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

By Nitin Chhoda PT, DPT on November 11, 2012

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.

About Nitin Chhoda PT, DPT

Nitin Chhoda PT, DPT is the CEO of In Touch EMR and In Touch Biller Pro, an electronic medical records and medical billing software system built be leaders in the physical therapy software industry, with thousands of satisfied customers across the world. For more information, please visit www.InTouchEmr.com and www.InTouchBillerPro.com

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  1. Pingback: Physical Therapy Documentation: Operational Analysis | EMR NEWS

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