How an EMR Can Work Miracles for Your Billing Process

Physical therapy billing is a process that begins well before your patients even enter your clinic. If your process is efficient, your bottom line likely will grow as a result of your efforts. However, if your process isn’t streamlined, you might find yourself regularly dealing with claim denials and reimbursement delays. And when it comes to process efficiency, there are few factors more influential than your software. I’m talking about your physical therapy EMR. Because with the right EMR in place, your billing process can miraculously transform from a pain-in-your-rear-end into a revenue-boosting machine. Here’s how:

Decreased Errors

Human error is inevitable. Why? Because we’re only, well, human. In general, making a mistake affords you the opportunity to learn a lesson and grow from the experience. But when it comes to coding mistakes, the lessons you learn will cost you—big time—in the form of claim denials. However, there is something you can do. With the right EMR in place—one with top-notch functionality—you can minimize coding errors. According to this study, using an EMR can increase revenue with a “better capture of charges, and decreased billing errors.” The same study goes on to reveal that “computerizing the encounter form could decrease these [billing] errors by 78%.”

Knowing the ins and outs of coding is complicated—even with highly-skilled coders and billers on staff. And as a PT, it’s incredibly challenging to mentally retain all of the information required to accurately code—especially with regulatory requirements that are constantly shifting. Having a system in place with a comprehensive code database is crucial for coding accuracy (say goodbye to cheat sheets). Clinical judgement has always been a crucial part of the coding process, but with ICD-10 right around the corner, the ability to code to the highest level of specificity is even more important. After all, if you don’t select the most specific code possible, you risk claim denials. But with the help of an EMR, coding correctly shouldn’t be rocket science.

Increased Efficiency

Take a few moments to consider the number of hours your staff spends entering charges from super bills into a billing system. What if you could eliminate all of that extra manual data entry? You can. When you work with an EMR vendor that’s integrated with your ideal billing solution, you eliminate all double entry. Your data flows seamlessly from your EMR into your billing software. From here, you can electronically scrub claims and submit them without missing a beat. And that frees up your billing staff to work on resolving other billing issues instead of toiling away at unnecessary data entry. As HealthIT.Gov explains, an EMR reduces the “time and resources needed for manual charge entry resulting in more accurate billing and reduction in lost charges.” Who doesn’t love a reduction in lost charges?

Improved Cash-Flow

The right EMR will help you code efficiently and accurately with the help of comprehensive documentation profiles. The system should prompt you to comply with all compliance requirements as well as provide tools for more accurate coding (e.g., 8-minute rule guidance, modifier options, and a comprehensive ICD-10 tool). What does accuracy mean in terms of cash-flow? Everything. When your documentation supports accurate coding, you have the best chance of getting paid—fast.

An electronic system will help you quickly determine what code is appropriate and accurate for that treatment. What’s more? When you submit a clean claim with accurate codes—the first time—that claim is paid quickly, which means you don’t have to deal with the hassle of going back through attending documents and resubmitting corrected codes. This NCBI study further illustrates this point: “With an EHR system, many billing errors or inaccurate coding may be eliminated, which will potentially increase a provider’s cash flow and enhance revenue.”

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If your practice could use a helping hand with your billing process, it might be time to re-evaluate your EMR. With the right system in place, you can streamline your workflow, increase your revenue, and clean up your claims for better billing results. And it doesn’t take magic—just some help from an EMR system that has your back.


Billing Software vs. Billing Service—and How Your EMR Fits into the Picture

In today’s post, billing software takes on billing service, and I’m giving you a ringside seat. In this epic billing showdown, we’ve got two fierce competitors. (Cue the entrance music, please.) Coming in from the cloud and weighing in at, well, nothing is your in-house hero: billing software. And hailing from Anytown, USA, our second contender has fast fingers and laser-sharp focus on timely filing: It’s the trusted billing service!

Let’s have a fair fight, shall we? (Ding, ding.)

Billing Software

Billing is a big job, but someone’s got to do it—and when you use a billing software, that someone is you (or another member of your billing staff). If you’re a billing heavyweight—or if you’re willing to hire someone who is—then billing software is a great option for you. You get all the responsibility, but you also get all the financial insight and control over your claims. Plus, web-based software doesn’t require you to purchase any hardware, so you’ll likely save some moolah. Another major benefit? Keeping your billing in-house allows you to quickly locate and resolve any issues that come up—so long as you have perfected your billing workflow.

But if you lack the desire, expertise, or workflow efficiency to handle your billing in-house, you’ll want to take a closer look at working with a billing service.

Billing Service

Billing software is great if you prefer to fly solo, but when you have a billing service, you and your crew work like tag-team champions. Your front office still has a major impact on the success or failure of the process, but once you finalize and transmit your documentation to your billing service, your revenue cycle management team takes over and crushes those claims into submission. (See what I did there?) If you already work with a billing partner, look for a billing service that integrates with your vendor. Otherwise, choose a full-service billing service that will file claims quickly and correctly—and help you investigate and resolve billing errors and claim denials.

However, keep in mind that most billing services charge 6-12% of your monthly revenue collection. That means that unless your clinic’s monthly revenue remains steady all year long, you’ll probably have a hard time estimating your billing costs, which could be a real blow to your bottom line.

The EMR Factor

Simply put, regardless of the method you choose, it must integrate with your EMR. If it doesn’t, you’ll waste precious time and money on double data-entry and coding errors. Plus, you’ll have to grapple with limited access to crucial documentation and financial data. The future of heatlh care demands interoperability; why settle for a billing software or service that doesn’t communicate with your EMR?

Billing software and services are supposed to help your business—not hinder it—so avoid the ones that could end up costing you big (that includes software or service teams that aren’t up-to-date on the latest billing and compliance regulations and/or don’t understand the particulars of your specialty or region).

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Well, the match is over and the judges are split (I made that title belt for nothing). Neither option had a definite edge over the other, because it all depends on your clinic’s particular situation. Deciding whether to keep your billing in-house or outsource it to a billing service is a tough call to make, so you’ll need to take a good, hard look at your clinic’s needs, processes, staff, revenue, and budget before you declare a winner.