Reimbursement Claims: How Can to Make Sure I Get It the First Time Around?

Reimbursement Claims: How Can to Make Sure I Get It the First Time Around?

Clean reimbursement claims are the bread and butter of the medical billing industry. They pass the scrubbing process at clearinghouses quickly and generate revenues faster. Billers can take a variety of precautions to avoid denied claims and in this telling article, Nitin Chhoda reveals the most common billing mistakes.

reimbursement claims The first rule of medical billing is never assume anything. If a medical insurance biller (MIB) has any doubt due to a practitioner’s illegible scrawls, the type of treatment received or procedure performed, it’s imperative to contact the clinician for clarification.

Coding Errors

Mistakes and oversights in coding represent the number one reason that reimbursement claims are denied. Electronic medical record (EMR) technology can identify potential claim problems and notify the user. Insurance carriers are constantly seeking ways to avoid paying reimbursement claims and examine coding closely for the following items:

  • Mismatched coding that creates inconsistencies in the claims. A good example is gender specific ailments.
  • Truncated coding doesn’t address all three levels of the practitioner’s diagnosis is suspect.
  • Up and down coding is a red flag for carriers. Trying to obtain higher reimbursement claims or coding at a lower level in an effort to avoid denials can result in penalties, or the carrier may decide not to do business with the clinician.

Document Everything

Clean claims provide the appropriate documentation for every item, from the patient’s identity to the treatment provided. MIBs must ensure that reimbursement claims contain complete and accurate information on all facets of the patient’s visit.

When claims are returned with a request for supporting data, insurance carriers can become suspicious and suspect the medical provider or the MIB of altering or recreating documents to support a claim.

Billing Blunders

Unbundling is the act of billing separately for elements that should have been claimed as a whole. Insurance carriers allow for unbundling under very specific circumstances, but MIBs should utilize caution when doing so. Coding is designed to cover an entire treatment or procedure and will single out a claim for closer inspection.

Complying with Carriers

There’s no standard procedure when dealing with insurance carriers. Each company establishes its own rules for reimbursement claims submissions. MIBs who don’t adhere to the carrier’s specifications will be deemed non-compliant and the reimbursement claims will be denied. That can also encompass failure to obtain a pre-approval prior to the patient’s treatment.

Clerical Oversightsreimbursement claims process

Correct coding and detailed documentation won’t avoid a denial if the reimbursement claims contain omissions, data entered in the wrong location or typographical errors.

Even simple items, such as misaligned paper in a printer, can pose sufficient reason for a clearinghouse to reject a claim.

Most mistakes can be identified and corrected prior to transmission to the clearinghouse. It takes only moments to double check a claim before it’s sent, but correcting and resubmitting reimbursement claims can take hours of work and severely disrupts the flow of revenue. Knowing where the most common errors occur is the first step toward filing clean claims.

The Right EMR System Provides the Solution to the Physical Therapy Practice

The Right EMR System Provides the Solution to the Physical Therapy Practice

Physical therapy clinics and providers should opt for the right EMR system that serves as the solution for improved management and better delivery of patient care. Nitin Chhoda reminds physical therapy practice owner to always choose the right EMR system to maximize its use and increase profitability.

EMR systemIndividuals in need of physical therapy services will always check on the expertise and capability of the clinic.

This will serve as the deciding factor in figuring out the physical therapy clinic or provider they will choose.

The same degree of professionalism and efficiency is also expected from the office solutions that are being utilized with electronic medical records for physical therapy services.

It is essential for any physical therapy clinic or provider to select the best EMR system or physical therapy documentation software.

Focus on What Your Practice Needs

Due to the wide selection of EMR system for physical therapy services, clinic owners and providers are having a difficult time sifting through the various features and functionality of every EMR system. Finding the right EMR system that fits perfectly with the practice’s needs and preferences are overwhelming.

The navigation and the user interface are the main features being focused on. The ideal EMR system can make the daily tasks a lot easier to handle while at the same time, make the office organized, thus, saving time and money for the practice.

User Interface

With many different EMR systems shown to practice owners, there are certain ways in which a user can interface in order to view and manage the documents online. The user interface is available in various forms.

The files are neatly categorized based on the chosen arrangement. This can greatly help in locating required files for a particular treatment as well as other important files such as the workflow items, insurance files, messages and many more.

Simplify Practice FlowEMR system software

The right EMR system should involve the review of the workflow processes, particularly repetitive steps undertaken in the office.

EMR system for physical therapy services that meets the needs of physical therapy clinic can greatly help save time and money in the long run.

The EMR system that will be chosen will not only establish how the practice is organized, but also how well the patients are treated.

The professional image of your practice is also greatly affected. As the best solution for better management, workflow and delivering quality patient care, the ideal EMR system for physical therapy services must be chosen.

Proven Tips on EMR Implementation Provides Physical Therapy Clinics with an Advantage

Proven Tips on EMR Implementation Provides Physical Therapy Clinics with an Advantage

Physical therapy clinics will gain an advantage by utilizing the proven tips on the implementation of the EMR for physical therapy services which Nitin Chhoda keeps on sharing to the practitioners.

EMRThe decision to integrate EMR for physical therapy services is the best choice due to the remarkable shift in the management of the patient files and the workflow.

The EMR system was specifically created in order to improve the accuracy for better patient care and management.

The implementation of the EMR system is important as well as the type of EMR system that was selected.

Certain aspects that range from the government standards up to the training of personnel must be carefully planned out during the implementation of the EMR so that the best results can be achieved.

EMRs Main Purpose

With the main objective of the EMR systems to reform the health care system as well as improve quality of health care, patient safety and efficiency, practitioners can achieve a better workflow and even provide the best patient care.

Today, physical therapy clinics that concentrated on providing superior care to their clients while at the same time managing the daily practice efficiently with the help of the EMR system, has a better stand in gaining monetary incentives in the long run.

Physical Therapy Staff Involvement

The involvement of the personnel in the implementation process will result in a highly efficient and effective EMR system that can greatly improve the workflow. During the implementation of the new EMR for physical therapy services, important personnel can voice out their own perspectives, which can help improve the patient care.

Staff should also receive training on operating the EMR system in order to make the implementation successful and highly effective.

Creating Plans for Implementing EMR

Implementing EMR for physical therapy service should require a plan B just to be prepared for unexpected surprises during the implementation process. EMR software

Doing so will help save a lot of hassle in the future. Even opting for a secondary electronic medical records system can help maintain the functionality while certain issues are dealt with to recover the main system.

Proper implementation of EMR for physical therapy services can greatly help out the practice in achieving better management, workflow and even the patient care they provided.

There should be adequate planning as well as working with the personnel involved to achieve a successful implementation.