Medical Billing Company Is Easier With an EMR

Medical Billing Company Is Easier With an EMR

To make your EMR more convenient, integrating it with a medical billing company is a good option.  NItin Chhoda explains why connecting your EMR system to a medical billing company software will make it easier to use.

medical billing company EMRThere are many advantages of electronic medical records and one of the most often emphasized is the advantage for medical billing staff.

Everyone else in the office can be a bit faster and more efficient, and the medical biller can process information much more smoothly.

But having an EMR isn’t just for those medical practices that do their own billing. Even if you hire a medical billing company, having an EMR will have distinct advantages over processing billing any other way.

Information Integration

The only challenge of hiring a medical billing company is deciding how the critical notes and information will be transferred from your practice to the medical billing company.

The billers will need a lot of information from your practice, and to ensure that information is accurate, you will need to integrate your information systems. It’s possible that this will not be an issue if you have a high quality EMR that records all of your information already.

Make It Digital

If clinicians are recording their appointments and notes using digital media, then the first step is already taken care of. The only question will be how to transfer the information from your practice’s EMR to the medical billing company.

Most medical billing companies will have experience with a number of EMR systems and with figuring out a transfer system. If you hire an independent contractor to handle your medical billing, rather than a medical billing company, they may be willing to adopt your software, making the process incredibly simple. And of course, if your EMR is online, then all the biller will need is access to the site.

Software Developed by Medical Billing Companies

There are also a number of medical billing companies that have decided to design their own medical billing software. This has distinct advantages for the medical billing company.

They can customize the software to suit their needs and preferences. Customized software can be a bit harder to get used to, but in the end it should work better than any other solution on the market because it will be designed with very specific needs in mind.

It’s possible that your practice will need to integrate your system with the custom system that the medical billing company is running.

medical billing companyIntegrated Solutions

Usually, they will have the solution already, offering a satellite feature of the software that can be used in your office. If their software solution is integrated with the Internet, you may be able to access it online.

No matter what you end up doing, having an EMR ready in place will allow you to transfer information quickly and efficiently.

In fact, when choosing a medical EMR, consider the reporting capabilities and features that will allow you to work with a medical billing company. There are plenty of EMR solutions out there that are designed to make medical billing easy, whether you do the medical billing in-house or you hire the work out to a medical billing company.

Physical Therapy Software: Relationship Between EMR, Clearing Houses, Payers and Your Wallet

Physical Therapy Software: Relationship Between EMR, Clearing Houses, Payers and Your Wallet

The major roles of EMR, clearing houses, and billing are very important because the flow of the business depends on it.  Nitin Chhoda explains these relationships and the impact it has on your practice’ income.

physical therapy software Reimbursements from private insurance, Medicare, Medicaid and Workers’ Compensation are the primary sources from which physical therapists collect revenues.

Those income sources pay the bills and salaries, fund expansion and equipment.

In an age where payments are being limited, capped and questioned, physical therapy software EMR offers assistance in locating the best payers that directly affects a practice’s profit margin.

An EMR offers online submissions for quicker turnarounds on payments, along with billing and coding options for greater flexibility. Physical therapy software also provides the means to identify the best payers.

Contracts with Payers

Therapists may have negotiated contracts with primary payers, but that doesn’t mean the dollars are going to start rolling in. Preferred provider organizations (PPOs) often sell their contracts to third party administrators (TPA) or another PPO that reimburses at a lower rate.

Selling contracts to other providers is a common practice, but most probably the one that’s financially disastrous for clinics. EMRs offer physical therapy software analytic tools that can be used to track payments from a wide range of third-party payers.

Therapists can ascertain which organizations pay the highest reimbursement rates and those that don’t limit or cap payments or services. EMRs offer physical therapy software billing and coding options to ensure practice owners are receiving the highest level of compensation for their services.

The Role of Physical Therapy Software

physical therapy software relationshipsPhysical therapy software provides the means for therapists to compare and contrast the financial benefits of working with specific third-party payers.

The current trend in healthcare is toward cost reduction, which directly affects access to established and potential patients.

Cost reduction is beneficial for insurance companies, but the plan doesn’t provide adequate reimbursements for clinic owners and their services. EMRs offer therapists physical therapy software options that help grow their practice.

Any therapist operating their own practice will soon learn about clearinghouses and the role they play in keeping their clinic funded. Millions of claims are filed with carriers each day, all of which would be traveling by mail to the four corners of the earth.

