim submissions and why it’s here to stay. More importantly, Nitin advises you how to find an EMR that integrates this critical feature to help you streamline and automate your practice.

physical therapy billingIdeally, every claim sent to an insurance company would be submitted as soon as the practice knew it was time to send a claim.

In reality, claims are delayed by many factors, including problems with clinician notes or weighted procedures, insufficient patient information, and mediocre time management and physical therapy billing.

With a physical therapy EMR, claims for regular patients to consistent insurance companies can be generated in real time. They also take much less time to prepare and send, something that will help improve overall efficiency of physical therapy billing.

Cash Flow Stumbling Blocks

Insurance claims are one of the biggest stumbling blocks for generating consistent cash flow at a physical therapy practice. Health care providers are at the mercy of insurance companies when it comes to getting paid, and insurance companies certainly don’t try to make it easier.

But if you can identify where your problems with physical therapy billing cash flow are, you can start to work on solutions to solve those problems.

The goal of a physical therapy billing solution using an EMR is to make the majority of claims automatic and instantly submitted. The majority of visits from patients are recurring. The initial visit involves some extra steps for collection of patient history and insurance information.

However, after that first visit, the physical therapy billing plan should be somewhat predictable. And yet, without an EMR, each time a claim must be filed for each patient, the biller must fill out new paperwork and submit the claim as if it was the first time.

physical therapy billing cashflowReal Time Claim Submission

With an integrated EMR, the possibilities for efficiency improvement in physical therapy billing are quite stunning.

To even imagine that insurance claims could be submitted in real time seems like a bit of a fantasy. But for the majority of claims, this kind of streamlined process is quickly becoming a reality.

The trick to submitting claims automatically is preparation and planning. With a detailed treatment plan for each patient, it should be possible for physical therapy billing professionals to know what they will bill after each visit for each patient.

The clinician must follow the treatment plan closely and record each visit according to the agreed-upon plan. The biller can then review an automatically generated claim based on the treatment plan and submit claims in real time.

Big Changes Take Big Work

The hardest part of implementing a physical therapy billing change to workflow like the one described above is getting everyone to do things differently.

We get into routines and then we stay in them – humans are very good at that. But we are also very good at adjusting when something outside of our control changes.

To bring about serious cash flow improvements will take some serious changes. Implementation of an EMR will help to shift the thinking of all staff so they can work from a new perspective. Physical therapy billing staff can begin to benefit from these changes immediately, and the practice as a whole will see greater cash flow efficiency.

Physical Therapy Billing Structure – The Foundation of Practice Performance

Physical Therapy Billing Structure – The Foundation of Practice Performance

To grow your practice, you need people, and systems. When it comes to physical therapy billing and medical billing, structure is critical.

In this article, Nitin Chhoda.reveals how an EMR can create structure for your billing systems, and the importance of using an EMR that is completely integrated with billing and payment collections.

physical therapy billing structureStructure is essential for a successful physical therapy billing department. With any financial job, the secret is in creating recurring practices that lead to consistency and success.

The truth is that anyone who works in physical therapy billing is going to have to repeat the same tasks over and over again, with slight differences every time.

Make Physical Therapy Billing A Success

To make sure that each time physical therapy billing happens it is successful, a system of communication, review, and follow-up should be put into place.

For some physical therapy billers, the system will already be in place even without help and cooperation from the rest of the staff. But getting staff members, especially therapists, on board will make the system more efficient and more successful.

Using an EMR to Create Structure

A complete and integrated EMR can help put into place certain structures and workflow standards that might be difficult at first. But getting some structure into the physical therapy billing process is essential, and without an EMR it could be much harder.

The structure that holds up the practice is successful billing and consistent cash flow – that structure relies on a system for physical therapy billing and documentation that is consistent alongside good contracts with payers.

If the problem you are trying to solve is a high denial rate from insurance companies, the first step will be to analyze the most common reasons for denial. Is your physical therapy billing high in errors?

