Best Practices

Billing Software Q&A

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Our exclusive Q&A explores the challenges surmounted, perks gained, and revenue management improvements that can be made through billing software.

 Rehab Management recently invited industry experts to weigh in on billing software during an exclusive Q&A. Participants in this Q&A include Nelson Aviles, PT, TherAssist Software; Andrea Cassese, director of PTOS Software, Patterson Medical; Eldad De-Medonsa, PhD, president, Billing Dynamix; Ricky Gomez, director of sales and marketing, Planetrehab; Heidi Jannenga, PT, MPT, ATC/L, founder and COO, WebPT; Phil Kilcoin, COO, BMS Practice Solutions; Charles Lee, national director—sales and marketing, Raintree Systems Inc; Steve Mackie, CEO of Optima Healthcare Solutions; David McMullan, PT, vice president of product management, SourceMedical; Dan Morrill, PT, MPT, president of TheraOffice by Hands on Technology; Amy Orr, vice president of Sales, ClinicSource; Jim Plymale, CEO of Clinicient; Steve Presement, president, Practice Perfect EMR + Management Software; Angelique Robinson, head of Client Relations, Therabill LLC; Brent Strieter, Regional Sales executive, ReDoc by Net Health; Ken Thomas, COO of EON Systems, Inc; and Sharif Zeid, Business Director, MWTherapy by MerlinWave Inc.

Rehab Management (RM): What are the common billing errors most practices make that cost them revenue?

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Nelson Aviles
TherAssist Software

Nelson Aviles: Data entry errors are still common to many practices. This can take many forms, from simple misspellings to erroneous entries. In most cases, the revenue is recouped, however at a later time and after lost man-hours.

Andrea Cassese: Errors in claim submission, ie, missing modifiers, not tracking the charge cap, [and] billing/treating without authorization.

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Eldad De-Medonsa
Billing Dynamix

Eldad De-Medonsa: The most common data errors include incorrect coding/diagnosis-procedure linking; not understanding CCI (Correct Coding Initiative) edits; incorrect modifier use; missing information/demographics data entry; incorrect referral/preauthorization info.

Ricky Gomez: Much lost billing revenue is due to CCI edits and the inexperience of staff to be able to correct these issues. Also, the inability of providers to document the services they are providing.

HeidiJannenga

Heidi Jannenga
WebPT

Heidi Jannenga: Many rehab therapy practices lose revenue—and time—to mistakes due to human error. This is particularly common among practices whose billing processes require double data entry.

Phil Kilcoin: Failure to verify benefits accurately or at all. Timely filing errors. Lack of knowledge about payor specific rules, including LCD (Local Coverage Determination). Also credentialing issues and submitting claims to the wrong payor.

Charles Lee: The most common billing errors that most practices make are incorrect CPT codes, incorrect code combinations, incorrect CPT and Diagnosis Code combinations, and either missing or incorrect modifiers.

Steve-Mackie,-CEO

Steve Mackie
Optima Healthcare Solutions

Steve Mackie: The most common billing errors practices make that cost them revenue include insufficient insurance verification efforts and heavy reliance on manual processes. Insufficient insurance verification efforts can result in possible delayed claim filing to the correct payor(s) and subsequent denials for exceeding the timely filing limit, as well as claim submission for dates of service overlapping with a Hospice.

David McMullan: Failure to capture all procedures leads to fewer claims, and less revenue for the center, and improper coding of claims, leading to rejection or underpayment.

DanMorrill

Dan Morrill
TheraOffice by Hands On Technology

Dan Morrill: The most common billing errors are typically related to modifier omissions and incorrect modifier use. Our software is designed to alert users to the errors before they are submitted to insurance carriers.

Amy Orr: Not having a system for filing claims in a timely manner. It is important that claims are filed on schedule. In addition, they need to have knowledge on updated CPT and diagnosis codes and what each specific insurer requires. Clinics small and large need to be able to adapt to the growing changes in the billing industry.

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Jim Plymale
Clinicient

Jim Plymale: The most common error practices make is letting their therapists decide how to bill versus having them report their time and converting that time to the appropriate number of units based on the payor being billed. Another common error is not collecting the correct information up front. The most common process failure is failing to verify benefits.