Clearinghouses and More

Clearinghouses were established to facilitate claims processing, resolve reimbursement issues and address physical therapy software errors. An EMR sends a therapist’s claims to clearinghouses electronically where they’re received almost immediately and checked for errors, before making their way to the specified payer.

The entire process can be accomplished in a matter of hours, compared to traditional mail that could take days to reach its destination. With the assistance of an EMR, questions can be answered, errors addressed, and corrections can be accomplished in the blink of an eye for a quicker turnaround on reimbursements.

Before the advent of physical therapy software EMRs, it could take weeks or even months of paper-based communications to clear a claim question and deposit the funds in a clinic’s account.

Physical therapy software provides the means to submit claims and obtain reimbursements quicker, offering better cash flow for any clinic.

An EMR saves long, tedious hours of phone time with individual insurance providers clarifying claims, allowing therapists to spend more time treating patients and less time waiting for reimbursements. They also contain the essential components needed for compliant physical therapy documentation to protect practice owners from a variety of legal ills.

Physical Therapy Billing: On-Site Patient Credit Card Processing

Physical Therapy Billing: On-Site Patient Credit Card Processing

The ability to accept credit or debit cards as a form of payment for physical therapy services rendered can boost practice revenue.

Presenting patients with simple, convenient ways to make payments and recurring payments if necessary is a way for a practice to minimize accounts receivables and increase cashflow, according to Nitin Chhoda

physical therapy billing process

Credit and debit cards represent one of the most convenient and easy way for patients to pay their bills, while providing practices with a point-of-purchase solution to collect funds before the client exits the clinic.

Physical therapy billing allows patients to make one time and recurring payments at the office and online to boost revenues. Patients are much more likely to relinquish co-pays and fund their healthcare costs if all they must do is provide their credit or debit card information.

Ease of Access

Convenience is the keyword for the 21st century clinic. Today’s population is busy and mobile, with little time left after meeting, work, and family obligations. Few clients carry cash with them nowadays, but virtually everyone has a credit, debit or pre-paid card.

It’s a trend that therapists can utilize to their physical therapy billing advantage. For those who want to move into the electronic age of physical therapy billing,coding and collections, an EMR is the first step. Financial institutions have offered online payment options as a courtesy for their members for years.

EMRs provide the same service through patient portals where clients can make a one-time or recurring payment without the need to enter extensive billing information.

Payments Made Simple With the Help of EMR

EMRs allow patients to make physical therapy billing payments from home or from their mobile devices, and funds can be transferred into the clinic’s account in as little as 48 hours. Practice owners can offer a variety of incentives to patients who pay with their cards, from special discounts to membership programs.

Many credit card issuers offer their own incentives, and when combined with offers from a practice, it provides additional motivation to pay early and often. physical therapy billing patient cardA physical therapy practice is a business and clinic owners must look at every available avenue to collect for their services.

Therapists can immediately determine if funds from physical therapy billing are available so as to initiate a transfer if payments are made at the office.

An EMR with a patient portal allows individuals to pay their bills and manage their financial obligations to the practice more effectively.

The ability to accept credit and debit cards can increase revenue by as much as 23 percent. Instead of waiting up to 90 days for a check to clear, funds can be deposited directly into the clinic’s account for better cash flow. Credit card processing becomes an automatic physical therapy billing process for savings in time and effort.

The Convenience of Using Credit Card 

Accepting credit cards via an EMR is an environmentally desirable solution that saves natural resources and cuts costs for practices. The ability to accept credit cards provides a speedy, flexible and convenient means of delivering a superior level of customer service.

Clinics also gain credibility from established and potential patients. Therapists utilizing physical therapy billing software contained within an EMR are perceived as the most modern and desired therapists. An EMR with physical therapy billing capabilities provides convenience for patients and increased cash flow for clinics.

Credit and debit card processing for one time and recurring payments enables practices to collect quickly for their physical therapy billing services and are perceived better by patients, leading to clients who enthusiastically recommend the practice to family, friends and co-workers. Combined with real time, automatic claim submissions, therapists can significantly boost their cash flow, even in a vexing economic climate.

Physical Therapy Billing: Real Time, Automatic Claim Submission to Boost Cash Flow Reiterated

Physical Therapy Billing: Real Time, Automatic Claim Submission to Boost Cash Flow Reiterated

Paper-based physical therapy billing not only consumes a lot of time but is also prone to claim submission errors that will affect the practice’s revenue.

