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.

Physical Therapy Software: The Benefits of EMR in a Physical Therapy Private Practice

Physical Therapy Software: The Benefits of EMR in a Physical Therapy Private Practice

Electronic medical records (EMRs) are becoming a commonplace in all private practices. Nitin Chhoda shares the benefits of using EMR, how to find the right one that can save time, improve quality of patient care and help the practice owner live a life of freedom and independence.

physical therapy software documentationMuch has been written about the benefits of physical therapy software automation, but the advantages extend far beyond savings and increased efficiency for private practice owners.

Electronic medical records (EMRs) provide the technology for patients and therapists to connect and manage care no matter where they travel.

Veteran’s hospitals have been using a form of EMR for years to coordinate patient care more effectively and physical therapy practices can now share in the bounty.

The Advantages of EMR

EMRs offer electronic billing options that can make the difference between a practice thriving or simply surviving. Therapists will see a quicker return on reimbursements for greater cash flow with electronic billing, allowing them to manage their clinics with greater physical therapy software accuracy and profitability.

Practice owners can easily ascertain where the bulk of their revenues are originating, allowing them to contract with the best payers.

While the majority of physical therapists won’t see a natural disaster on the scale of raging wildfires, deadly twisters or Hurricane Katrina, all those events amply demonstrate the need for physical therapy software automation. There’s no need to rely on a patient’s traumatized memory to recall injuries, medications and past procedures.

EMRs can be used to access essential health information from anywhere an Internet connection is available. They effectively speak for patients when they’re unable to communicate for themselves.

EMRs provide continuity of physical therapy software service in the event that a therapist retires, moves or dies. Paper records can become lost, misplaced or destroyed, but electronic data provides a permanent record that can be accessed anytime.

More Benefits of EMR Defined

An EMR patient portal gives clients access to their personal health records and test results, allowing physical therapy software clients to take a more active role in their health care.

Therapists that employ an EMR will quickly discover the savings available with physical therapy software automation. They save on paper and folders, space requirements for housing reams of documents, and the time necessary for staff to file them. EMRs can be established to operate from laptops or tablets for maximum efficiency.

Cloud-based EMRs enable multiple healthcare providers to view a patient’s record at the same time for coordination of care. An EMR for physical therapy software can be used for educational purposes to explain procedures and impress upon clients the importance of their treatment and the intricacies of their condition.

Prescriptions and refills can be submitted online, appointments scheduled and forms completed.

Automation Can Save You Time

Physical therapy software automates many of the tasks that can take hours to complete by hand. Therapists can include notes within the EMR, eliminating the need to decipher handwritten notations made on the fly, reducing the possibility of errors, reimbursement denials and paybacks.

physical therapy software EMREMRs integrate easily with existing office systems for communications and marketing, including Clinical Contact and Therapy Newsletter.

Physical therapy automation software streamlines office processes and procedures, allowing practice owners to offer an elevated level of care and access to patients.

The adoption of an integrated tablet-based EMR will make physical therapy practices more efficient and profitable. They open up numerous possibilities for the future, from online diagnostic software to specialized apps.

Physical therapy software automation will facilitate research and collaboration among professionals. EMRs are setting the standard for a new age of patient care and the way medicine is practiced.

Physical Therapy Management: Importance of Technology and Automation for the New Economy Practice

Physical Therapy Management: Importance of Technology and Automation for the New Economy Practice

Nitin Chhoda discusses the importance of an automated electronic medical records software to streamline and automate the ‘drivers’ of your practice. These include marketing, documentation, coding and billing.

physical therapy management softwareToday’s society is a high-stress environment with a myriad of ways for injuries to occur that require the services of a physical therapist.

To meet the needs of a burgeoning clientele, physical therapy management must include office systems and automation to provide better patient care, control costs, increase revenues, and market practices efficiently.

Learn to Coordinate Physical Therapy Information from Other Sources

The day of the single healthcare provider is over. Today’s patient receives treatments from multiple providers and consumes a multitude of prescriptions.

The need to coordinate, as part of physical therapy management, of information from numerous sources is obvious, and electronic medical record (EMR) systems simplify the process for fewer errors, more effective treatments, less waste and faster payments.

Any therapist evaluating an EMR should choose one that allows for the exchange of information with other patient-centered care facilities.

Extreme sports and amusements, an aging population, and healthcare reform present an increased need for therapists to automate as many low-dollar activities as possible. Web-based EMRs provide the means for therapists to control labor costs, schedule staff, purchase equipment, and plan expansions.

The Role of Having a Physical Therapy Software

Physical therapy management EMRs provide metrics and analytics that assist therapists to define where marketing campaigns should be implemented for the highest return on investment and where referrals are originating.

Physical therapy management software allows information to be updated once, used in a variety of ways, and is available to other authorized professionals who require access. Data can be used to track patient progress, educate clients and manage better treatment outcomes.

Information contained within an EMR provides therapists with a powerful tool for reporting statistics, creating new and innovative treatments and providing data for the public good.

Use Electronic Medical Records or EMR

Electronic medical records utilize the latest physical therapy management technology to facilitate reimbursements through electronic billing for better cash flow, while reducing the instance of paybacks and denials. Web-based systems provide instant access to everything from patient records to billing from any location equipped with an Internet connection.

EMRs can be installed on laptops or the iPad and are compatible with Windows and Mac operating systems.

physical therapy management programsEMRs are positioned to become the norm for physical therapy management, providing essential automation for the 21st century practice.

Why Use EMR Technology?

Enhanced patient care, quicker reimbursements and more efficient physical therapy management allows practice owners to gain better control over every aspect of their clinic for greater profitability.

The technology is available and there’s no logical reason not to employ it to benefit physical therapy management. The systems handle low-dollar activities, allowing therapists to concentrate on innovative treatments, better patient care and future financial planning to establish their personal income goals.

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