Steve Presement: The most common errors we see involve not billing for the full amount of time that the client was seen by the therapist—for example, the client is with the therapist for a full hour but is only billed for 3 units of service. We also do see, more often than you would think, services that have simply not been billed at all due to a flaw in the clinic’s internal procedures.

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Angelique Robinson
TheraBill

Angelique Robinson: The most common billing errors are: missing information, duplicate claims, and timely filing. Failing to enter information required to submit a claim is the most common error.

Brent Strieter: We see two consistent problematic behaviors related to billing. The first is that they may not be using the correct modifiers or even omit a modifier completely. The second is that frequently they may not be capturing all potential billable codes from a note or chart—literally leaving money on the table by not even asking for it.

Ken Thomas: One of the most common billing errors made that result in lost revenue is inaccurate and cumbersome tracking of carrier payments. Not utilizing an intuitive software system that can track adjust-offs BEFORE you bill, and not being fully electronic can be very costly, both in lost revenue and time.

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Sharif Zeid
MWTherapy by MerlinWave

Sharif Zeid: The best practice is to follow three basic steps: code properly, bill in a timely fashion, and follow up on unpaid claims promptly. By just following these three steps, a large number of issues that end up costing revenue can be eliminated.

RM: How does your software help practices avoid these errors and maximize revenue?

Aviles: Since all users share a common chart in our software, more eyes and feedback help reduce the number of simple errors. The fact that redundant data entry is eliminated, the ease of the billing process, and filing claims and resubmissions electronically significantly impact the cost of common errors to the practice.

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Andrea Cassese
PTOS Software

Cassese: Automating as many things as possible and providing audits and reminders, eg, tracking charge caps, LCD and CCI audits, tracking fee schedules for multiple insurance companies for comparison to EOBs.

De-Medonsa: For the most common data errors, our billing expert-system includes more than a million rules, such as matching DX and CPT (LMRP rules), and NCCI (National Correct Coding Initiative). It also includes the “network effect”: custom rules we learned during the past 2,500 practice-years of our billing experience. For the common methodology failures, our built-in workflow engine triggers exceptions, automatically alerting about unbilled visits and claims that require manual handling or follow-up call.

Gomez: We have built in the applicable CCI edits that pertain to the market we represent. We literally stop the process of choosing mutually exclusive codes that are denied in the adjudication process by their corresponding edits and cause the provider of the service to think through and choose an option that is most appropriate and billable for the circumstance.

Jannenga: The WebPT documentation platform is designed to seamlessly transfer information to the billing software, which eliminates double data entry. Beyond the information exchange, practices receive white glove service with our software. Each clinic has a dedicated billing team that not only submits clean, error-free claims, but also investigates and resolves any denials. These teams also possess regional specialization, which results in speedier claims processing and maximized reimbursements.

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Phil Kilcoin
BMS Practice Solutions

Kilcoin: Our proprietary billing software has a robust Rules Engine that scrubs charges both real-time in the EMR and as a nightly batch process. BMS has a “Clean Claims” rate of 97% to 98% for all claims sent, both electronically and on paper. We have also built-in rules initially when the patient data is entered into RevFlow—we have some validation of ID numbers and basic information.

Lee: Raintree helps practices avoid these errors by incorporating coding edits that verify and validate codes and modifiers before they are posted to the ledger and sent off to billing. The system will alert the user when attempting to post if there are any CCI errors or posting errors.

Mackie: We offer a real-time 270/271 Eligibility request and response to streamline the process and increase the accuracy of the information in order to maximize revenue. It also allows the user verifying benefits/eligibility to enter external stays, such as Hospice.

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David McMullan
SourceMedical

McMullan: An automated system that tracks procedures via tablets at the side of the patient (or immediately after a procedure) captures every charge, and ensures more accurate claims will be submitted. Also, proper coding: charge optimization maximizes the allowed benefits per case, minimizes claim denials, and maximizes profitability.

