Physical Therapy Billing: Using Revenue Cycle Management Software to Boost Revenue in Your Practice

Physical Therapy Billing: Using Revenue Cycle Management Software to Boost Revenue in Your Practice

Discover how real-time software can instantly determine the patients’ insurance coverage and eligibility. This helps you get paid for your services. Discover the importance of eligibility verification function in your EMR.

physical therapy billing guidelinesRevenue cycle management should be a top priority of any physical therapy business. Simply putting it as taking the necessary physical therapy billing steps to ensure therapists are paid for their services and that they’re compensated in a timely manner.

Where Revenue Cycle Starts

A revenue cycle is attached to every client. It begins the moment the patient calls the office for an appointment and ends when their balance is zero.

It’s essential during that initial contact to gather patient data that includes their name, phone number and information about their insurance provider.

Typically, data is provided by the patient when they arrive for their appointment, a time consuming endeavor that involves numerous pages of written documentation that can be streamlined and simplified with physical therapy billing software.

Some clinics gather basic information when a client calls to schedule an appointment, but neglect to ascertain insurance information, an oversight that can cost the practice dearly.

Insurance Coverage and Eligibility Should Be Verified Immediately

Verifying insurance coverage and eligibility for services saves time and physical therapy billing headaches for the clinic in the future. If problems arise, it’s an easy matter to contact the patient or their insurance provider for further details, or reschedule the client if necessary.

Reimbursement denials can be significantly reduced with the use of an EMR that provides electronic billing, coding and submission capabilities. Physical therapy billing software offers flexibility and multiple coding options to reduce rejections and denials significantly.

It’s estimated that it costs approximately $25 per claim to manage each denial. An EMR reduces those costs, while drastically cutting the time needed to provide additional information or challenge denials.physical therapy billing services The value of an EMR can’t be overstated in the management of revenue cycles.

Patient portals provided by physical therapy billing software allows therapists to capture a wide variety of client data ranging from names, phone numbers and insurance providers to email addresses, mobile device information and complete health histories.

EMR Advantages

The advantages of an EMR doesn’t stop with the initial intake physical therapy billing documentation. They offer powerful tools that can be used to track claims, file disputes and provide additional information when a denial occurs. Claims can be submitted individually or batch filed for greater efficiency and they can be automated.

EMRs allow therapists to clear up questions in hours or days instead of weeks or months.

Therapists that harness the power of an EMR have the needed physical therapy billing tools for patients to make convenient one-time or recurring payments, notify clients when they have an outstanding balance and obtain critical insurance information for verification of eligibility.

EMRs also provide practice owners with multiple ways of contacting patients for any number of reasons using text and voice messaging, phone and email. Using revenue cycle management software provides clinic owners with essential tools to track client accounts for better profitability.

Enhanced  physical therapy billing and coding options, combined with electronic submissions, facilitates the reimbursement process from self-pay patients and claims that go through individual insurance companies and clearinghouses. Physical therapy billing software works for therapists to reduce denials and clear up claim problems when they arise.

EMR and EHR – The Difference

EMR and EHR – The Difference

EMR and EHR are two different terms that are often used interchangeably. Nitin Chhoda discusses the difference between EMR and EHR and why this is important for your practice.

EMR programsThere’s been a lot of confusion about the difference in an electronic medical record (EMR) and an electronic health record (EHR), with some using the terms interchangeable.

An electronic medal record is an integrated software system that allows therapists to interact with patients and submit billing claims online, and increase the productivity of the clinic.

An EHR is a collection of data that includes a client’s medical history, personal statistics, billing information and demographics.

The two are very different and many researchers and vendors are still struggling to define each, though both groups tend to agree that EMRs will revolutionize the way medical professionals conduct business, deliver patient care and boost the prosperity of a practice.

EMR is the New Technology

As the debate rages on, one fact remains. Therapists must implement an EMR by 2014 as per The Affordable Care Act. There are dozens of available EMRs, most of which were designed with hospitals, physicians and critical care facilities in mind. They’re generally expensive to purchase and require huge monthly fees.

The good news is that there are very affordable options available that are designed specifically for physical therapy practices. Clinicians should exercise due diligence when researching an EMR and not install the first system they explore, thinking any system is better than none.

The goals of The Affordable Care Act were many and lofty. Some facets of the act were designed to lower healthcare costs, enhance patient care and provide improved access to healthcare services. EMRs will definitely be a cost saver for insurance providers, but they also have distinct advantages for physical therapy practices.


With an EMR, therapists can access a patient’s EHR to discover what tests and procedures have been ordered, prescriptions being taken and how the client responded to treatment. There’s no need to rely on a client’s memory for crucial medical information.

