The ICD 10 Countdown for Your Private Practice

The ICD 10 Countdown for Your Private Practice

The transition to ICD-10 codes is the most significant change in 30 years and many clinicians still don’t realize that without the new codes, all their claims will be rejected after Oct. 1, 2014.

ICD 10 codesThe deadline for implementation won’t be pushed back again.

Practitioners need to prepare now and establish a timeline to give themselves adequate time for staff training, to update/upgrade systems and conduct testing.

Conduct an Impact Analysis

The code transition will impact systems and people in multiple ways.

Clinicians will need to conduct an impact analysis to determine how extensively implementation will affect both manual and electronic systems.

The American Medical Association has indicated that the process of updating clinician and vendor systems will take up to six months.

Finding a Vendor

Practitioners will need to contact vendors to ascertain costs and how quickly implementation of new software and hardware can be completed.

It’s essential to find a vendor that supports staff training and maintains responsibility for updates/upgrades, while minimizing costs.

Clinicians may find they need to locate a new vendor to meet their needs.

Communication Is Key

No practice stands alone and clinicians will need to communicate with one another, their biller or billing service, vendor, clearinghouses and insurance companies to ensure systems are compatible.

Extensive system testing will be required between all the entities involved and will take two to three months to complete.

Custom Templates and Modifications

Clinicians should begin now to familiarize themselves and staff with the new codes. Documentation may need modification to reflect coding changes, create claims and accommodate data collection methods.

Don’t use cookie cutter templates – create customized templates that are relevant to the practice.

An EMR and billing software that provide crosswalks between ICD-9 and ICD-10 codes are critical.

Training for SuccessICD 10 codes

Staff training will take two to three months.

A training schedule will need to be created that provides every staff member with a working knowledge of the codes and how they will affect their duties, but one that minimizes the effects on daily operations.

Training exercises using the new codes is good practice for the implementation deadline.

The transition to ICD-10 codes can’t happen overnight. It takes extensive planning and communication between all the parties involved. ICD-10 isn’t a catastrophe, but getting caught unprepared will be catastrophic for the survival of practices. One break in the chain anywhere along the line and clinicians won’t be paid.

Medical Management — How to Streamline with EMR

Medical Management — How to Streamline with EMR

One of the many and major benefits of using electronic medical records system is the ability to streamline the entire documentation and billing process.

This can significantly improve  productivity and boost cash flow. Nitin Chhoda explains how to streamline your practice with a simple, efficient and integrated EMR system.

medical managementCorrect medical management is the key ingredient to a healthy, growing practice. The way therapists manage their clinics will determine whether they succeed or fail.

Practice owners must think like business owners instead of medical providers, a task that many find difficult to reconcile with the everyday treatment of patients.

Assistance With the Help of EMR

Electronic medical records system offers valuable assistance and significantly lightens the load of medical management. Effective medical management of a physical therapy practice involves more than just getting more patients in the door.

It means identifying problems and issues within the clinic, tracking trends, and streamlining the entire range of office procedures. Along with improving client care, superior management means being reimbursed in the timeliest manner possible.

Reducing administrative costs and efforts, while planning for the future, are all earmarks of an efficiently run clinic that will experience exponential growth.

The Benefits of EMR

The most obvious benefit of an EMR in medical management is the ability to identify where unknown problems have crept into office procedures. Time is money in the business world and a physical therapy practice is a business with all the attending problems, issues, wasting of resources and marketing requirements.

Therapists who embrace the features of an EMR will see increased revenue, cost reductions, more effective marketing efforts and better utilization of resources.

Therapists will first notice an increase in cash flow through faster payments via electronic reimbursement submissions. The entire medical management claim and payment system is accelerated and funds can be deposited directly into the clinic’s account.

EMRs eliminate the days of waiting for claims to reach their destination and the return of paper checks that must then be physically transferred to the bank. EMRs provide clinics with the means to capture one-time and recurring payments online via credit or debit cards.

Determine Best Payers

medical management streamlineClinicians can easily determine the best payers through the metrics available in an EMR.

Therapists can ascertain each client’s insurance coverage and eligibility for services, and have the data entered long before the patient’s appointment, allowing for quicker medical management billing and coding that attains a new level of accuracy.

Information is power and EMRs place a wide range of data at a therapist’s fingertips to evaluate medical management staffing needs and deploy clinicians where they’re most effective. It may be possible to eliminate employees or practice owners may discover they can add staff to expand services into spas, corporate and home health programs, and senior facilities.

EMRs provide data that equips therapists with medical management information on local and national demographics, along with treatment trends, that can be used to formulate streamlined and more effective marketing campaigns that target groups by age, gender, location, services or insurance providers.

High Tech Communication

The ability to communicate with clients via multiple methods, including voice and text messaging, offers clinics 21st century technological tools with which to work. The term paperwork is destined to become obsolete with EMRs that record and store documents digitally.

