10 Billing Reports that Make or Break your Practice
Cash flow is the engine of any practice and it should be easy for clinicians to obtain reports on any aspect of their practice in a simple, streamlined and efficient manner that doesn’t require contacting the billing department.
Those reports are the metrics by which a practitioner can determine profitability and the health of his/her clinic.
The most important aspect for clinicians is that billers to do their part in the most efficient manner possible. They may be familiar with particular medical billing software and only choose to use certain programs. That preference doesn’t matter, as long as the software is capable of generating the 10 billing reports needed to track and monitor different practice metrics.
The aging report, which shows a summary of all accounts receivable (known as AR) is the primary tool for assessing and analyzing high level practice profitability across multiple metrics. The AR is typically viewed as a way to identify late or non-paying patients, but the right EMR software can provide in-depth data in an extensive variety of areas that affect the viability of a clinic.
Payer Payment Patterns
It doesn’t take long after a clinician opens a practice to discover that all payers don’t reimburse at the same level and those payment rates can change over time, necessitating periodic reviews. Payer reports are essential for a clinic to determine which insurance companies and clearinghouses reimburse at the highest levels and those who are slow to pay / pay less than others.
Medicare now pays approximately 80 percent of private health insurers
80%
Medicaid pays at an average rate of 56 percent.
56%
Medicare and other payers determine the rate at which practitioners are reimbursed according to the resource-based relative value scale (RBRVS). Part of the 1989 Omnibus Budget Reconciliation Act, this was created to address disparities in the payment system and a large number of private insurance payers reimburse practitioners at rates that are lower than Medicare.
It’s a particularly troubling problem for clinicians as Medicare and Medicaid has reduced reimbursements after passage of the Affordable Healthcare Act, and this may change further with the new administration.
Practitioners don’t want to deny care, but many are weighing the pros and cons of accepting Medicare, Medicaid and payments by certain payers. The ability to generate a corresponding report provides clinicians with the essential reimbursement rates by payer, allowing them to work with companies with the highest payments.
Provider
It always pays to examine the competition and the right EMR billing medical software can provide clinicians with an overview of what other providers are charging for the same services. It’s essential for practitioners to evaluate their fee schedules to make reimbursements a priority, but be wary of radical increases or setting fees at $200 if others in the area are only charging $75.
Many practice owners mistakenly believe that setting their fees at the level allowed by payers will ensure payment. They feel that payers will only reimburse at a set level and are happy if they receive that amount. Fees should be established at a higher rate than what providers pay. The difference will be paid by secondary insurers or the patient.
Patient
Every practice encounters patients that are habitually late on paying their balance or don’t pay until threatened with a collection agency. The ability to generate sophisticated reports to identify those patients is a critical step in increasing revenues. Patient reports can show those who are slow or delinquent on co-pays and outstanding balances.
One solution is not to schedule more appointments for the patient until they’ve paid their bill in full. Clinicians aren’t bill collectors and EMR reports provide a way to identify the most desirable patients and those that readily pay their portion of medical costs.
Referring Physician Reports
Referrals are an essential part of operating a practice, but some referral sources are more valuable than others. One of the 10 billing reports practitioners need is a comprehensive view of referring physicians. An EMR report should provide clinicians with information on which physicians are providing the greatest number of referrals of patients with the highest paying insurance companies.
Provider Productivity
In practices with multiple providers, there are always individuals who treat more patients and consistently provide higher paying services to individuals. With sophisticated EMR software, practice owners can determine which providers are making the most money for the practice.
Location Analysis
Practices with multiple locations often have widely varying revenues that can be related directly back to where patients are originating. Reports provide practice owners with patient demographics to ascertain variables that include location. Business owners can focus marketing efforts on areas that are being underserved and populations most likely to require their services.
ICD-10 Codes Reimbursements
ICD-10 codes can be used to more precisely document each diagnosis for increased revenues. A comprehensive EMR provides key data about which ICD-10 codes make the most money for the practice. Clinic owners can use that data for marketing to patients most in need of services that can be justified through the ICD codes and an EMR should be able to link ICD-10 codes with CPT codes. Reports will reflect which diagnosis codes generate the most income.
CPT Code Analysis
CPT codes can be exhibited through reports to show which services achieve the highest level of compensation. It’s valuable information that provides insights for marketing. CPT codes can be used effectively with multiple ICD-10 codes to more accurately reflect the full extent of the services provided. The data can be especially important for treating patients with chronic conditions, providing value-based care, and marketing to specified populations.