It’s all there in the EHR and can be accessed via an EMR by multiple healthcare professionals. Therapists can begin treatment sooner, without the need for duplicating costly tests. Access to the information in an EHR saves time for both clients and therapists.

The documentation in an EMR is stored electronically and can be submitted online for quicker turnarounds on reimbursements.

Denials can be addressed in a fraction of the time offered by traditional paper methods and postal service, and there’s no need to wait days or weeks to obtain patient information.

EMR web basedAn EMR also offers a convenient means of communication between therapists and patients to send payment and appointment reminders, post test results, request prescription refills and verify insurance coverage.

Healthcare providers can consult and collaborate through the medium of an EMR for more effective patient care.

In contrast, an EHR is a document representing a collection of data rather than a software solution. EHRs provide a complete record of a patient’s illnesses, ailments, allergies, prescriptions and immunizations.

It offers in-depth information about the client’s health history that can be instantly updated and accessed by multiple healthcare providers through an EMR. Along with health information, it encompasses valuable demographic data that therapists can utilize to market their practice and track referrals.

Multiple Tools

The 21st century method of record keeping has arrived with EMRs and they offer therapists multiple tools to create better patient care outcomes, market their clinics, and save enormous amounts of time, effort and money. While many continue to use the terms EMR and EHR interchangeably, therapists need to understand the difference for the good of their business.

Medical Record, Health Record, Health Information and Its Differences

Medical Record, Health Record, Health Information and Its Differences

Nitin Chhoda differentiates between the terms ‘medical records’, ‘health record’ and ‘health information’. The importance of HIPAA laws to protect patient privacy, and how this relates to EMR security is also discussed.

medical record information

With the advent of electronic medical record, a specialized vocabulary has arisen and it’s confusing to many. The terms are often lumped and used to indicate the same type of document.

While one type can encompass information contained in another, they’re distinctly different.

Therapists would do well to differentiate the three, as one contains sensitive information that can create a breach of privacy and security.

Medical Record, Health Record and Health Information

A patient’s medical record includes a wide variety of information that’s been compiled over an extended period of time by multiple healthcare professionals. It includes prescriptions, therapies, x-rays and tests, along with illnesses, surgeries and notes from any number of healthcare providers.

In contrast, a health record compared to medical record is compiled and maintained by a single healthcare provider. A health record is a comprehensive document that details the treatments provided by a single healthcare professional and are kept by the individual therapist.

Health information is personally identifiable data that’s protected by law to ensure privacy. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) set forth national standards for healthcare providers and institutions of all types for the collection, handling and maintenance of client health information.


HIPAA limits the types of medical record information that can be collected, the way it can be shared, and with whom. There are also restrictions on how much client’s medical record data therapists can use in their marketing endeavors.

Patients must be provided with a copy of their own medical records when they request them in writing. HIPAA also makes provisions for the sharing of client data or medical record among healthcare providers to coordinate care. Generally, client information can’t be sold.

Exceptions for the dissemination of medical record data are made when the data is used for research, public health reasons, or in the event of a company merger. It’s also permissible if the president declares a disaster or emergency, or if a public health emergency is declared by the Secretary of Health and Human Services.

EMR Transition

medical record definedWith the transition to electronic medical records, patients and many clinicians have expressed trepidation about the ability to maintain sufficient confidentiality and privacy of healthcare and medical record.

Those doubts and misgivings have prevented healthcare facilities and professionals in all fields to delay the transition to an EMR.

With the deadline of 2014 looming large on the horizon for EMR implementation, the question has been taken out of the hands of therapists. The question facing professionals now is which EMR they should choose.

EMR Security

Security is a primary consideration. Previous generations of providers could simply secure patient information within the office under lock and key. Electronic records require more stringent methods of protection to ensure individual health information and medical record isn’t leaked, stolen or hacked.

Therapists can opt for an on-site server-based system or a web-based solution. Those who select a server-based system are responsible for maintaining a sufficient level of security. With a web-based system provided by a vendor, HIPAA-compliant security is handled by the EMR provider.

Records management and the steps necessary to keep sensitive information secure will play an increasing role in the everyday operation of physical therapy practices for years to come. It’s imperative for therapists to understand the importance of securing medical information and the difference between medical records, health records and health information to avoid the inadvertent release of sensitive and protected data.

HIPAA Regulations 101

HIPAA Regulations 101

HIPAA laws are designed to protect unauthorized access to a patient’s personal and medical information.

Nitin Chhoda elaborates on HIPAA regulations and how to comply with them to avoid fines and penalties in your practice, and the role that your electronic medical records (EMR) system plays in the process.

