Physical Therapy Management Best Practices Using EMR System

Physical Therapy Management Best Practices Using EMR System

Adopting a multi-faceted approach to running a physical therapy EMR practice allows more streamlined and productive business. Nitin Chhoda shares how an effective scheduling, documentation, billing and marketing, with the help of EMR, are very important in a private practice in order for the business to survive.

EMRPractitioners are also business entrepreneurs and, in most cases, their practices are for profit enterprises, but they are not recognized or treated as such.

Below are the most important factors that practitioners should prioritize so that their businesses will become an effective and profitable one.

Scheduling

For every open appointment slot of each day, there should be a patient coming in to the clinic. Proper management is necessary for this to be achieved. Electronic medical records system is the latest physical therapy software system that organizes and summarizes all appointments or schedule not only for the day, but also for the week or month depending on the user’s preference.

With technological advances like electronic medical records, scheduling has evolved so that filling slots is easier and tracking patient visits becomes automated.

Documentation

The responsible physical therapy management staff must take the time to look over the schedule and pull the correct records each day. An organized physical therapy documentation can be automated and streamlined with the use of physical therapy EMR technology.

Billing

Having a proper and correct physical therapy billing and coding with the help of EMR are keys to successful practice operation. The collection of payments from the payer, whether directly from the patient or their health insurance company depend on this part.

Marketing

Marketing is also important and patients are part of the EMR system. Giving them the best care and service will automatically encourage them to bring referrals. It is important that current or even previous patients should be part of the healthcare practice management plan. EMR system

The plan can be easily implemented using a physical therapy software like EMR, where everything is updated and streamlined. Without good marketing, it will be hard to keep your schedule full.

By realizing the important connections between the four major parts of a practice, physical therapy management can easily look for ways to improve, making the practice more efficient.

Utilizing EMR for physical therapy services will greatly help as most of the common tasks found in these approaches can be integrated to this physical therapy documentation software.

The Ins and Outs of Your Clearinghouse

The Ins and Outs of Your Clearinghouse

Clearinghouse represents the first step on a reimbursement claim’s journey toward money in a clinician’s pocket, but a lot can happen once it’s transmitted from the practitioner’s office.

In this revealing article, Nitin Chhoda provides an inside look at factors that can affect a claim and the ultimate reimbursement.

clearinghouseBefore And After

A clearinghouse is an essential element of the entire medical or physical therapy billing cycle. They ensure that each claim is routed to the appropriate insurance company for payment.

They perform other useful functions before a patient arrives at the office and afterward. Billers can utilize their services to ascertain a client’s insurance eligibility and coverage prior to treatment. They can also issue a statement of services to patients.

Cleaning the Claim

The first step for a claim after its arrival at the clearinghouse is a thorough scrubbing for errors and inconsistencies. Some mistakes can be quickly corrected online, allowing the claim to continue on its journey. These are typically clerical errors and while they may seem minor, they contribute significantly to the wait time for the claim to be paid.

Other problems aren’t so easily rectified and the entire claim will be returned to the clinician’s office to be corrected and resubmitted. These types of problems can arise when the clearinghouse doesn’t recognize the payer. Many smaller insurance companies don’t accept electronic payments and the claim will be returned, necessitating submission of a paper reimbursement request.

Matching Identification

Clearinghouse is responsible for matching payer identification numbers with the right claim, a process that tells the organization where to direct the reimbursement request. The practice’s billing and coding specialist must include the correct payer ID number on the claim or it will be returned to the medical provider, further delaying reimbursement.

Reports and Records

Medical clearinghouse maintains a record of each claim that goes through the facility’s system and generates a status report.

The record can be accessed by the practice and used to monitor the location of the claim, where it was sent and when. Sometimes a claim may seem to disappear. Billers can check their batch report against those generated by the clearinghouse to discover what happened to it.

clearinghouse - in and out

Clearinghouse provides clinicians with a single location to manage all their reimbursement claims and to do so electronically for speedier payment.

Multiple claims can be submitted at the same time and clearinghouse reports allow clinics to track and monitor the status of any claim 24/7.

Practitioners that contract with clearinghouse have the advantage of fewer rejected and denied claims and quicker reimbursements.

How an EMR Can Lead to Your Personal Freedom

How an EMR Can Lead to Your Personal Freedom

Implementing the EMR technology is essential in the 21st century for clinicians to convert to digital records, submit reimbursement claims and get paid.

EMR expert, Nitin Chhoda, was one of the first to use the software and is sharing his expertise on the many ways an EMR contributes to a practitioner’s personal freedom.

EMRTime is money and an EMR provides savings for clinicians on both fronts.

Verifying Insurance Coverage

From the moment a client makes an appointment to the moment the patient encounter is completed, an EMR is on the job, increasing efficiency and boosting productivity.

An EMR has the tools to verify insurance information prior to the client’s visit, providing practitioners with the information needed to formulate a treatment plan based on insurance limitations, coverage and eligibility.

Fewer Hours and More Money

A fully integrated EMR includes a secure patient portal where individuals can complete a health history online. That information is available prior to the client’s visit, allowing clinicians to familiarize themselves with the patient’s problems before they arrive. The data can decrease the wait times for patients and practice owners by up to 47 percent and reduces time spent gathering information in the exam room.