Co-pays and Outstanding Balances
As patients become responsible for a greater financial portion of their healthcare, clinics must make every effort to collect co-pays at the time of the patient’s appointment and achieve a quick turnaround on their balances. Clinicians should have software that can generate reports on patients who pay their co-pays, those with outstanding balances of long duration, and those who are chronically late paying their bills.
Productivity By Day, Week and Hour
The ideal for any practice is a steady stream of patients each day without cancellations or blank appointments. The clinic’s EMR should have the functionality to produce a report that identifies the most productive times of the day, the times and days of the week that cancellations are most likely to occur, and even which individual within the practice is experiencing the highest level of unproductive down time.
Conclusion
Errors remain a common problem for many practices with NCCI edits for Medicare topping the list. Problems depriving clinics of revenues range from misspellings, erroneous entries and coding difficulties to improper use of modifiers, demographic data and incorrect referral and preauthorization information.
Sophisticated software such as In Touch EMR™ can be customizable and provides an integrated solution that can generate the 10 most critical reports required for a practice’s financial well-being. The reports are highly detailed, yet displayed in simple and easy to understand formats.
The software can check insurance eligibility online when appointments are made, post ERAs, and bill secondary insurance sources. The EMR scrubs claims before they’re submitted and provides automatic alerts if it detects a potential problem that would affect acceptance and reimbursement.
In Touch EMR™ reduces errors and has one of the highest levels of successful reimbursements in the field. It offers an integrated scheduling, documentation, billing and marketing software solution fully capable of generating the 10 types of reports that make or break a practice.
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In Touch EMR is a fully integrated scheduling, documentation and billing software for physical therapy practices. It is a simple and user friendly web-based, ICD-10 and HIPAA compliant EMR, and it offers customizable templates for notes, the ability to attach files, electronic signatures, and the ability to track progress notes, treatment plans, and assessments.
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Click here for answers to your most frequently asked questions about EMR selection and transition.
In Touch EMR has grown to over 1000 clients, our company / founders have been mentioned on CNN, Forbes, Huffington Post, Amazon, been featured as a Cleardata success story, received the prestigious ONC certification, 2015 and 2016 PQRS registry designation, integrated with Microsoft’s cutting edge patient portal technology and initiated groundbreaking healthcare partnerships with companies like Novartis. All of this is possible thanks to clients across the country, who have embraced In Touch EMR.
In Touch EMR is featured on our HIPAA compliant hosting partner (Cleardata) website along with other industry leaders such as the Cleveland clinic, Nexttech, Saint Mary’s regional medical center and UCLA health.
SIMPLE, TRANSPARENT PRICING MODEL
At In Touch EMR, we charge a flat fee per licensed clinician (no hidden fees or surprises) and it includes everything, unlimited claims and notes and infinite custom template creation. We are also a CMS recognized PQRS registry, we automate the reporting of PQRS and Functional Limitation G codes and provide automatic alerts for plan of care expirations, authorizations, progress note reminders and KX modifier alerts.
Clients also get a self-paced video training program on how to get up and running, custom documentation template builder, iPad app – one touch document import, Instant Intake iPad app, unlimited patient manager and patient portal.
Every license unlimited ongoing support (phone / email / live chat), billing software integration, unlimited appointments, unlimited documentation, unlimited document uploads and unlimited electronic faxing.
OFFICE OF THE NATIONAL COORDINATOR CERTIFIED ELECTRONIC HEALTH RECORD TECHNOLOGY
We are a premier vendor in the rehabilitation space, and on the prestigious, certified Health IT Product List, which is a division of the office of the National Coordinator for Health Information Technology, a division of the Department of Health and Human Services.
Very few vendors can make this claim, and they generally won’t bring this up (in some cases, out of ignorance) mostly because this is not a mandatory certification, it is optional and requires a significant investment of time and effort. This certification is a sign of our commitment to a HIPAA compliant, secure and stable EMR system for your clinic.
If you ever get audited, the fact that you are using ONC-certified EHR technology (CEHRT) will work in your favor. CMS looks favorably on the use of CEHRT since HHS is trying to encourage the adoption of CEHRT amongs providers nationwide as part of a long term push towards electronic documentation and interoperability between EMR systems. Your practice can state that it carefully vetted and selected “a rehabilitation-specific vendor that passed all of the ONC HIT 2014 Edition EHR Certification criteria required to satisfy the Base EHR definition”
Since In Touch EMR has been very proactive at staying at the forefront of emerging guidelines for EMR vendors, you are assured higher quality, higher security and more compliance with CMS and other payer regulations.
