Do Cash-Based Practices Need an EMR?

Many therapists are beginning to add cash-based services to their practice offerings—everything from gait analysis and golf fitness programs to aquatic therapy and deep tissue massage. After all, as Brooke Andrus writes in this post, “…in the current environment of declining reimbursements from third-party payers, adding cash-pay options to your practice’s current menu of services isn’t only smart—it might just be necessary to secure your survival.”

For some, offering a few cash-pay wellness services on the side might be enough, but for others, like physical therapist Ann Wendel, it’s cash-based all the way. While this business model certainly alleviates a lot of headaches when it comes to dealing with payer contract negotiations and increasingly stringent payment regulations, operating a cash-based practice isn’t all sunshine and rainbows—which is why even cash-based practices need an excellent EMR. Here are a few of the biggest reasons cash-based practitioners should equip themselves with top-notch EMR system:

Your patients still need insurance reimbursement, even if you don’t.

Sure, you get paid immediately, but many patients who are willing to pay out of pocket for physical therapy services do so because they’re able to submit claims to their health insurance providers and receive reimbursement directly. In this post, Wendel writes, “You may find it shocking, but my documentation and billing practices are not that different from [those of a PT in a traditional practice]. The end goal…is to get paid—it’s just that in my case, it’s the patient who is waiting for reimbursement.”

To ensure your patients are able to continue benefiting from your services, you have to help them get their money back—and that requires the same attention to quality documentation and billing processes you’d need to demonstrate if you were collecting reimbursements for yourself. But you’re not going to get that level of quality with pen and paper—or with a subpar EMR. That’s because only the best EMR solutions feature the alerts and safeguards necessary to ensure you create correct and comprehensive documentation that supports your invoices, gets them paid the first time around, and helps you generate those invoices and track patient payments—all within one streamlined system. And only the right EMR securely stores all that information—along with your patients’ medical records—so you can access it anywhere, anytime while remaining fully HIPAA-compliant. Plus, a physical therapy-specific EMR provides SOAP note formats that fit your workflow, so documentation is a breeze.

An EMR does more than improve documentation.

No matter how you choose to collect payment for your services (i.e., via cash pay or through third-party insurance providers) you still have a practice to run. And there are some practice management benefits that only the right EMR can provide. These include:


An integrated scheduling feature allows you to view and edit schedules for patients, therapists, and treatment rooms. And, because your calendar is connected to your documentation, your patient records and patient appointments are linked—thus enabling you to gain valuable insight from tracking no-shows, cancellations, and lost patients.

Automatic Patient Reminders

Sending your patients automatic appointment reminders via phone, text, or email can help you maximize your office hours and reduce no-shows. Plus, you can track your results directly within the EMR.

Referral Reports

Curious as to which referral sources are generating the most business for you—and which ones might need a bit of extra attention? Use referral reports to identify the marketing efforts that are worth your while.

Information Sharing

Whether it’s with your own staff or other members of a patient’s healthcare team, information sharing is critical to ensuring excellent care at every level. Use your EMR to easily communicate with staff via secure instant messaging and with external providers via secure email and faxing. Plus, with the right EMR, all of your external communication will be legible and branded with your clinic logo (talk about a leg up on the professionalism front).

Outcomes Tracking

An integrated outcomes tracking solution allows users to collect objective data, thus empowering them to prove their value and enhance patient care. With a library of standardized, industry-accepted tests, you can set concrete performance goals and track your team’s progress toward them. That’s great for your patients—and for your bottom line.


HIPAA breaches are incredibly costly and can destroy patient trust, which is critical in a provider-patient relationship. With the right EMR, the burden of keeping PHI safe doesn’t rest solely on your shoulders, because the application is fully HIPAA compliant and stores all your data in a world-class, extremely well-guarded data center. Now, that’s a whole lot better than keeping it in a filing cabinet in your clinic—fireproof lock or not.


In case you’re wondering, Wendel uses WebPT, because she likes the portability of a web-based application, the fact that she doesn’t need to store paper charts in her basement for seven years, and the professional quality of the notes she’s able to securely send to physicians and other healthcare professionals on her patients’ care teams.

Want to learn more about the best EMR for cash-based practices? Schedule your complimentary demo of WebPT today.

What’s the Best Software for Physical Therapists?

There are plenty of software systems for physical therapists on the market today, but you wouldn’t want to waste your time on anything but the best—especially if the best is super affordable with no long-term contracts and a ton of fantastic features, right?