The information gathered with an EMR allows practice owners to see more patients during the normal work day and manage treatment options, without the need to stay late or conduct extended hours.

Clinicians have more free time and the funds to enjoy personal activities with friends and family.

Anytime Access

Patient records are updated instantly with an EMR, anytime the client’s information is retrieved. The systems provide a single resource for all aspects of a practice’s management needs. The records can be accessed from multiple locations and by numerous medical professionals to coordinate care.

If a patient requires treatment in an ER, the on-call physician has all the information needed to assess and treat the patient, without the need to contact the client’s physician.

Space and Time

Office supplies represent a major expense for practices. An EMR saves everything digitally, eliminating the need for paper documents, files, folders and all the related products needed to manage a mountain of paperwork.

EMRs require a fraction of the space needed for file cabinets to house paper records. There’s no need to search and sift through dozens of documents to locate a specific paper and the technology eliminates misplaced files.

Errors and Reimbursementselectronic medical records

With an EMR, reimbursement claims are submitted electronically, in real time. The technology contains the ability to identify errors, mistakes and potential difficulties with claims before they’re transmitted.

A complete record of each transaction is maintained, along with patient balances, and payments can be received in as little as 10 days.

Electronic medical record provides the tools for clinicians to work smarter, not harder. They save time through increased efficiency and productivity within all departments, and work to identify errors and mistakes that can virtually eliminate denials and rejections. The result is that clinicians have increased revenues and the freedom to reap the benefits of their labor.

Reimbursement Using EMR System — The Secret to a Low-Delay Claims

Reimbursement Using EMR System — The Secret to a Low-Delay Claims

As insurance companies scrutinize reimbursement submissions more closely, clinicians are enduring longer turnaround times to collect money on claims.

The simple installation of an integrated EMR can transform those extended waits for funds into a low-delay reimbursement system and Nitin Chhoda explains it here, in this article.

reimbursementEMRs enable faster reimbursements and can detect claims with potential problems before they’re submitted, virtually eliminating denials.

The majority of denials and contestations can be traced to simple human errors in data entry and by preventable problems that can be avoided by verifying a client’s insurance coverage before services are rendered.

An integrated electronic medical record submits claims electronically to arrive almost instantaneously at the intended destination and can detect an extensive array of errors and notify practitioners prior to submission.

Human Data Entry Mistakes an EMR Can Help Avoid

Mismatched, incorrect procedure codes and improper patient information that doesn’t reflect the information for the client’s complaint is a common cause of denials. An example would be listing a procedure for a male when the client is female.

Each insurance provider has its own set of rules for reimbursement submissions. That includes specific claim forms. An infraction results in an automatic denial until the correct forms are submitted.

Health insurance providers are requesting prior authorization for an increasing number of treatments and procedures. If the clinic fails to obtain authorization, the insurance company can refuse to pay clinicians anything.

It happens infrequently, but a patient may need to see their healthcare professional twice in the same day to receive the same or similar treatments. Practitioners encounter difficulties when submitting these types of claims. Insurance companies view this as a duplicate reimbursement request and will reject it automatically.

It would seem like common sense, but clinicians who don’t file reimbursement claims in a timely manner will forfeit payment. Practitioners have one year to file their claim and such oversights can cost clinics thousands of dollars.

Check the Facts Before Treatment Begins

In a time of high unemployment and loss of benefits, it’s essential for practices to verify insurance coverage and client information before the patient ever reaches the clinic. An EMR provides the means to accomplish these and other tasks with alacrity, reimbursement claims included.

Insurance coverage that has lapsed, been terminated, wasn’t in force when the patient received services, and clients not eligible for coverage represent a major reimbursement problem for practitioners. All of that information can be ascertained easily prior to the patient’s appointment.

Many healthcare insurance providers are offering basic or minimal services and few patients understand their coverage or limitations. It’s imperative that clinicians determine the type of treatments covered under each insurance plan.

What constitutes a reasonable fee for practitioners and insurance companies varies widely. Each insurer has its own guidelines on the amount that can be reimbursed for specific treatments and reimbursement claims that exceed which will be rejected for unreasonable fees.

reimbursement claimsClinicians and insurers also differ on procedures. Ordering a CT scan instead of a less expensive x-ray can result in a determination of not medically necessary by the insurance company and loss of income for the practitioner.

An EMR represents the best solution for a low-delay reimbursement system. It has the tools to identify an extensive array of human errors that will delay or prevent claim payments.

An integrated EMR is the key to verifying patient information and insurance coverage to ensure practitioners receive the reimbursement to which they’re entitled.

HITECH Act – Economic Stimulus for EMR Adoption

HITECH Act – Economic Stimulus for EMR Adoption

The Health Information Technology for Economic and Clinical Health (HITECH) Act helps physicians to cope with the EMR transition by providing financial assistance.

Nitin Chhoda elaborates on the importance of the HITECH to practices that are just starting to use electronic medical records.

