Physical Therapy EMR for Growth | Get The Do-Re-Mi In Place
Start at the very beginning | Know the notes to sing
Making sure that the right processes are in place would be a good place to start. At a high level, we could sum up our priorities as:
- Securing qualified patient appointments and providing a seamless, connected experience.
- Efficiently onboarding and processing patients and providing quality care to them.
- Improving efficiency and growing profitability by optimizing operational and clinical workflows.
Getting into some more detail, we would need to cover some of the basics:
- Obtaining patient information on arrival like authorizations, eligibility, and co-pays.
- Keeping a close watch on the arrival rate to keep patients on their plan of care.
- Documentation/notes that is tightly integrated with appointments and with billing.
- Reviewing and following up on delayed or denied claims.
- Upfront claims review and scrubbing to lower denials and increase collections.
Finally, some key metrics to watch out for:
- Total referrals
- Top referrer
- Referrals by type of insurance
- Patient arrival rate
- Total number of new patients per day/week/month
- Average/total new patients per therapist
- Average visits per patient/per therapist
- Total number of patients seen per location
- Total charges billed
- Collections per visit
- Average charges per visit/per therapist
Tools to build the process | Sing most anything
What if some of the processes are manual? For example, manually entering charges and applying payments that are received.
Enter the integrated EMR/practice management system. Here are some of the basic features that the platform should bring in (at a minimum).
- Scheduling patients by therapists or by the front desk team.
- Inviting patients to the patient portal to fill out information that imports into the EMR.
- Scheduling patients from a waiting list after matching criteria for open calendar slots.
- Reviewing therapist schedules in a single view or zooming in on individual therapist views.
- Generating documentation and claims/billing from the scheduler.
- Checks and balances for example needing an appointment to generate a clinical note.
- Tracking patient cases for different disciplines benefits, diagnosis, and authorizations.
- Setting up timesheets for therapists and applying them to the scheduler using templates.
- Handling of different types of appointments eval, follow up, and so on visually for tracking.
- Setting statuses like canceled, canceled under 24 hours, rescheduled for the cancellation policy.
- Customizable appointment types, appointment statuses, and warnings during check-in.
- Reports like a list of patients who are going to become unauthorized in the next two weeks.
- Fully customizable clinical note templates that are built into the system.
- Documentation that is accessible from the scheduler or from the clinician dashboard.
- Reviewing status of notes and accessing unsigned notes and any missing charges.
- Marking notes as ready to review for supervising therapists by assistant therapists.
- Tests built into the system along with scoring tables.
- Summarized patient information cards including authorizations and missing certifications.
- Charges baked into clinical templates (flowsheets/SOAP notes) after tracking minutes and units.
- Flexibility to generate the claim, adding notes later. Or tying the claim to a signed off note.
- Rolling forward previous daily notes and charges with filled out sections for printing.
- Enforcing clinical compliance through required questions.
- Automatically faxing case information to the referring doctor, case manager, and PCP on file.
- Goal tracking including templating and customizing goals with data points and text.
Billing and Collections
- Configuring the billing rules engine for each payer.
- Reviewing charges and identifying any problems like missing diagnosis pointers, eval codes.
- Grouping claims by therapist, account type, patient etc. and creating claims batches.
- Catching any additional charge or claim issues, and validating claims.
- Transmitting finalized claims batches to the clearing house.
- Following up with payers per a predefined schedule for collections.
- Importing EOBs/ERAs from the clearing house, auto posting payments, patient statements.
- Reports including therapist productivity, facility summaries, and audit reports.
Reports and KPI dashboards that provide detailed insight on current business processes would provide a pathway to continuous business improvement.
Once, we have the tools in place to build the processes, we could address hundreds of different scenarios by mixing them up. Do-re-mi, the first three notes just happen to be!