Nitin Chhoda shares how an integrated physical therapy EMR can produced automated claim submissions and boost cash flow for your business.

physical therapy billingA steady cash flow is a primary concern for any physical therapy practice and it’s one of the most difficult aspects for clinic owners to predict.

Coding errors, claim denials and time spent exchanging correspondence via the postal service reduce the turnaround time on physical therapy billing reimbursements and can quickly place a clinic in the red.

Billing with EMR

The future for physical therapy practices of all sizes is good physical therapy billing through the utilization of an EMR.

They offer superior coding options to reduce denials and errors, while providing paperless electronic claim submissions that reach their destination almost instantly.

Submissions can be transmitted individually as clients are seen or set for a batch submission at the end of the day.

One of the biggest problems facing practices is the need for proper coding and documentation in the claims process to ensure clinics receive the reimbursements to which they’re entitled. Information management is a hallmark of automatic claim submissions, providing crucial physical therapy billing and documentation to facilitate and accelerate the reimbursement process.

Paper Submissions are Reduced

Electronic submissions reduce the need for paper physical therapy billing and invoicing for significant savings and can reduce associated costs by up to 15 percent over traditional methods. Electronic submissions are environmentally friendly, highly efficient and enable therapists to collect for their services in hours instead of weeks.

Funds are automatically deposited in the practice’s account. Coding errors are the bane of a physical therapy clinic and electronic claim submissions offers a wide variety of options to accommodate physical therapy billing by the session, services rendered or treatment setting.

Electronic claim submissions via EMRs are secure and HIPAA-compliant. Claims can be sent virtually to any agency or payer with which therapists work, from private insurance, Workers’ Compensation and TRICARE for veterans to Medicare, Medicaid and clearinghouses.

Software for Physical Therapy Billing

physical therapy billing claims submissionPhysical therapy billing software can virtually eliminate coding errors and drastically reduces the number of denials, post-payment audits and requests for clarification.

When an instance does occur, disputes can be handled quickly and efficiently through electronic methods.

EMR documentation software provides a clear record of the patient’s visit so therapists don’t inadvertently submit claims that contradict coding and billing rules or lack specific billing codes.

Electronic claim submission capabilities allow clinic owners to file for reimbursement from any location with Internet access. The system enables payers to deliver crucial correspondence and responses through the same claim submission system.

Automated Physical Therapy Billing

An automatic physical therapy billing record is created of what was filed and when, along with the current status of the claim. Ceilings on payments and reduced benefits for employee insurance programs are costing practices dearly.

Physical therapy billing software enables clinic staff to verify a patient’s insurance eligibility and range of coverage before they arrive at the office. Therapists can utilize that information to develop a treatment plan that falls within the constraints of the client’s available coverage.

Automatic claim submissions provide enhanced coding options to boost reimbursement levels. Submissions can be set to send individually, or as a batch at the end of the day for added convenience.

Physical therapy billing allows therapists to receive payments in hours or a matter of days instead of weeks for better overall cash flow. Superior speed and documentation significantly reduces errors, denials and audits, while placing more cash in clinic coffers where it can do the most good for the practice and patients.

CPT Codes Defined

CPT Codes Defined

Along with ICD-10 is another term called CPT codes. Nitin Chhoda defines and differentiates these two terms, and explains the impact they will have on the whole physical therapy documentation process.

Practitioners must become familiar with the codes in order to minimize errors upon claim submissions.

CPT codesWhile owners of physical therapy practices are contending with the switch to ICD-10 coding, another term with which clinicians must be familiar with is current procedural terminology (CPT) codes.

CPT Codes

Every procedure, task, service, device and surgery a patient receives is associated with a specific numerical code. Insurance companies utilize CPT codes to determine the amount healthcare providers will be paid and CPT codes must be linked by medical necessity.

The American Medical Association (AMA) develops and copyrights CPT codes. They’re responsible for changing, revising, updating and discarding those that become obsolete as new technology and treatments become available. They encompass thousands of individual codes that are updated annually.

CPT codes, even when used in physical therapy documentation purposes, are uniform and apply to all clients except those with Medicare coverage. Medicare utilizes the Healthcare Common Procedure Coding System (HCPCS) that encompasses three levels of coding.

HCPS Levels

HCPCS Level I is maintained by the AMA and Level II consists of alphanumeric codes. Level III codes were abolished in 2003 and were state-developed for Medicaid and Medicare contractors. Therapists should be aware that the reimbursement amount for each code varies widely among insurers and assigning the correct code to the appropriate treatment is a complex endeavor.