Morrill: Reducing errors begins when a new patient contacts the clinic. The intake process is where successful clinics reduce errors; TheraOffice is designed to make the process more efficient and repeatable. The software has specialized features such as alerts, tasks, and customizable charge scrubbing to make sure the data entered into it is correct. Users can also further customize our software to monitor specific data requirements for unique payors.

AmyOrr

Amy Orr
ClinicSource

Orr: Automation of patient record updating and patient data transfer within the practice as well as at the time of claim filing enhances the overall efficiency and productivity of your billing process. You can minimize human errors, standardize coding and billing formats, and record, as well as access large amount of patient data more effectively.

Plymale: Clinicient Insight automates the process of converting therapist’s time into the appropriate number of units and CPT codes based on the payor being billed. This increases the number of units billed and ensures compliance with the payor billing rules, which helps to increase revenue and decrease denials. The reports and alerts tell therapists and managers when they are leaving unbilled time, a common source of revenue loss. In addition, Clinicient Insight has a payor rules engine, which helps ensure the correct information is gathered to bill clean claims as well as ways to automate the verification of benefits to reduce denials and write-offs.

StevePresement

Steve Presement
Practice Perfect EMR + Practice Management Software

Presement: Practice Perfect has several daily reconciliation reports that identify potential missed revenue opportunities. The report identifies “time versus billing” discrepancies showing where the number of units is lower or higher than the booked appointment time. For example, if a patient is booked for an hour but only 2 units of time have been billed, a flag is raised. Patients who are booked in the schedule but have had no charges entered at all are also identified.

Robinson: Our software has a built-in “pre-scrub,” which reviews claims for errors prior to submission. If fields are missing, such as a rendering provider’s NPI, Therabill will provide a warning alerting which field needs to be completed to submit the claim. Our members find this to be a helpful tool as it prevents rejections for simple data entry errors. To assist with timely filing, our software has a color-coded system and an “Unacknowledged Billing Report” to follow up on claims not acknowledged or received by the payor.

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Brent Strieter
ReDoc by Net Health

Strieter: Knowing that busy clinics have a propensity to see the types of errors mentioned above, our software is designed to capture appropriate modifiers and search for all potential billable codes associated with a patient’s chart.

Thomas: The answer to this is two-fold: First, EON Systems’ software has the ability to set up a fee schedule per policy so that all adjust-offs are predicted BEFORE you bill. This means that what you collect from the patient is accurate and our accounts receivables are accurate.  And secondly, EON has an exclusive Insurance Follow-up Center that greatly speeds up collections while being more accurate than any rolodex or aging report system. It allows you to see real time, at a click of a button, what carriers owe, down to the number of days owed and from which payments and which bills. Rebilling is so simple it can occur completely automatically or manually at the click of a button.

Zeid: There is no double-entry within our software, which means there is no chance for errors when transferring data from one system to another. Our software also features a complete suite of alerts, warnings, and notifications to help keep therapists and staff alike on track and on the same page. It also offers easy-to-understand billing reports that practice owners can use to see if they are underpaid by some insurance companies.

RM: What can most practices do to improve their billing practices?

Aviles: Simply stated, get it organized. Start by looking at the current process and see where time is lost, errors occur, and confusion enters. This is certainly more problematic the more places you enter data (ie, different programs, charts, billing services). The best thing you do to help yourself in this regard is minimize the number of places you have data.

Cassese: With billing and regulatory requirements becoming so complex, look for a software that automates the areas where errors are most likely to occur. Be sure your biller keeps up with all the changes and understands how to use your software to its fullest extent.

De-Medonsa: Integrate your billing process within your practice workflow. Review your billing performance frequently or at least weekly. Submit accurate claims in the first place to save effort down the line, and track down and follow up on exception, such as unpaid or delayed claims. Also, pay your billers upon success—only when you get paid.

Gomez: Maintain billing staff who are committed to continuing to learn their profession and support them by acquiring further education or seminar events as part of that process. Your billing staff should be held in the same regard as your providers of service.

Jannenga: In this day and age, much of a practice’s billing efficiency and success has to do with the software it uses. It is imperative that rehab professionals select a software that works on the devices and operating systems they use both in their clinic and at home. In addition to operating system, web-based billing software offers improved accessibility, flexibility, and hyper-secure data storage.