For more information about the ONC, please visit:
http://www.healthit.gov/newsroom/about-onc
In Touch EMR is one of the only EMR vendors in the rehabilitation space to pass all the 2014 Edition EHR Certification criteria required to satisfy the Base EHR Definition as stated by the Office of the National Coordinator for Health Information Technology, as listed here: http://www.healthit.gov/sites/default/files/pdf/BaseEHR_8-18-12_Final.pdf
In Touch EMR is on the Certified Health IT Product List (CHPL) website.
http://www.healthit.gov/policy-researchers-implementers/certified-health-it-product-list-chpl
The product is listed here:
http://oncchpl.force.com/ehrcert?q=chpl
Search for In Touch EMR > CHPL Product Number: 150002R00
PRAISE FROM THOUSANDS OF SATISFIED CLINICS ACROSS THE UNITED STATES
“In Touch EMR has emerged as a comprehensive, customizable EMR solution for our growing organization. Support is always there when we need it, options to customize options to match our workflow are endless, clinicians find it simple and easy to use, front desk and billing love the integration between documentation and claims and compliance is built-in. This is exactly what we needed and it has boosted our efficiency. Couldn’t have asked for more. In Touch EMR is a leader in web-based EMR for our practice. Thank you!”
Julie Edelman PT, DPT – Avanti Therapy
“Moving to In Touch EMR was a process of adjustment, but it was worth it, for several reasons. Not only has the staff at In Touch EMR been proactive in adding new features and responding to support calls and streamlining our billing processes, they have been understanding, professional, polite and patient. The ability to create our own documentation templates, generate professional reports on demand and submit claims to billing with one click has allowed us to streamline our practice. The billing software is extremely versatile – I can review number of claims sent / on hold, payer breakdown, charges per visit and collections per visit. Our biller is able to pull up detailed reports, exactly the way we want. My front desk staff has the ability to track authorizations and create progress note alerts, physician prescription alerts and fax reports to physicians with the click of a button in In Touch EMR. My management is now exploring analytics to identify areas of growth and efficiency and expect to drive our practice further with analytic insights. Best of all, the transition for our entire staff was streamlined and consistent and help was readily available. I like that we are able to talk to someone whenever we need to. If you are looking for a powerful, reliable, and responsive team to help you implement EMR and billing software to grow your practice, look no further than the team at In Touch EMR. We support this therapist owned EMR company wholeheartedly.”
Matthew S. Fischer, MSPT – Fischer Physical Therapy
“In my 30+ years as a compliance auditor, author and instructor, I have yet to see an EMR and billing software as comprehensive as In Touch EMR. If you are looking for compliant ICD-10 documentation, and a ‘gold standard’ that can survive auditing, get In Touch EMR. A well defined workflow for the front desk, clinicians, billers and coders makes this a one-stop shop for quick, compliant documentation and flawless billing. I’m impressed with their HIPAA compliance, PHI protection and data breach prevention protocols. The front desk automation (certification alerts, patient portal, birthday reminders, e-newsletters) and clinician automation (progress note and reevaluation countdown, autotext technology, flowsheet templates, tasks and messages) are sufficient to set them apart. They didn’t stop there. The billing automation (claim cleanser, automatic transmission to billing, CCI edits – modifier 59 automation, autopost ERAs) and the administrator functions (access controls, audit logs, time tracking, productivity metrics) result in an incredible EMR and billing software combination for all clinicians. It’s a no brainer – forget the hype from other products and get In Touch EMR”
Cheryl House RMC, CHI Compliance Auditor, Author, Coder and Instructor at Illinois Valley Community College
“I was looking for a Practice Management Software that combined both documentation and billing platform systems that work in unison. I had previously tried more complicated systems that made me exhausted at the end of the day. In Touch EMR and In Touch Biller Pro represent a united and unified package that helps the private practice clinician govern a practice. It’s easy to use, it is concise, and it has a plenty of analysis variables to study.”
Sammy K. Bonfim PT – Rehabilitation & Performance Center
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At In Touch EMR, we charge a flat fee per licensed clinician (no hidden fees or surprises) and it includes everything, unlimited claims and notes and infinite custom template creation. We are also a CMS recognized PQRS registry, we automate the reporting of PQRS and Functional Limitation G codes and provide automatic alerts for plan of care expirations, authorizations, progress note reminders and KX modifier alerts. Schedule a demo to see why practices across the country are switching to In Touch EMR.
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