HIPAA complianceHIPAA or known as the Health Insurance Portability and Accountability Act of 1996 is something with which every therapist must be closely acquainted.

The act sets forth the rules regulating patient privacy and security, and the way personal health records are collected, maintained, used and shared.

Therapists are in possession of sensitive client data each day and clinic owners must take steps to safeguard the security of those documents. Practice owners that aren’t in compliance with HIPAA regulations will find themselves facing harsh and costly fines, along with civil and criminal penalties.

HIPAA Regulations

The HIPAA privacy rule protects patients by prohibiting the release or sharing of individually identifiable health information. It applies to all forms of communication, including oral, paper or electronic.

Protected data includes a patient’s past, present and future medical condition. It includes demographic information such as name, address, date of birth and insurer information. There are exclusions under HIPAA, but therapists must be absolutely sure they’re not violating the law. The parameters are quite narrow concerning the release of client data.

There are unique circumstances in which a patient’s data can be divulged. For example, if the president declares a state of emergency or the Secretary of Health and Human Services declares a public health emergency. The client’s own health information can be released to them if they make the request in writing. HIPAA also makes provision for the release of information to parents and legal guardians of minors.

The usage of unidentifiable information is more liberal. It can be disseminated when used for public health reasons and research. Data can also be included in a wide range of marketing efforts, as long as no data leads back to a specific client, including names, addresses, social security and insurer data.

State Laws and Disclosures

HIPAA regulationsTherapists must also be cognizant of state laws of disclosure, always keeping in mind that HIPAA rules supersede state requirements.

Typically, states can divulge information to prevent payment fraud or abuse, for state reporting on healthcare costs and regulation of controlled substances.

As more clinicians implement electronic medical records, the question of documentation security will continue to grow and evolve to meet the changing needs of electronic medical record systems.

Physical therapy documentation software ensures practice owners are HIPAA-compliant, while providing superior security and safeguards. User login information and verification are required for authorized personnel.

The Connection between your EMR Provider and HIPAA

In an effort to comply with HIPAA requirements, consider the use of an EMR system. With a web-based system, records are maintained in the cloud instead of on local computers, laptops and tablets, where they’re safe from fires, floods and other natural disasters.

Server-based systems are kept and maintained on-site. Therapists run the risk of having equipment stolen that contains personally identifiable patient information. Identity theft and disgruntled employees also place records in danger.

Complying with HIPAA guidelines isn’t optional, it’s the law. It’s one that can cost practices dearly if patient information isn’t adequately protected and is inadvertently made available to unauthorized third parties.

Recent penalties for infractions ranging up to $1 million amply demonstrate this. It highlights the need for clinicians to ensure staff members are trained in privacy regulations and procedures. Even innocent mistakes could lead to penalties that can cripple a private practice.

EMR Adoption, Selection and Implementation Checklist

EMR Adoption, Selection and Implementation Checklist

If you are switching from one EMR system to another, you need to consider several factors including portability, integration and security.

Nitin Chhoda provides a detailed checklist to help you make the transition to an EMR system that will help you prepare for the future, streamline and automate your practice.

EMR systemThe selection of electronic medical records system is one of the most important decisions a practice owner will make over the next two years. It will affect every aspect of the clinic, from communicating with patients to submitting reimbursement claims.

With hundreds of available EMR options available, selecting a documentation software system can be an exhausting and confusing process without a well-thought action plan and clear expectations of what the system will accomplish. Look for the following features in an EMR.

  • Evaluation – Decide what the EMR is expected to accomplish within the clinic.
  • Teamwork – Form a team to evaluate the different EMRs and report back to the final decision makers.
  • Specialization – Choose a documentation system specifically designed for physical therapy practices.
  • Privacy and security – To maintain HIPAA compliance, therapists must ensure their EMR meets stringent requirements to safeguard personal health information. Practice owners that fail to do so will find themselves faced with costly fines, along with civil and criminal charges.
  • Customization – Physical therapy practices have unique need and an EMR should allow clinicians to create custom documents and templates.
  • Web-based – Select a web-based system that stores information in the cloud to eliminate the dangers of fires, floods, natural disasters and identify theft.
  • Workflow integration – Some therapists are attached to their existing systems and don’t want to give them up.

Choose an EMR that integrates any existing office software and offers the ability to remove old systems easily should they no longer be wanted or needed.