Kilcoin: Have well-defined best practices and workflows from the front desk all the way through payment posting and follow-up with payors. It starts with sound fundamentals, verify benefits quickly and accurately, collect from patients when they are in the office.

Charles Lee Raintree Systems

Charles Lee
Raintree Systems

Lee: Stay current with billing changes by the insurances they bill and keep the system up to date with the correct CPT combinations, CPT to Diagnosis combinations, and modifier rules.

Mackie: The first step to improve billing practices is to select and implement great billing software. After that, it is important to hire a great billing staff that wants to work smarter, not harder, by fully utilizing what is available in the software.

McMullan: Capture procedure claims more accurately and more completely.

Morrill: We are big fans of process improvement. We encourage all companies to write billing processes on paper (or whiteboard), as a way to evaluate billing efficiency and promote positive change. Once that step is complete, find a software solution that helps execute your improved processes, and you are well on your way. Documenting process is also a great way to train new employees.

Orr: Typically, you would want a product that will address reporting capabilities, scheduling capabilities, customized forms, monthly statements, and superbills. Therapists may want to consider which of these areas consume the most resources (time and money). Typically, you would want a product that will address all of these areas in one integrated solution.

Plymale: The best way to improve billing practices is to implement a data-driven system that automates the coding, billing, and collections processes. Supplement this with a dedicated, well-managed staff that uses a proven methodology for collecting every available dollar. The system and staff should also be constantly learning from the data so they are up-to-date with the latest billing requirements and best practices. If you can’t ensure these yourself, partner with a revenue cycle management company that combines automation with a dedicated staff, a proven methodology, data driven management, and constant process improvements.

Presement: Generally, putting procedures in place that are followed religiously will mitigate billing errors. If running specific reports or even manually checking what has been entered in a consistent manner is put into place, most errors will be caught. Sending charges out without any kind of review at all will lead to denials and lost revenue. Of course, automating the entire process as much as possible with good billing software will minimize the amount of administrative time required to make this all happen.

Robinson: To improve billing practices, we recommend hiring someone with a medical billing background and finding great software. For first time billers, the task can seem daunting. We also recommend having a dedicated person responsible for A/R (Accounts and Receivables). Failing to follow up on outstanding claims is the easiest way to lose revenue.

Strieter: It requires regular attention to get your practice’s billing rhythm where you want it. Meet monthly with your billing company (or administrator) to understand what your revenue picture looks like. Frame it in language of “days to bill” and rejections. These are functional areas where poor performance can be turned around. Know how fast you get your claims submitted and know how to make them clean at first submission. Establish revenue, increase action items and goals for the next 30 days, and review progress at the next meeting.

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Ken Thomas
EON Systems Inc

Thomas: Stop doing paper billing and stop doing electronic billing that uses a print image file as they are just not efficient and will waste hundreds of hours a year in staff time. Instead use ANSI 837 electronic billing and ANSI 835 electronic remittance coupled with an insurance follow-up system. Doing just this will revolutionize their office with faster and more accurate billing, faster and more accurate EOB processing and excellent follow up for carriers that fail to pay.

Zeid: Practices can always improve by ensuring consistency among staff, having good procedures with checks and double-checks, as well as an efficient piece of software. The best way to implement these ideas is to have a solid and well thought out procedure for everything from registering patients, to documenting, to treating, to billing, and, finally, to following up. Having such procedures in place will ensure a consistent and smooth stream of revenues, claim after claim.

RM: What feature in your billing software product do practices report they use the most, and why?

Aviles: Automatic posting using ERA files is the functionality that saves the most time.

Cassese: Integrated electronic claims and remittance advices, bulk payment processing, audit and alert features. All save time and improve efficiency.

De-Medonsa: Billing Workflow Engine, which improves transparency, collections, and efficiency, including follow-up on denials, underpayments, or stalled out claims, tasks and backlogs, and key practice performance indicators (KPIs) displayed on a single radar chart. [Also] the expert engine that improves efficiency by highlighting potential errors and leveraging the “network effect.”