As therapists fine tune their EMR documentation software to reflect their individual practices, medical management in all its many facets will become more streamlined and efficient than ever before, allowing clinicians to market their clinics more effectively, increase cash flow and manage practices for greater efficiency and profitability.

Physical Therapy Billing: Simplifying Enrollment with Insurance Companies

Physical Therapy Billing: Simplifying Enrollment with Insurance Companies

There are times when new practices are unable to enroll with major insurance companies. In this article, Nitin Chhoda provides some valuable tips on how to simplify the complicated process of enrollment and get your practice in-network with the payers you wish to work with.

physical therapy billing enrollmentAlthough physical therapy billing is complicated by the various billing requirements of insurance companies and government programs, some private practices are finding ways to simplify the process.

In fact, physical therapy billing is being redefined by physical therapy documentation software and EMRs.

The changes that are being make streamline the process, improve claims acceptance from insurance companies, and improve the patient experience.

Applications to Insurance Companies

For each insurance company that a physical therapy practice would like to bill, an application process must be completed and even certification may be required. Insurance companies have a lot of power in this regard and the process can be time consuming and costly.

These physical therapy billing applications cannot be taken lightly, and the terms of the final contract with each insurance company should be carefully reviewed.

The contract terms will determine just what you can bill for and what the limits are for each insurance company. Not only will this inform what the physical therapy billing staff does, but it should also be used to instruct physical therapists on how to work with patients to get the most benefit from the limits imposed by the insurance companies.

The Most Efficient Way to Enroll

There are now services that offer to apply on behalf of your practice for a fee. In many cases, this can be worthwhile, as the time and energy it takes to complete this kind of application takes physical therapy billing or management staff away from other duties.

Hiring a specialist to do this temporary work may be the most efficient way to enroll with a number of insurance companies as well as government programs like Medicare and Medicaid.

But this still involves a great deal of attention, at least from physical therapy billing and management. You may want to start by determining exactly which companies you want to enroll with.

Not every insurance company will be worth working with, especially if the limits are particularly low or they have a particularly high rate of rejection and denial of claims. Once you have drafted a list of potential companies and programs, you can work with an application company to get enrolled more quickly and efficiently.

Integrating Insurance Requirements into an EMR

physical therapy billing companies

A fully integrated and flexible physical therapy EMR can provide clinicians with the correct weighted procedures and treatment options so that when the information is transferred to the physical therapy billing staff, the billing process can be seamless and smooth.

A physical therapy billing and documentation software solution can help make enrollment smoother for physical therapy billing staff as well as for management. Once the terms are set, the specific can be entered into your EMR.

Without wasting time looking up the details of each insurance contract, the physical therapy billing staff can fill out the necessary claims and submit them more quickly and accurately than ever before. If the requirements are integrated into the EMR, everyone benefits including the practice as a whole.
How to Minimize Your Accounts Receivable

How to Minimize Your Accounts Receivable

Accounts receivable is one of the biggest problems for private practices. Across the nation, there’s millions of dollars that practices are still waiting to collect from insurance companies. The problem is twofold. Practices aren’t using integrated software that performs automatic functions and many billers are being forced to enter each bit of data manually. That leaves them less time to concentrate on collecting from payers.

To remain financially secure, clinicians must do everything they can to shorten the revenue cycle for each patient and get paid faster. That means streamlining the biller’s job with software that contains automation and one-touch functionalities, along with scrubbing and editing abilities. Next to the clinician, a biller is the most important person in a practice. They’re highly trained professionals that keep revenue flowing into the practice.

Accelerated Submissions

In Touch EMR™ and In Touch Biller PRO are the two most advanced software systems available. The integrated systems work together to provide billers with tools that facilitate the entire billing process from start to finish. Efficiency is extremely important in today’s economic climate and In Touch EMR™ allows practitioners to create a claim and submit it to the biller by the time the patient leaves the office.

The system contains essential time-saving features that notify billers of potential problems that could delay the claim, such as incompatible CPT codes. If an inconsistency exists, billers can edit the claim as needed. The claim is automatically optimized, batched and sent the same day. The biller doesn’t have to manually load and send.

Where’s The Claim?

A critical part of the biller’s job is to track, monitor and follow up on submitted claims. In Touch Biller PRO enables billers to track each claim at every stage of the process. The software tells billers exactly where the claim is and its status, an ability that’s missing in most systems, but one that allows billers to track and process claims seamlessly.

The system automatically posts ERAs to patient accounts without the need for billers to do the task manually. That one ability alone provides an enormous time savings that can add up to $1,200 or more per month and thousands each year.

Next t to the clinician, the biller is the most important person in a practice. Any opportunity to streamline his/her job with automation should be implemented. In Touch EMR™ and In Touch Biller PRO makes the biller’s job easier, shortens the revenue cycle and allows practitioners to get paid faster.

