Physical Therapy EMR That is Growth Ready

Physical Therapy EMRIf you are adding more clinics (and disciplines) and treating patients across multiple locations (physical and/or virtual locations) then your physical therapy EMR would need to step up to meet the increased clinician case-loads that come with the territory. Is your current EMR able to cope or have you outgrown it? The solution would lie in a more robust physical therapy EMR and practice management system that incorporates the flexibility of managing multiple disciplines along with the maturity of an industry standard billing system and reporting engine. Security features would include the ability to customize roles and templatize permissions, layering them on top of each other. There are some key capabilities in your EMR and practice management system that would help shoulder the increased workload.

Managing tasks without coming unstuck

An internal task management system for follow-ups would be one such component. This would track when the task is due, who it is assigned to, and include a customizable reasons list that is broken down by department and function. Viewing tasks in a dashboard would ensure they get the attention they deserve. Some tasks may have a patient context and these may get created in the middle of a clinical workflow, for example. Tasks with a clinical component would need to be closely tracked for audit purposes. Also, it may be necessary to automatically create work tickets for claims generated.

Scheduling patients on the fast track

Another key component is the Scheduler. It should be possible to look at all therapist schedules in a single view or alternately zoom in on individual therapist views. Documentation and claims generation/billing should be seamlessly integrated with the scheduler. Checks and balances would be crucial for example making sure there is an appointment in order to generate a clinical note. Charges would be created from the clinical template, baked into the note taking screen. Flexibility would be key. Either get the charges and generate the claim right away, adding notes later. Or tie the claim to a completed and signed off note. In some cases, therapists could manage their own schedules and even process new patients themselves. Alternately, intake and/or scheduling would be handled centrally from the admin side. Every practice deals with different types of appointments ? eval, follow up, and so on. Using different colors for depicting appointments would help stay on top. Setting statuses like canceled vs. canceled under 24 hours vs. rescheduled would ensure that your cancellation policy is properly implemented. Both appointment types and appointment statuses would be customizable. Customizable warnings in the patient check-in window and in the clinical note would keep things in line. A productivity booster would be a quick-add screen to capture the minimum information to schedule a patient. This could be followed by inviting patients to the patient portal to fill out their own demographic and clinical information through customizable clinical questionnaires that directly import into the therapist evaluation. PDF forms like consent and office policies could be taken care of through the patient portal. For tracking patient progress in the portal, a dashboard would be helpful. Reports on the scheduler would add additional value like a list of patients who are going to become unauthorized in the next two weeks. Additional features would include:
  • Scheduling patients from a filtered waiting list after matching criteria for open calendar slots.
  • Tracking patient cases for different disciplines ? benefits, diagnosis, and authorizations.
  • Setting up timesheets for therapists and applying them to the scheduler using templates.
A built in telehealth module that uses specific appointment reminders, sends out instructions, and helps set up billing rules would be another piece of the puzzle.

Fast, compliant, and painless documentation

Fully customizable clinical note templates would be built into the system. Documentation would be accessible from the scheduler or from the clinician dashboard. From their follow ups and appointments, therapists would be able to review the status of their notes and access unsigned notes and any missing charges. Assistant therapists could mark notes as ready to review for their supervising therapist. Tests would be built into the system along with scoring tables. A patient information card that is accessible from any clinical notes page with a summary of clinical and demographic information including authorizations and any missing certifications would come in handy. Charges would be baked into the clinical template after tracking minutes and units. Rolling forward the last daily notes and charges would provide an additional fillip to productivity. Only filled out sections would show up in the final printed output. Enforcing clinical compliance would be accomplished through required questions. Automatically reading case information and sending faxed information to the referring doctor, case manager, and PCP on file would close the loop. Goal tracking using an existing goal bank would include templating and customizing goals with data points and text. Several types of goals like percent correct, task analysis, and rate or duration goals. Trials would be independent or prompted. For each trial, specifying the data point would generate a visual graph.

Billing to keep the cash registers ringing

Setting up billing plans would be key to managing the clinic?s financial health. Avoiding manual processes would raise efficiencies in terms of processing, scrubbing, and tracking claims and managing denials, authorizations, and accounts receivable. A billing dashboard would show claims that are outstanding, rejected, and so on. All information to work on a claim should fit on one screen for ease of analysis. Billing and Financial Reporting would help determine KPIs like the first pass resolution rate. The billing process would unfold as follows:
  • Starting with a claims/charge scrubbing process would enable a quick review of charges before creating the claim.
  • Reporting workflows would include charge review to flag any issues like charges for dates of service that are missing an appointment, required authorizations that are missing, diagnosis pointers not assigned to charges.
  • Highlighting charges that are above/below the norm and documentation not signed off.
  • Billing teams could fix problems themselves for example adding missing modifiers and diagnosis pointers before creating the claim.
  • They could update billing rules to preload modifiers and navigate to the related note for reviewing documentation. They could also log tasks in the system to fix documentation issues, assigning task to the therapist to remediate charges.
  • Next is to create the claim. Applying filters by account or by therapist for example grouping together specific payers or Medicare or Medicaid claims would enable a more efficient process. The result would be a batch of claims.
  • Running one final rule check would identify any red or yellow flags. Splitting the batch to let the ?green? claims go through after previewing the batch to address charge level issues and data entry inconsistencies would help cash flows.
  • Sending claims to the clearing house would be followed by pulling in EOBs/ERAs, electronic eligibility checks, and claims status. ERAs would show paid and transferred amounts, adjustment code reasons, as well as denied, reversed, and unmatched claims. Posting ERAs and adding notes for claims follow up would tie it all together.
Growth is exciting. But if your physical therapy EMR is unable to step up then it could well come become the millstone that slows you down. It may be time to assess the growth readiness of your current EMR.