Gomez: One of the most popular features is the autocomplete note feature. Essentially, when a user checks off the charges for the visit, the system automatically inserts the justification for that charge and the time spent on that treatment. And the text is completely modifiable, so the user can determine what is said in the note. It makes for very fast and easy documentation.

Jannenga: We’ve found that rehab professionals are most interested in tools and alerts that reduce compliance errors. As we’ve seen with functional limitation reporting, PQRS, the 59 and KX modifiers, and the 8-minute rule, compliance-related billing errors can result in delayed or incorrect reimbursements or worse—flat out payment denials. Thus, compliance reporting tools and alerts—paired with correct billing practices—are crucial to ensuring timely and complete payment.

Kilcoin: Reporting and metrics. We have well-defined metrics for all aspects of the revenue cycle and great reports for owners and managers to track their business and maximize revenue and payment per visit.

Lee: One of the features used most by practices is the collection worksheet.  It is an easy way to manage the outstanding A/R and work each insurance and each patient balance.

Mackie: The 835 import, because of the immense timesavings it offers, as well as the increased accuracy for payments, adjustments, and even take-backs.

McMullan: The comprehensive Collection Module in TherapySource, which decreases A/R days and centralizes collections activities.

—The full suite of billing tools

—The automatic charge extraction, coding, and claim submission tools, all of which process on the day of treatment

Morrill: At the end of the day, the physical therapy business is no different than any other business; success and growth is about cash flow and revenue management. TheraOffice has specific tools built in to monitor accounts receivable from an insurance company, patient, or other guarantors. The tools are designed to identify issues and allow the user to take immediate actions. Resubmission of a claim, creating an updated patient statement, and calling an insurance carrier are all examples of tasks that can be completed from a single screen within the billing tools.

Orr: Aging report. There are always claims to check up on. It allows you to see if the practice is losing money to claims that never get to the insurance company, claims that get denied but notice of the denial is never received, and checks that never make it to the practice’s checking account.  It can amount to a serious sum of money.

Plymale: The key automation feature is Clinicient Insight’s coding and rules engine, which is ideal for converting therapist activities into optimized bills. The key management features are our interactive drill down reports and task alerts that help to identify collectable dollars and facilitate the accountable collection of those dollars.

Presement: Our practices use both the Accounts Receivable reporting and Contact Log report on a regular basis. While the Accounts Receivable report shows outstanding balances divided into aging buckets, the Contact Log shows broken promises. A patient or adjuster has committed that payment will made by a specific date—this report shows when those promises become broken, allowing the user to follow up right away and not wait until the entire situation has become stale.

Robinson: Therabill has many features our members find useful for claims revenue management. Our software allows members to check the status of claims submitted electronically and electronic claims errors. Therabill offers a simple, color-coded key that allows members to track the status of claims submitted electronically.  Members are able to view real-time status messages from the clearinghouse. If a member sees the color red, they can direct their attention to the home screen (or Dashboard) where they will see a list of electronic claims errors. The member is able to open the rejected date of service, view the reason for the rejection by the payor, and read an article that corresponds with the rejection error. Often, payors use technical terms such as “loops and segments,” which mean little to the everyday person. Over time, the developers at Therabill have created articles that decipher technical jargon into plain terms. The articles also walk our members through the steps needed to resubmit the claim to get paid.

 Strieter: Our clients report that the scheduler is a highly valued tool—it’s also something that we’re continuously improving. Our latest iteration was built to mimic the fluid “white board” style of scheduling that actually happens throughout the day at a clinic. We want it to be intuitive for users, a real foundation for practice management. Alongside that, clients love easy-to-access real-time reporting. Being able to tie together the daily/weekly/monthly picture of client visits, treatments, and billed amounts provides critical knowledge.

Thomas: Most practices use our interactive Insurance Follow-up Center to ensure super high collections percentages without the need of a Rolodex or aging report.  The fact that it allows you to see real time, at a click of button, which carriers are past due in their payments and provides calling information and complete records of the conversations with the insurance company. This single feature can pay for the entire software package and has saved staff uncounted hours. The time-saving features in the billing and Insurance Follow-up Center unleash vast amounts of time, allowing that staff to concentrate on better patient care and retention.