Here’s what you should be looking for in the very best software for physical therapists:

One with an Intelligent ICD-10 Tool

Your EMR doesn’t need to make your breakfast à la Rosie from The Jetsons, but it does need to help you stay ICD-10 compliant. Make sure yours does the following, at the very least:

  • Prompts you to document the specific details of every patient’s injury or issue
  • Suggests a more specific code when one with a greater level of specificity exists
  • Alerts you when you’ve selected an invalid code or one that’s not billable
  • Maintains a complete library of ICD-9 and ICD-10 codes (some payers, like auto and workers compensation companies, can still use ICD-9)
  • Provides free ICD-10 training, support, and resources
  • Bases its ICD-10 code library on more than just general equivalence mappings (GEMs)

Beware of any EMR that claims to have an automatic one-to-one crosswalking tool that translates ICD-9 codes into ICD-10. According to this ICDLogic whitepaper, ICD-9 and ICD-10 “differ so widely that all attempts at translation offer only a series of compromises and subjective choices. This is necessarily so because there is no ‘mirror image’ of one code set in the other.” In other words, beware: they aren’t a magical solution and can end up costing you a lot of problems (read: claim denials) in the long run. Instead, go with a software that helps you streamline your ICD-10 coding by using detailed, defensible electronic documentation as the foundation for code selection.

One that’s a Certified PQRS Registry

Physical therapists have the option to report PQRS via paper, but why would you? Medicare has made clear that it intends to move toward electronic reporting for all future regulations. (That’s why, over the last few years, CMS has been strategically removing claims-based reporting eligibility for certain PQRS measures, encouraging providers to go the registry-based route.)

But even if claims-based reporting was here to stay—which it isn’t—there are plenty of other reasons why the best software for physical therapists also is a certified PQRS registry.

Here are some of the benefits of registry-based reporting:

  • All you need to do is choose your measures and document. The right software manages the rest (read: collects your reporting data and submits it directly to CMS).
  • You won’t ever have to complete a paper PQRS form for an applicable note again. With a certified PQRS registry, the measures on which you choose to report are built right into your documentation.
  • You get automatic checks and balances, because the registry will alert you if you’re not properly reporting.
  • The available measures are always up to date based on the most recent final rule.

One with Built-In Outcomes Tracking

We’re in a pay-for-performance healthcare environment, so it’s crucial for therapists to have the tools necessary to demonstrate their value. That’s why the best software for physical therapists has built-in outcomes tracking, complete with a library of evidence-based, risk-adjusted tests—as well as integrated patient surveys and comprehensive reports—that are already familiar to, and respected within, the healthcare community at large. With access to these tools, you’ll be able to objectively demonstrate your clinical performance to insurance providers, patients, and referrers.

Here are some of the outcome measurement tools your software should include:

  • Quick DASH
  • Lower Extremity Functional Scale (LEFS)
  • Oswestry
  • Neck Disability Index
  • Dizziness Handicap Inventory

One that’s Web-Based

You’re busy treating your patients and running a practice, which means your software systems need to be available whenever you are, wherever you are. That’s why the best software for physical therapists is web-based, so you can access—and document—your patient records, schedules, and reports from any device with an Internet connection.

Plus, your data is secure, because each therapist, PTA, front-office staff member, and administrator has a unique ID and password. This way, clinic owners can control everyone’s access to patients’ protected health information. And all of that data is housed in gold-star data security centers like IO in Phoenix, which boasts a defensible perimeter, digital video surveillance, biometric screening, and round-the-clock armed guards—so there’s almost no threat of a physical or digital breach impacting your data.

Finally, the best web-based software is always up to date with the latest technology and compliance regulations, because it can make upgrades and amendments fast—like, as fast as Medicare changes its reporting regulations. Speaking of updates, the best software for physical therapists provides updates:

  1. automatically,
  2. at no charge to you, and
  3. with as little downtime as possible.

To learn how much downtime is the right amount, check out this article.

One that’s Designed for PTs

You’re a physical therapist—not a physician, not an opthamologist, and not an oral surgeon. And that’s an important distinction, because your software solution should be tailored to you and your workflow—not theirs. The best software for physical therapists comes complete with a host of other features that make it easy for users to succeed in business, including:


If you’re thinking there’s simply no way that one software solution offers all of this, think again: WebPT has it all and more. Schedule your complimentary demo today to see for yourself.