An EMR facilitates the process, but clinic owners will want to ensure their coding and billing expert has the best possible training to manage CPT codes and the upcoming ICD-10 changes, along with a thorough knowledge and understanding of medical terminology. Entering the wrong codes will result in denials and delays in reimbursements.

It’s imperative that physical therapists use the code that most accurately reflects the service or treatment that was provided. It should match the current ICD coding and therapists must provide sufficient documentation to support the CPT code that was entered to avoid denials, audits and requests for more information.

CPT codes definedCPT Codes Standard

CPT codes allow for two-digit modifiers should they be required, but they must conform to standard definitions. Incorrect coding costs valuable clinical time, interrupts cash flow and can delay essential services to clients.

CPT codes provide the means for healthcare providers to communicate effectively with insurance companies about the services, treatments and procedures rendered to any given patient.

Using correct coding is essential if clinicians are to be adequately reimbursed for their expertise and ensures payments reach the clinic in a timely manner.

There is no uniform payment for specific procedures. Each insurance provider has its own fee schedule and reimburses according to the company’s guidelines. Proper coding ensures therapists are reimbursed at the highest possible level.

An EMR provides clinic owners with tools to monitor and track agencies that provide the best reimbursements, allowing them to make informed decisions about the best payers with which to contract.

The use of CPT codes in conjunction with ICD codes directly affects the profitability of practices. It’s a complex system that requires knowledgeable staff, careful attention to detail, and stringent documentation to support every diagnosis, treatment and procedure. An EMR makes the coding and billing process easier, and provides practice owners with the tools to track the best payers for increased revenues.

Healthcare Coding Basics

Healthcare Coding Basics

In the 21st century, paying for visits to healthcare providers is a simple process for patients. They simply present their insurance cards, make a copay and go on their way.

The system can be a nightmare for medical insurance billers (MIBs), who complete hundreds of reimbursement claims each week covering a wide spectrum of treatment. In the following article, Nitin Chhoda examines what MIBs need to know about healthcare coding basics.

healthcare codingMIBs will encounter a multitude of technical terms in healthcare coding that will affect the codes used when preparing a claim for reimbursement.

Billers will need to be fluent in medical terminology and healthcare coding procedures to accurately code claims.

The knowledge enables them to submit claims that are reimbursed quickly, meet the demanding standards required by insurance carriers, and maintain compliance with federal and state standards.

Documentation

Billers will be working with multiple and disparate healthcare coding documentation that provides substantiation to payers that the services, procedures and treatments provided were needful and appropriate to the practitioner’s diagnosis.

Each piece of documentation is the evidence that carriers will utilize for reimbursements and a single omission will result in a denial.

CPT Codes

The acronym CPT stands for current procedural terminology. CPT codes will be used on claims to describe the medical services and procedures provided by the practitioner.

CPT codes must match the services they represent to avoid denials and payment interruptions. This is very important.

ICD-9 Codes

The International Classification of Diseases (ICD) codes will soon be updated to CPT-10 to encompass new diseases and technology.  The alpha-numeric healthcare coding is the primary diagnostic tool used to document and explain the signs, symptoms, illnesses and diseases clinicians will encounter.

The codes provide insurance companies with essential information about a patient’s condition and resulting treatment.

Some billers will encounter alpha-numeric C codes and V codes:

  • C codes are used to identify the external causes of poisonings and injuries.
  • V codes are utilized to categorize factors that have a direct influence on a patient’s health status, along with encounters that aren’t due to an illness or injury.

Modifiers

There are times when a procedure is altered from its original description. Healthcare coding modifiers are used when a procedure requires additional time and expertise, or has extenuating circumstances.

Billers will use the two-digit modifiers in the CPT healthcare coding to report such occurrences. They provide MIBs with the means to bill very specifically and obtain additional revenues to compensate practitioners.

Modifiers are also appropriate when a technical component (TC) is involved.

Sometimes a clinician will need the use of equipment, labor and/or supplies to perform a procedure that is maintained by another specialist or medical facility.

healthcare coding basicsModifiers in healthcare coding are used to explain that those items are billable by entities other than the practitioner.

MIBs will encounter a host of different codes and medical terminology that must be entered on claims accurately to facilitate quick reimbursements and avoid costly denials and delays.

Medical billing staff who are familiar with the healthcare coding basics are well on their way to becoming masters in their profession.