Zeid: While MWTherapy has countless features, its integration and reporting rank highly as favorites. Practices can use MWTherapy for EMR, Scheduling, and Billing all in one affordable and intuitive system. That means streamlined operations and smooth sailing from start to finish. MWTherapy also features very strong reporting. From revenue and receivable tracking to patient source tracking, MWTherapy is fully featured and ready to go. Many practices spend a lot of time in the dark trying to assess performance and get a grasp on finances. MWTherapy makes that much, much easier!

RM: What role does billing software play in a practice’s overall revenue management strategy, and how might that role evolve in the future?

Aviles: Billing is integral to revenue management. As our users continue to divest themselves in the program, we see them linking their treatment plans to their charges, having their treatment minutes calculate from the work done with the patient, and correlate to their charges, and using clinical data for selecting appropriate modifiers.

Cassese: Most importantly, your billing software can make a difference in how quickly and accurately you get paid. Beyond that, it can help improve overall efficiency in managing your business. The future appears to be one of continued change in regulations and insurance requirements. Your software can help you keep up with these changes by building in the appropriate checks, balances, and reminders to keep you on track.

De-Mendosa: Guarantees a controlled and predictable stream of revenue, allows transparency across all activities and all team members, simultaneously presents both the big picture and individual details, and secures network effect; the ability to grow the rule base and help every practice using it. In the future we see faster connectivity between software and various payors/clearinghouses,better coding guidance from the EHR to the billing module, and meaningful contribution to practice growth and compliance

Gomez: Software allows a practice to submit claims quickly and correctly. Good software should be able to make sure that the claim will be submitted without errors. And then the software should give the practice a means to find out where they stand financially.

Jannenga: The right billing software is an essential piece of the revenue cycle management puzzle, but it’s only one piece. The right EMR is crucial, too. If you’re currently using an EMR or plan to use one in the future, it’s essential that your billing system can cooperate with it. Benefits of a billing and EMR integration include increased front office efficiency, decreased coding errors, easily accessible documentation attachments, and improved access to financial data. Beyond an ideal EMR-billing software relationship, your billing software’s impact on your overall revenue cycle management largely depends on the quality of the billing software’s service. If the billing service isn’t current on the specifics and nuances of your specialty, then you can bet that your practice will suffer. The same applies if the billing service lacks regional knowledge—especially if it’s your region in question. The billing service may promise you that they’ll get up to speed on your specialty or region, but how long will that take

Furthermore, whoever handles your billing should be an expert in all things compliance—including every billing and coding regulation under the sun—and should be able to correctly apply those rules to your region and specialty. Your billing go-to also should be prepared to handle any regulatory changes well before they actually occur. And on that topic: ICD-10 is fast approaching. If you’re not properly billing for the new code set, you’re going to see big time denials, which means there will be no revenue to manage. So, your billing software better not only be totally up to speed on ICD-10 (and thus be able to help your practice get hip to the new codes, too), but also be thoroughly prepared for handling post-transition claims—and working with payors that may be experiencing their own set of challenges with the new diagnosis codes.

Kilcoin: Billing software should play the important role of enabling clean claims to bill out, without relying on the Clearinghouse to fix and clean up claims. If clean claims are not billed initially, this results in delayed payments and increased labor costs. Billing software will continue to evolve to be able to auto-post more and more payments, resulting in lower labor costs.

Lee: Billing software plays a significant role in the practice’s overall revenue management strategy.  In order for the practice to be solvent they must manage their cash flow effectively.  The billing software is critical to making sure charges are being captured correctly, bills are being sent to the insurance company’s correctly and timely, payments are being posted accurately and quickly and any write-off’s or adjustments are being closely monitored.  The role of the billing software will continue to be a primary factor is the practice’s success.

Mackie: Billing software plays a vital role in a practice’s overall revenue management strategy. Great billing software, used to its fullest potential, results in a shortened revenue cycle. In the future, as regulatory changes place an increased burden on practices and reimbursement schedules shrink, the role of billing software will only become more vital as a means to maximize revenue.