5 Reasons Why PTs Love Their Cloud-Based EMRs

Some physical therapy clinics seem to have it all together: documentation gets done in a flash, claims are processed—and reimbursed—with ease, and everyone’s up-to-speed on all the latest regulatory changes. Maybe they’re born with it—or maybe it’s their EMR. Great cloud-based EMRs are designed with PTs in mind; these systems help make running a clinic seem like a breeze. Here are the top five reasons why PTs love working with a cloud-based EMR:

1. Affordability

Thanks to the cloud, PTs no longer have to shell out big bucks upfront—or cover the recurring costs associated with manual updates and IT staff—to use server-based EMR systems. Plus, software-as-a-service (SaaS) EMR vendors typically offer month-to-month payment models, making a cloud-based EMR an even less risky investment—an especially crucial selling point for smaller practices. Plus, users of these systems can switch to another EMR at any time. Vendors know this, which means they’re dedicated to providing customers with the highest-quality products and support.

2. Support

Speaking of support, like your best friend (or a pint of ice cream), a good EMR vendor is there when you need it with top-notch customer service. Think you have to bust out a user manual or comb through compiled help files if you have issues during setup or implementation? Not with a cloud-based EMR that’s ready to assist you with how-to guides, extensive knowledge bases, and an expert support staff.

3. Ease-of-use

A great cloud-based EMR is simple, user-friendly, easily scalable, and flexible. PTs love that cloud-based EMR vendors provide constant software and compliance updates to improve the user experience. Some vendors even develop enhancements based on user suggestions. With cloud-based EMR systems, PTs never have to lift a finger to access the newest version of an application or waste time worrying about—or fixing—notes or claims that aren’t up to payers’ standards.

4. Security

When it comes to keeping your patient data safe and secure, never fear—cloud-based EMR is here. With bank-level security encryption, tough password guidelines, automatic data backups, audit trails, super-secure data centers, and specialized staff, cloud-based EMRs have your back (and your front, and your sides, and—you get the picture).

5. Accessibility

PTs enjoy the convenience of working with a truly cloud-based EMR, which can be accessed anytime, anywhere, from any browser, and on any Internet-enabled device (unlike those bulky server-based EMRs, which sit in your office like a bump on a log—and require downloads, installations, and manual upgrades).


Cloud-based EMR vendors work hard behind the scenes to make documentation, billing, compliance, and practice management less of a hassle—and less of a hit to a clinic’s budget. But it’s not just about saving time and money (or wearing long-lasting makeup). A truly great EMR makes PTs feel all of the feels. Why? Because these features give PTs the freedom to get back to doing what they love most: helping patients.

Is Your EMR Hurting or Helping Your ICD-10 Efforts?

We’re several days into the transition to ICD-10, and it seems like most folks made it through to the other side just fine. Many of you might even be thinking the new code set isn’t such a big deal. But is this the calm before the storm? After all, we’ve yet to see whether providers coded correctly, and thus, whether their ICD-10 claims actually will get paid. So, between watching the leaves change color and picking a prime pumpkin from the patch, you’ve got to maintain your ICD-10 efforts. While I’m sure you studied and practiced your tail off in anticipation of October 1, you may have overlooked one key part of a successful switch: your EMR. Here are two reasons why your EMR might be leaving you out in the cold (without your North Face jacket):

Automatic Conversions

Be wary of any EMR that claims it can automatically convert all of your codes or pick an ICD-10 code for you. While it may be tempting to “cheat” your way through selecting ICD-10 codes, taking shortcuts likely will come back to haunt you. As the American Health Information Management Association (AHIMA) explains in this post, thanks to “significant differences in language and structure between ICD-9 and ICD-10,” automatic conversions aren’t all they’re cracked up to be. The article explains that while “ICD-10 conversion can be highly automated [they] cannot be fully automated, and they cannot be finalized without review and evaluation by a person familiar with each system being converted.” In fact, AHIMA warns that “autoconverted ICD-10 systems may not work as intended, and skipping a human review can expose an organization to legal and financial risk once the converted systems go live.” If your EMR has automatically converted all your ICD-9 codes, do your due diligence. If you don’t make sure the conversions are accurate and as specific as possible, no one else will.   