Errors to Avoid Denials 

Human error is one of the most common and the most avoidable reasons that insurance claims are denied. An incorrect code, inaccurate diagnosis, or errors related to an insufficient understanding of the terms of the contract between the insurance company and your practice can cause a lot of wasted time and energy. And time and energy in this business are the same as money.

physical therapy billing foundationThe structure of your physical therapy billing practice should take into account the full process of caring for and billing for a patient.

Starting with the intake process and diagnosis, every aspect of the process should be recordable in a standardized way and using a system that all relevant staff members can access and understand.

The reason that so many physical therapy practices turn to physical therapy billing and documentation software is that with an integrated EMR, everything your practice already does will be integrated into a structured database.

Integrate EMR With Physical Therapy Billing

When the clinician first sees a patient, they will use a standard set of terms and notes to communicate with the billing staff.

The treatment plan can be instantly translated into a billing plan, so that after each appointment, the physical therapy billing staff can simply review the therapist’s notes about the visit and ensure that the weighted procedures that were agreed upon were actually accomplished during the session.

Considerable amounts of time can be cut from the physical therapy billing process when everyone in the practice is on the same page, using the same standard terminology and technology. Physical therapy EMRs are designed to give the structure and framework – literally putting everyone on the same page.eighted procedures that were agreed upon were actually accomplished during the session.

Physical Therapy Billing: How to Reduce (and Contest) Payment Denials

Physical Therapy Billing: How to Reduce (and Contest) Payment Denials

Since payments from insurance companies provide vital cashflow, it’s essential to have a system in place to minimize denials. Once a denial does happen, a system must be in place to contest those denials.

Nitin Chhoda explains how to minimize denials and also contest them successfully. This is one of the most essential elements of a successful, cash-rich practice.

physical therapy billing codesOne thing is certain, no matter how hard you work to perfect your physical therapy billing practices, you will still be faced with denials and rejections from insurance companies.

Every physical therapy private practice experiences a high rate of denials and rejections and unless the entire system changes dramatically, this is going to continue to be part of the deal.

Find the Solutions

Rather than getting frustrated with denials, it’s time to think about minimizing them and finding ways to contest them successfully. When we think about problems and attempt to find solutions, the place to start is in the practice.

Minimizing denials is the job of physical therapy billing professionals, and in many cases they simply need the structure and the space to do just that.

Reporting for Physical Therapy Billing Improvements 

The best way to avoid making mistakes is to start with the mistakes that have been made in the past. The reporting capabilities of physical therapy documentation software can make the process of physical therapy billing much more accountable.

Rejected or denied claims can be tracked with reasons and time stamps, and by using reporting functions physical therapy management can determine just what goes wrong and how much time it is costing the practice in re-submittal of claims.

The back to basics approach of reinventing physical therapy billing is critical to finding solutions. Any system that has grown and changed as much as health care billing and insurance payments, is going to have inefficiencies built right into the process.

To get rid of those inefficiencies, the whole system may need to be torn down and re-built.

Start at the Beginning to Avoid Mistakes

A physical therapy EMR is going to allow for reporting and documentation that has previously been nearly impossible to extract and use. This is great news for physical therapy management.

billing for physical therapy services

But for physical therapy billing staff, it’s going to be a tough adjustment. Rather than focusing on the mistakes of individual billers, changing over to an EMR can help turn the process of re-education into a whole-office re-education.

Training the physical therapists to document their patient visits a little differently will be made easier if the entire staff is learning to document differently and use the information differently.

The burden of making adjustments of physical therapy billing to reduce the chances of claim denials and rejections will be shifted to the whole staff, rather than focused on billers who only have control over one portion of the process.

Responsibility is Key

At the same time, physical therapy billing staff are responsible for a certain portion of mistakes, and finding and eliminating those kinds of mistakes is going to be a big part of reducing denials. If you find that insurance companies are blanket denying claims, and it’s not the fault of billers, you can address the problem differently.

It may turn out that billing staff are actually spending time contesting denials because an insurance company is not worth working with. But you’ll never know that unless you have a system for recording the processes of physical therapy billing, documentation, and claims denials.

