What is Physical Therapy Software?
A ‘one stop shop’ system should empower the therapists to streamline and integrate all aspects of the practice. This system should provide scheduling, documentation, billing, compliance and the monitoring of provider productivity. This integrated structure can reduce the time taken to submit claims, and improve cashflow.
The decision to get a physical therapy software, and to hire a billing service, is one of the most important business decisions for any clinic. It is crucial to choose a trusted company with proven results as your partner
The volatile and evolving nature of healthcare requires due diligence, and a highly informed decision prior to the selection of a service provider. In Touch Billing includes physical therapy software, including physical therapy emr, physical therapy billing software and physical therapy billing services.
Unlike other specialties, physical therapy billing is different from medical billing. Physical therapy practices need physical therapy specific billing software for more accurate and seamless billing. Aspects such as functional limitation (G code) reporting and modifiers like GP,KX are specific for physical therapy practices.
Here are some of the things you should look for, in a physical therapy software system:
Integrated Scheduling, Documentation, Billing AND Marketing
Your EMR should allow you to schedule a patient, document, bill the claim and follow up with the patient to increase referrals. It should be designed with the ‘end in mind’ – a system that allows you to run a streamlined, profitable practice.
Fast, Simple, Customizable Documentation
Your EMR and the billing software should allow fast, simple and comprehensive note taking. It should speed up physical therapy documentation. This allows you to concentrate on treating patients, instead of writing notes.
You should be able to create your own documentation templates, and control what you document in the subjective and objective components of your notes.
When you complete your notes faster, you will bill faster and leave your office sooner, moving one step closer to a lifestyle of freedom and independence as a healthcare professional.
Your EMR should empower you to narrate your own clinical decision pathway. Your patients, your way. It should adapt to you, not the other way around.
If a patient exceeds the therapeutic cap, the billing software should have an automated alert system to append KX modifier. This will help prevent denials from payers who cite the reason “Maximum Benefits Reached”.
The EMR system should also include alerts for upcoming progress notes, upcoming reevaluations, upcoming physician certification requests (expiring plan of care), documents that need to be reviewed, cancelled appointments and much more.
Friendly for Billers – Electronic and Paper Claims
A claim should be automatically scrubbed and submitted to the billing software for biller review.
The biller should be able to push a button to scrub and edit the claim against millions of pre-programmed payer rules. Another click should automatically batche the claim and submit it to the insurance company electronically, or allow the biller to print the claim on a CMS 1500 or UB04 form. This allows the clinic to get paid more, faster.
The EMR and billing software should not just work together, they should enhance one another.
Physical therapy billing software should also handle coding in a compliant fashion with the help of in-built payer specific “unit” rules to track if there’s any over/under-billing.
ICD-10 code carry forward
Your physical therapy software should automatically ‘carry forward’ ICD-10 codes from one visit to the next. In most cases, the diagnosis code remains consistent with each subsequent physical therapy encounter. Your billing software should automatically pull the diagnosis codes from the previous visit. The biller should retain complete control at all times. If there are any changes required in the diagnosis code for the current visit, the biller should have an option to edit the diagnosis field before the claim is billed out.
Claim scrubbing is a process of validating the plethora of data on a health insurance claim. Many billing softwares utilize an unmodified version of the CCI Edits to check claims and check for missing components.
They don’t audit for coding validity of diagnosis, procedure, procedure-modifier and revenue codes. Only a few physical therapy billing softwares like In Touch Biller Pro achieve this in an accurate manner, since the algorithm is constantly updated with the latest physical therapy coding best practices.
Creation of Payer Specific Rules
Your billing software should be customizable and allow you to set up check points. It should allow you to set up payer specific rules to prevent denials and ensure clean claims submission.
For physical therapy, Medicare will accept G0283 instead of CPT 97014. You should be able to set up your billing software in such a way that your billing software should not accept CPT 97014 for Medicare claims. It should alert you to bill G0283 for Medicare instead of CPT 97014.
For physical therapy, referring physician is mandatory in the CMS 1500 form for Medicare and most other payers. Your billing software should not allow you to submit a claim without referring physician information.
Customizable Patient Statements
Customizable patient statements with the clinic’s logo will create a positive impression for your patients. Your billing software should allow you to add your clinic logo in the patient statements.
Your billing software should have the option to add the statement messages like co-pay, co-ins, deductible, maximum benefit reached, non-covered services. The statement messages will provide the patient with relevant information, such as the outstanding balances. This eliminates the need to call the clinic to seek clarification about the balance. This will reduce staff overwhelm and unnecessary calls back and forth between patients and staff.
Custom Physical Therapy Billing Reports
Customized physical therapy billing reports can help you diagnose the health of your physical therapy practice. Reports can demonstrate how a physical therapy practice is performing on important revenue cycle metrics, whether claims are being paid in a timely fashion and how well insurance carriers are paying for key procedures and diagnosis.
Many billing software systems have hundreds of reports. The fact is, you need a few, critical reports. Based on our 10+ years of experience in physical therapy billing services, we found that the following reports are the most important reports for a physical therapy practice. You should ask your billing company if they can provide you with these specific reports, before signing a contract with them.
- Appointment status report
- AR aging report by payer/patient
- Missing charges report
- Payer payment report
- Hold/Unbilled claims list report
- Patient payment and balance summary report
- AR aging summary report for individual patients/payers
- Most commonly used diagnosis code and CPT code list
- Percentage of business by payer
- Percentage of business by CPT code
- Overall billing efficiency report
- Analytic reports for charges and payments
Conclusion and Next Step – Schedule a Demo of In Touch EMR
In Touch EMR has all this, and many more features designed to help you run a profitable practice, along with a simple, transparent pricing model.
If you have any questions, please click here to schedule a demo of In Touch EMR to learn more.
If you can’t wait, here is a quick, 10 minute walkthrough of In Touch EMR software.