Cheat Sheets

Some EMR vendors have created cheat sheets, and those resources might seem like a great idea, because they convert your most frequently used ICD-9 codes to their ICD-10 code counterparts. But according to this resource, that’s exactly the problem. Why? Because “pain codes…are the most commonly used ICD-9 codes for PTs. In ICD-10, though, you shouldn’t use a pain code as a patient’s primary diagnosis if you can help it. ICD-10 requires a far greater degree of specificity; thus, payers want you to code for the underlying injury or condition first and foremost. Only then should you list the pain codes associated with the main diagnosis.”

Plus, even though seventh characters are required for injury codes, cheat sheets don’t account for the seventh character because this character—and the information it represents—doesn’t exist within ICD-9 (hence, part of why we needed to make the leap to ICD-10). Plus, you must use clinical judgement to determine which seventh character best describes the patient’s condition or treatment phase. Don’t waste your time on an EMR that spends its time creating cheat sheets that put your practice at risk.

Working with an EMR that relies on code selection shortcuts is like wearing Uggs with shorts: just plain ridiculous. So, how do you know your EMR can protect your clinic’s productivity and cash flow post-transition? Look for an EMR that offers these three crucial features:

1.) An intuitive ICD-10 code selection tool

Your clinical judgement is critical to selecting the correct ICD-10 codes. An intelligent ICD-10 tool can assist you with making the best choice possible while simultaneously ensuring that you, as the therapist, make the final judgement call.

2.) Built-in alerts and safeguards

Does your EMR let you know when you’ve selected an invalid or non-billable ICD-10 code? If not, you’re leaving your clinic open to a heap of trouble.

3.) Free training, support, and resources

If your EMR doesn’t offer free training, support, and resources, then figuring out how to use the system’s ICD-10 functionality—and understanding ICD-10 itself—is entirely up to you.


Don’t settle for a basic EMR (that doesn’t even like pecan pie-scented candles). When it comes to ICD-10, ensure your EMR isn’t out apple-pickin’ and pumpkin-carvin’ instead of supporting you in your transition efforts. If your vendor is taking shortcuts—or is plain ol’ unprepared—you could be left feeling like someone left the pumpkin spice out of your latte.

Physical Therapy EMR, Practice Management Software, and Billing System: What’s in a Name?

Say my name, say my name. When no one is around you, say PT EMR, PMS, and billing system, I love you—if you ain’t runnin’ game. Huh? Destiny’s Child may have said it best; but while rehab therapy providers aren’t runnin’ game, they might feel played by all of the indistinguishable healthcare jargon that directly impacts their workflow. So, what’s in a name? Could it be that you are at the crib with a misunderstanding? Here’s what you need to know about EMR, practice management software, billing systems, and how each one impacts your processes:

Physical Therapy EMR

You are, in fact, on, so I’m going to take a wild guess that you at least have an idea of what an EMR is. But do you know what your EMR really does? According to this WhatIs article, “An electronic medical record (EMR) is a digital version of the traditional paper-based medical record for an individual. The EMR represents a medical record within a single facility, such as a doctor’s office or a clinic.” And based on that broad definition, your PT EMR should contain everything your practice would document on paper—but in digital form. Some EMRs also include practice management, and they might even integrate with your preferred billing system. (Hint: An ideal EMR should offer reporting capabilities as well as billing integration options).

Practice Management Software

Speaking of practice management: Practice management (PM) software helps employees handle the day-to-day tasks involved in running a practice. These can include managing patient demographic information, scheduling appointments, and tracking business metrics through automated reports. Keep in mind that your EMR and your billing system may offer practice management capabilities as well. In fact, software systems that combine documentation and billing functions with practice management capabilities actually make a lot of sense, because the information that a PM system manages is already contained within the EMR or the billing system. And having all of this information right at your fingertips—in a readable, digestible format—makes any rehab therapy software system even more valuable.

Physical Therapy Billing System

When it comes to billing systems, the typical workflow revolves around an electronic process. That’s because, aside from payers like workers’ comp and auto insurance, claims are typically processed electronically—which requires software to handle the work. This SearchHealthIT article states it best: “Electronic medical billing is the process by which a health care provider electronically submits a bill, or claim, to a health insurance company, or payer, for the rendering of medical services.” Without a billing system (and software) in place, providers wouldn’t be able to submit, track, and process their claims. And in the interest of streamlining your workflow, you should look for a billing system that integrates with your EMR and includes PM functionality.


So, there you have it. A great EMR offers integrated practice management and billing systems so you have the ability to better manage your practice. And finally? Yeah, yeah, yeah, yeah, yeah, yeah—where my PTs at?

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.”


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).


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.