How to Bill More Efficiently

How to Bill More Efficiently

Quick and efficient billing is a necessity in today’s economic climate. Reduced reimbursements and changes brought about by Obamacare are forcing practices to work smarter and more efficiently to collect the revenues they’re due. The best way to accomplish that goal is through integrated software systems with automatic features.

In Touch Biller PRO has advanced features that allow billers to submit claims that are far less likely to incur a rejection and to submit those claims quicker. In Touch Biller PRO is a completely integrated scheduling, documentation, billing and marketing system available in a single product to shorten the revenue cycle.

Sophisticated Functions

With an integrated system, scheduling and documentation should work with the billing software with no need for a separate system. In Touch Biller PRO is designed to communicate with other systems for a seamless solution that carries data through to wherever it’s required. The biller is the most important person in a practice after the clinician and In Touch Biller PRO allows the biller to do his/her job more efficiently to keep funds flowing into the practice. Making the biller’s job easier means more revenue.

Automatic Data Entry & Tracking

In Touch Biller PRO eliminates manual entry of patient data that’s time consuming and robs billers of valuable time that can be better spent tracking and monitoring payments and claims. The software detects potential problems and inconsistencies and allows billers to edit claims before they’re submitted, a feature that’s lacking in other systems. Claims are scrubbed and optimized before they ever leave for the clearinghouse.

Customized Reports

The ability to generate sophisticated reports is an essential means of increasing income and determining the health of a practice. In Touch Biller PRO can produce customized reports whenever needed, based on a comprehensive array of criteria. Reports can be generated according to accounts receivable, ICD and CPT codes, payers, providers and referral sources.

To keep revenues high, practitioners require a system with seamless integration, the ability to edit claims, and generate sophisticated reports using multiple criteria. In Touch Biller PRO provides billers with essential tools to shorten the revenue cycle and offers clinicians multiple ways to diagnose the health of their practice.

The Revised CMS-1500 Claim Form

The Revised CMS-1500 Claim Form

The transition to ICD-10 codes comes with a revised CMS form to facilitate reporting. The National Uniform Claim Committee (NUCC) approved the use of the revised CMS- 1500 Claim Form in February 2012. The new CMS-1500 form will be printed with 02/12 in the lower right hand corner to indicate it’s the replacement for the 08/05 version.

The CMS-1500 must be used when billing Medicare and other federal payers for services. Clinicians must indicate when submitting claims on CMS-1500 if they’re using ICD-9 codes or if they’ve already made the transition to ICD-10. It’s essential that clinicians maintain communication with their payers and clearinghouses and conduct testing to ensure submissions are being transmitted and received correctly.

Medicare began accepting the revised version of claim form CMS-1500 on Jan. 6, 2014 and all submissions after March 31, 2014 must be done with the revised CMS-1500.

For those who have received a waiver for electronic transmission, Medicare will continue to accept paper claims, but only on the revised form. Medicare will deny any claim submitted on the old CMS form on and after April 1, 2014.

The new CMS-1500 was required to correctly report and document the thousands of new ICD-10 codes and the alpha-numeric system that will be used. Use of the new form is mandatory when billing any federal payer. Many of the line-by-line item changes were relatively small, such as changes in wording. For example, TRICARE CHAMPUS has been shortened to TRICARE and the Social Security number is now referred to as an ID number.


Other line items with which clinicians were familiar were eliminated entirely, since the information will now be reported elsewhere on the form or not at all. A number of lines now read “Reserved For NUCC Use” and data that includes employer’s name, school and balance due that wasn’t reported on 837P weren’t deemed necessary and aren’t required on CMS-1500.

An enhancement on the form allows clinicians to list up to 12 diagnosis codes per patient. CMS-1500 has a number of open fields, but they can’t be utilized to report additional data. Practitioners now have qualifiers to identify them as a referring, ordering or supervising provider and diagnosis codes that were labeled 1-4 now have an A-L designation.

The ICD-10 codes are more specific and the CMS-1500 reflects that. The new form has a QR Code that can be scanned with a smartphone. The QR Code takes users to the NUCC website. The revised CMS-1500 also underwent changes that would provide practitioners with the ability to add extra qualifiers when needed.

Any reimbursement claims filed prior to implementation of the revised CMS-1500 that must be resubmitted for any reason should be transmitted utilizing the revised form. This is true even if the previous claim was submitted on the earlier form.

A copy of the form can be downloaded for examination purposes, but it can’t be utilized to submit claims. CMS-1500 uses exact red ink match technology and much of the embedded information will remain invisible when it’s scanned with an Optical Character Recognition (OCR) device. Clinicians should be aware that payers can opt not to process claims that are submitted in black ink and doesn’t use the red ink match technology.

It will take some time for clinicians to familiarize themselves with the revised CMS-1500 form and the new ICD-10 codes, but the form is now an accomplished fact. The new codes and forms are a reality of the healthcare environment and clinicians must use them or risk not receiving reimbursements.