HITECHImplementing electronic medical records system is an expensive undertaking, but assistance is available to defray the cost as part of the American Recovery and Reinvestment Act (ARRA) of 2009.

Federal funds were allocated in the act to help ease the cost of transitioning to an EMR and to facilitate an increase in their usage.

The portion of the act that deals with financial assistance is the Health Information Technology for Economic and Clinical Health Act (HITECH).

HITECH Act

Depending upon the vendor, an EMR can easily cost $45,000 or more, an amount that takes a big bite from the budgets of smaller practices. Through HITECH, physical therapists can apply for financial aid as “meaningful users” of EMR systems.

The act makes provision for $18 billion through Medicaid and Medicare reimbursement systems, $2 billion for necessary infrastructure, and $1 billion for acquiring IT professionals, along with repair and renovation of health centers.

HITECH also sets aside $550 million as an incentive to purchase equipment and services, and $400 million for research on the impact of EMRs. In addition, $300 million has been earmarked towards health information exchange among providers and $40 million to facilitate the submission of disability claims to the Social Security Administration.

EMR Implementation

Implementing an EMR requires training of authorized users and grants are available for training centers for IT staff needed to support necessary infrastructure. Practice owners that can exhibit meaningful use of EMR-certified technology are eligible for a variety of HITECH funding, but many clinicians still aren’t aware the money is available, or that incentives are only being offered until 2015.

Many incentives hinge on the HITECH’s “meaningful use” clause and it’s a term that’s been confusing to many clinic owners. Meaningful use is a three-pronged approach to the incentive program established by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT.

Stage One

Stage one encompasses 25 criteria and consists of 15 core requirements. Of the remaining 10, therapists have the option of choosing five to comply with requirements.

In stage one of HITECH Act, therapists must adopt an EMR by Dec. 2014 that meets government requirements to qualify for federal funding. To qualify for the maximum amount of HITECH incentive money, clinicians have to attain meaningful use standards at least 90 days before the end of Sept. 30, 2012.

Stage Two

HITECH stimulusStage 2 of meaningful HITECH use launches in 2014 and is a continuation of stage one.

It includes increased demands for electronic transactions, the exchange of health information electronically, and online access for patients to their health data.

Stage Three

Stage three activates in 2016.

Therapists must continue to meet the requirements in previous stages and demonstrate that the quality of client care has improved.

With all that clinicians must keep in mind when implementing a qualified EMR, it’s easy to fixate on the cost and lose sight of the federal incentives available.

Therapists must implement an EMR, but they don’t have to shoulder the burden of expense by themselves.

Federal funding is available through the HITECH Act to assist practice owners purchase, equip and implement an EMR, install the needed infrastructure and obtain training for staff members. Deadlines are attached to federal dollars, making it essential that clinic owners begin evaluating their options as soon as possible.

Claim Appeals 101

Claim Appeals 101

Reimbursement claims can be denied at any time and for any number of reasons. Most problems can be remedied easily, but when talking fails to facilitate a desirable outcome it may be necessary to file an appeal. In this revealing article, Nitin Chhoda addresses the basics of filing an appeal.

clearinghouseMost appeals in the billing process, physical therapy billing included. will involve commercial insurance companies.

How a clinician approaches an appeal has a huge impact on how quickly and smoothly the process is concluded.

Unfortunately, the onus is on the practitioner to prove why a claim wasn’t processed properly for payment. That requires knowledge of the payer and the terms of the contract that was signed with the insurance provider.

Provider Relations

Many contracts include a prompt pay clause that can cost the payer fees and interest on late payments if they didn’t file or process the claim according to the terms of the contract. The first point of contact when filing an appeal will usually be provider relations to ascertain if the claim was received and how it was processed.

A phone call can be all that’s needed to quickly remedy the situation. Some payers provide online reconsideration forms that can be submitted, while others require a formal written appeal. It’s critical to maintain complete documentation of all verbal and written communication associated with the appeals process.

Provider Representative

If the claim wasn’t processed due to the contract loading incorrectly in the payer’s software system, the next step is to speak with the provider representative. This individual is charged with ensuring the contract between the medical provider and payer is correct and loaded in the claims processing software system.

Expect to be vetted and answer specific questions about the claim. The provider representative may be able to locate the problem and solve it.

Representatives also have the power to send the claim back to the payer for reprocessing.

Written Appeals

If a phone call fails to resolve the issue, a written appeal must be submitted. It should include all the pertinent information about the claim and clearly state the expected outcome for settlement. Explain why the actions are being sought and further steps that will be taken, such as referring the matter to the practice’s attorney.

Exercise Control

Appealing a claim rejection is time consuming and frustrating. It’s critical to exercise control and professionalism at all times. claim submission

The appeals process relies on facts for resolution and it’s important to clearly state the problem and the payment expected. Refer to specific clauses in the contract to prove points.

A denied or rejected claim delays payment and appealing the decision can require considerable time and effort.

The process is sometimes necessary to collect the fees to which clinicians are entitled and it’s important to keep a cool head throughout the process.

Most disputes with commercial payers can be solved if practitioners approach the situation armed with the facts and the terms of the payer contract.