  • Portability – iPad compatibility is essential for portability throughout the office, at home and other venues where the clinic offers services.
  • Electronic billing – An EMR equipped with electronic billing reduces the turnaround time on reimbursement claims and allows for the quick submission of documentation and resolution of denials.
  • Communication – Interacting with clients can be automated to deliver appointment and billing reminders. Communications can be sent via email, phone, and text and voice messaging.
  • Patient portal – Clients can schedule an appointment, view test results, complete health histories and provide insurance information with a patient portal. Therapists can easily verify insurer information and contact patients if there’s a problem.
  • Prescriptions – The ability to submit medication orders to a wide variety of pharmacies saves time for therapists and patients.
  • Interconnectivity – Tests, x-rays and lab work from outside facilities can all be ordered from the office with an EMR. Therapists should ensure their EMR is compatible with other facilities in the area. Results can easily be returned to the office electronically and posted through a patient portal where clients can view them.

  • Importation capabilities – EMRs are designed to eliminate voluminous paper files, but the information contained within existing documents must find its way into the documentation software. It’s essential that the EMR offer the ability to import notes, documents and test results for a complete electronic solution.
  • Online training – Staff must be trained in the use of an EMR, but training provided by vendors often results in an overload for staff. Online training can be accessed multiple times and whenever it’s needed to reduce the learning curve and assist staff in retaining more information.
  • EMR adoption checklistCustomer service – Choose an EMR that provides automatic updates, 24/7 support, regular back-ups, and the ability to upgrade and add new modules as needed.

The idea of implementing an EMR can be a scary thought and has led many professionals to delay the process.

An electronic documentation system must be in place by 2014 and therapists need to initiate the search for a suitable EMR as soon as possible to ensure sufficient learning and shake down time before the deadline.

Physical Therapy Documentation: Productivity Benchmarks in Your Documentation System

Physical Therapy Documentation: Productivity Benchmarks in Your Documentation System

If your practice is still using pen and paper, the thought of electronic medical records can be daunting.

Nitin Chhoda explains how to boost productivity using a web-based documentation system to make life easy for the practice owner, the staff and the biller.

physical therapy documentation systemsProductivity is a key element in all facets of a physical therapy practice, from obtaining vital patient information to receiving reimbursements.

For a struggling clinic, an increase in productivity can mean the difference between eliminating positions to hiring new staff that can help the practice grow.

Physical therapy documentation software provides automation of tasks for increased productivity for every member of a clinic’s team.

As new treatments become available and reimbursement regulations escalate, an EMR provides better and more elaborate coding and physical therapy documentation options to satisfy third-party payer provisions.

Physical Therapy Documentation

Every therapist has experienced the time consuming process of recording, rebilling and providing explanations to insurance companies, Medicare and Medicaid. EMRs offer multiple coding abilities for practices working with an extensive array of providers to ensure therapists are adequately paid and clients receive ongoing care.

Employee wages constitute one of the largest expenses for a physical therapy practice. Clinic owners can utilize their physical therapy documentation software to ascertain where the abilities of staff members can best be allocated. An EMR helps therapists ascertain if they’re overstaffed, identify time wasters, and where positions can be eliminated for greater overall productivity.

Patient Scheduling

A full patient schedule is one of the goals of a productive practice and a physical therapy documentation system provides essential information therapists can use to market their clinic successfully. Referrals can be monitored and marketing efforts tracked to ascertain methods that work best based on a variety of demographics.

physical therapy documentationAn EMR provides improved patient management, eliminating duplication of testing, prescriptions and treatments. Lost charts and missing information is never a problem with physical therapy documentation software.

A secure patient record is created that can be accessed by numerous medical professionals and quickly updated as surgeries, procedures, prescriptions and treatments are implemented.

Patient care can begin immediately instead of waiting for essential records to be transported by the postal service.

The Advantage of a Physical Therapy Documentation Software

Those in the medical professions have notoriously bad handwriting that’s eliminated with an EMR. Personal notes can be added with no loss of legibility.

Therapists work with a wide variety of incidental documents that includes work and school excuses, referral letters and requests for records. Physical therapy documentation software allows therapists to produce and transmit those and a myriad of other documents with just a few clicks.

There’s no need to maintain copious amounts of physical therapy documentation paper-based records, space to house them, or engage staff in the time consuming task of finding them with an EMR.

‘Patient information is available at a moment’s notice anywhere an Internet connection is available, reducing the time needed to implement a course of treatment. EMRs speak for a patient in an emergency, preventing errors or inappropriate treatment.

Clients like the convenience of patient portals with physical therapy documentation software, but patient portals save significant time and effort for therapists. Insurance information can be validated prior to services and a complete health history can be submitted, allowing practice owners to familiarize themselves with the client’s data and formulate possible options.

The highest level of productivity is necessary for clinics to survive and thrive and EMRs provide practices with the tools to achieve that, along with tools to analyze trends and the productivity of their entire business operation.