McMullan: Billing software can reveal where the claims process is breaking down: Is charge capture inadequate? Which insurers are slower to pay or more resistant? Which collections agents are most (or least) productive? These are all strategically compelling concerns for the business manager, since even small improvements to a center’s accounts receivable can make or break its financial success.

Morrill: Billing software needs to be the organizational engine that allows great billers to perform their jobs at the highest level of productivity. In our experience, successful rehabilitation practices have great employees, implement effective tools (in this case billing software), and culture that is productive and driven by measurable goals. Pairing billing staff with effective billing software will drive revenue management and improve decision-making, but that is only the beginning. We encourage our clients to look beyond the software and look at the developers of that software to see how they see the future of rehabilitation and how they will continue to support, develop, and innovate in the future.

Orr: Billing software needs to incorporate both business process and technological change. The software has to adapt to these changes. People want mobility and the opportunity to access their data from anywhere. It is important that the software can be accessed from multiple device types, ie, laptop, tablet, smartphone, and from any location using Internet access. Look for a software product that will save providers’ time, allowing them to focus more on providing quality services while also electronically processing claims and increasing cash flow efficiency.

Plymale: Today, practices are paid based on their ability to maximize the utilization of therapists, to bill all of their time appropriately, and to get paid as quickly and fully as possible. This requires dedication, discipline, a proven methodology and management. In the future, as we transition to new types of partnerships and payment based on performance or population health management, it’s all about the ability to use data to make decisions. The practice must be armed with the best possible data to make better decisions that drive proven outcomes. This will lead to better relationships with patients, physicians, and payors. The practice’s ability to collect, analyze, and make decisions based on clinical and financial data is the most important factor for future success.

 Presement: We see our software as a tool to assist in generating additional revenue within a clinic but helping to fill a clinic’s schedule. Good software can identify patients who have stopped attending in a timely manner; report on referral trends to spot marketing efforts that are not working well or physicians who have reduced referrals; e-mail/text/phone clients the day before their appointment; automatically manage a waiting list; outline clients who are not living up to their prescribed treatment plans and more.

Robinson: A revenue management software is critical to the success of any clinic. Software is intended to streamline processes to ensure clinics are receiving optimum reimbursement for services provided by allowing you to enter payments, track claims status, and follow up on denied claims. Without this tool, you are bound to miss out!

Strieter: Net Health leverages the strength of ReDoc, our specialized outpatient EHR, and the in-depth knowledge of our partner Med Billing Solutions, to optimize customers’ financial performance. The way ReDoc is structured, the billing functionality is part of our PMS (Practice Management System). We believe that software-based billing guidance is a paramount obligation. Clients look to software solutions to enhance and automate the functions that a human would normally have to lead. Optimized revenue management is a core piece of solid practice management. You trust the software to evolve with changes in standards and codes, otherwise every practice would need a dedicated in-house expert. That’s just not feasible.

Thomas: The key word here is management. Does the software actually assist you in managing your clinic? Does it give you stats? Real-time, up to date collections with accurate accounts receivable figures? Interactive insurance collection with fully automatic rebill? As technology continues to advance, the software programs that advance with it will be able to save staff time and increase collections.  The results will be the freeing of staff to help enhance patient care and increase patient retention with the resulting expansion of the practice and a ground swell of new patients.

Zeid: With the ever-increasing complexity of billing from secondary and tertiary billing, to ICD-10, to Medicare compliance, to additional payor regulations, software really is at the heart of successful billing practices. These days, there are simply too many things for a person to keep up with by memory or manual work alone. MWTherapy can help clinics stay financially sound with consistent revenues by automating many mundane repetitive tasks and operations, reducing and eliminating double-entry and other time-wasting tasks of the past. MWTherapy is also quite adept at turning raw billing data into useful reporting, giving practice owners information when and where it is needed, driving better business decisions. While there is no telling what the future holds, we know some things like ICD-10 will come. The trend of increased complexity of insurance rules as well as Medicare regulations appears poised to continue.RM

 

 

 

 

 

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