Physical Therapy Billing: Revenue Cycle Management and Profitability

Physical Therapy Billing: Revenue Cycle Management and Profitability

Receiving payment from insurance companies and payers does not always translate into a profit for a practice owner. In order to generate income, a revenue cycle management system (software) managed by billing professionals (in-house or outsourced) should be in place.

Nitin Chhoda explains what to look for in a revenue cycle management and how to increase profitability in your practice.

physical therapy billing codingThe revenue cycle is the process of bringing in revenue, starting from the sale and ending with revenue recognition, or the receipt of payment.

In a simple café setting, the revenue cycle starts when the guests order their food and drinks and is completed when they pay their bill.

Revenue Cycle in Physical Therapy

In physical therapy billing and management, the process is much more complex and can be drawn out over much longer periods of time. Any time your practice is waiting for money, you are losing money.

Revenue cycle management is the process of looking closely at your revenue cycle and determining where there are problems. The most obvious kind of problem is errors in physical therapy billing, but there can be much more subtle problems which pose similar threats to the revenue cycle.

Problems with contracts, recurring billing issues, and regulatory compliance problems can also pose a threat to the practice’s ability to collect the revenue that is due.

Evaluating Issues Within the Revenue Cycle 

The first place to start if you want to improve the efficiency of the revenue cycle is with time management.

Many of the tasks that physical therapy billing staff completes are quick and simple. A few clicks here, check the numbers there, print and send.

But it is precisely these kinds of tasks that can take up more time than is necessary if an employee is not managing their time well. Here are a few questions that will start the process of improving both time management and efficiency within the revenue cycle:

  • How much time does it take to fix mistakes?
  • What percentage of revenue is not reported just in case?
  • How much time does it take to compute physical therapy billing revenue?
  • Are staff members forced to do a lot of duplicate entry?
  • How confident are you that you can find mistakes?
  • Are you taking risks by reporting inaccurate revenue?
  • How realistic are your recognized revenue numbers each month?

physical therapy billing softwareImproving Profitability

There are many ways that evaluating your revenue cycle can improve profitability, but the process will require that your physical therapy billing staff make some changes.

Problems with revenue mistakes are a big one for physical therapy billing, because a tiny mistake can cause a huge delay in revenue recognition.

But another way that the system can be improved for physical therapy billing is to remove the duplicate and sometimes triplicate entry that staff members perform.

Avoid Redundancy

Redundant tasks are almost as bad for the revenue cycle as errors in physical therapy billing. For many billing departments, the process of eliminating duplicate entry can add hours to each day in free time. And free time is time that can be spent on other tasks, otherwise known as an increase in productivity.

Evaluation and action are essential if your practice is going to improve productivity in the physical therapy billing process. But the real benefit to the staff and the practice will come when you introduce revenue cycle management software.

Physical Therapy Documentation: The Essential Components of Compliance

Physical Therapy Documentation: The Essential Components of Compliance

What makes a physical therapy and medical documentation system compliant? In this revealing article, Nitin Chhoda explains the  key components to look for in any EMR system.

physical therapy documentation guidelinesThe issues associated with remaining compliant are many, varied and can be tricky to navigate. Federal regulations and payer requirements constantly change and therapists must remain vigilant to avoid stiff civil and criminal penalties.

Remaining in compliance is a challenge that faces any practice owner and there are key components therapists should seek in any EMR physical therapy documentation system they decide to use.

A Very Important Matter

The primary concern of any EMR is the protection, privacy and security of patient information. Any physical therapy documentation system must contain sufficient safeguards to ensure individually identifiable health information is secure, and that appropriate efforts have been taken in that direction.

That includes electronically submitted claims, referral authorizations, and eligibility inquiries to insurance providers, clearinghouses and medical professionals.

The Heath Insurance Portability and Accountability Act (HIPPA) spells out in detail the security and safeguards necessary to remain in compliance and establishes the policies, procedures and conditions under which medical information can be disclosed without specific authorization from patients.

Administrative safeguards and controls must be in place that limits access to patient information to authorized physical therapy documentation personnel only.

EMR As A Tool

An EMR is an important tool for therapists, enabling them to remain current on laws and maintain compliance. Individual login capabilities and the ability to validate the credentials of those accessing information are an essential element of any EMR.

Physical therapy documentation staff must also be trained in the rules and guidelines governing the management of medical records and an EMR can be utilized to accomplish that. EMRs encompass the ability to provide powerful security at all levels of access to maintain the confidentiality of patient records, reimbursement submissions and administration of the practice.

Date and time stamps are especially helpful in a physical therapy documentation system, providing detailed reports of when patient records were accessed and by whom. If another healthcare provider discovers a breach in the system, the medical professional can quickly notify the therapist through a variety of means with an EMR.

physical therapy documentation requirementsAdopting EMR System

The adoption of an EMR allows for almost instantaneous interaction among physical therapy documentation healthcare providers.

This ability ensures the highest level of treatment possible through extreme accuracy, while addressing privacy concerns.

Patients who believe that their medical data is safe with their therapist are more likely to provide complete health information that could mean the difference in a life and death situation.

The adoption of an EMR is part of the American Recovery and Reinvestment Act and requires any EMR to meet Meaningful Use standards and certification. An EMR helps physical therapy documentation therapists in all areas of their practice, from ensuring secure access of medical records to the submission of reimbursement requests.

An EMR significantly reduces the possibility of errors.

Security is the primary component of any EMR. Physical therapy documentation software helps therapists maintain the integrity and privacy of patient medical information, and healthcare providers can easily report the instance of a breach should a situation occur.

Therapists seeking an EMR should also ensure their chosen software includes sufficient flexibility in the documentation process to protect the patient and the practice in the event of a lawsuit or audit.

Physical Therapy Billing: How to Create Your Own In-House Medical Billing and Coding Service

Physical Therapy Billing: How to Create Your Own In-House Medical Billing and Coding Service

If you want to save money by creating your own in-house medical billing and coding services without affecting too much time of your staff’s workflow, then this article will walk you through the process.

physical therapy billing softwareFor a small private practice, hiring a contractor to handle physical therapy billing and coding can take a lot of the set-up and training costs away from the practice.

The process of physical therapy billing is simplified and you know that the individual or company that you hire is invested in getting good results on your behalf.

But at some point, you will want your practice to graduate to the next level of efficiency and self-sufficiency. That’s when you’ll decide that your physical therapy billing and coding should happen in-house.

Greater Control

The main reason that having the physical therapy billing staff in-house is preferable is that physical therapy management will have greater control over the revenue cycle and revenue cycle management.

If the billing company is inefficient in any way, there will be no way to find out why and there will certainly be no way to make improvements. At a certain capacity, being able to periodically review the revenue cycle is a very big advantage.

Tools Exists, It’s Time to Use Them 

And with the existing tools today, there’s no reason not to take control of your own revenue cycle. Creating your own in-house physical therapy billing and coding service is as simple as purchasing and implementing a fully-integrated physical therapy EMR.

As you probably know, there are some more details to consider, such as how to go forward with implementation so that the process is successful. But with an implementation plan and proper preparation of staff, a good EMR will change your revenue stream for the better.

Physical Therapy Billing Role

Physical therapy billing and management involves a lot of big picture viewpoints. You’ve got to be able to see how a small change to one staff member’s workflow will affect the entire office.

physical therapy billing serviceYou’ve also got to be able to identify inefficiencies that are worth tackling with an EMR, and those that are better tackled with a bit more training and some positive reinforcement.

With an EMR, you can streamline the billing and coding process so that when a clinician enters notes, they do so directly into the system.

They can choose from a drop-down menu and their choices will make physical therapy coding automated.

The job of physical therapy billing will change from a process of looking up information, filling out forms, and reviewing hand-written clinician notes, and become a process of quick reviews of fully-automated claims ready for submission.

You can make the entire process of physical therapy billing more procedural, with most of the work focused on entering contract details from insurance companies and details of a treatment plan for each patient. That one-time entry for each patient creates an automated physical therapy billing process.

The cost of having your own in-house medical billing and coding service becomes significantly lower. And the benefits of having control over the revenue cycle will allow your staff to make adjustments which will improve efficiency and productivity even further.