Pivoting from Processes to Engagement
Physical Therapy has become a critical part of healthcare and within physical therapy, the Physical Therapy EMR has turned into a largely indispensable tool.
Things were not always this way. There was a period before the EMR made its debut when business processes in the clinic were likely more one-off and somewhat disorganized.
EMR Past | ?Chaos and Disorder?
It could perhaps be said that the ?pre-EMR? period was typically characterized by a litany of problems. Wasted appointments. Challenges in communication. Misalignment between patients, providers, and payers. Therapists were busy treating patients and found it hard to keep up with charges and documentation for patients. This in turn increased the length of the payment cycle and AR. Variation in care was an issue in the past. Lack of adequate standardization led to the ?chaos.? The move toward value-based care and outcome-based payments meant that strengthening business processes needed to move up in priority in order to maximize outcomes from clinical interventions. With reimbursements coming down, efficiency became a key part of the equation. Documenting faster. Creating defensible documentation. Measuring outcomes. Staying compliant with payer rules, including the right codes and modifiers. Submitting claims faster. Reducing delays and denials. Appealing denials. Following up on payments. Communicating with patients more smoothly. The list goes on. Also, with multiple appointments forming part of the physical therapy plan of care, as many as 10-12 visits typically, keeping track of the schedule acquired added urgency.EMR Present | ?Processes and Order?
Enter the physical therapy EMR. Through automated workflows and data management, EMR helped physical therapists bring back order and standardization and step up efficiency. Not all EMRs are made equal. Here are some of the key features that the right physical therapy EMR should include. Eligibility Verification- Automatic verification of each patient’s insurance eligibility and flagging of warnings.
- This provides a chance to resolve insurance eligibility issues before the patient arrives in the clinic.
- Customizable flowsheets with CPT codes and modifiers that carry over between appointments.
- Patient history and therapist notes that could be easily updated with goals and outcomes tracking.
- Faster documentation, evals, and daily notes by carrying forward data and earlier entry of charges.
- Inclusion of Medicare rules like functional limitation reporting, 8-minute rule, MIPS and MACRA requirements.
- Snapshot view with number of patient visits and ?missing? charges not yet submitted in the claim.
- This would enable the therapist to quickly focus on the list and get it squared away.
- End-to-end workflows from documentation through billing with multiple rounds of claims review.
- Resulting in cleaner claims with required modifiers, compatible ICD and CPT codes, faster payout.
- Billing workflow automatically routing scrubbed claims to primary payers, then to secondary payers.
- Any balances added to patient statements or marked for write off if the practice so chooses to do.
- Transmittal of claims to the payer electronically via the integrated clearinghouse.
- All information from payers routed through ERAs and EOBs back to the practice.
- Automatic posting of EOBs/ERAs to the patient record with detailed analysis of claim submissions.
- Ease of altering rejected claims and resubmitting them via a centralized, automated workflow.
- Wide selection of reports that provide insight into the clinical and financial process.
- Workflow sequence of steps to streamline the process of obtaining data and analysis.
- Integrated view of the treatment journey with dates, short term and long term goals, and outcomes.
- Enabling the right treatments and responses to be provided to patients to meet their goals.
- Telehealth software that is seamlessly integrated into the EMR for a unified patient experience.
- Accessing exercise libraries, flowsheets, and other clinical documentation in the telehealth session.
- An online bridge that digitally connects the patient, therapist, and front office staff.
- Scheduling appointments, filling forms online, viewing balances, making online payments.
- Patients able to contact their practices and therapists without having to go through long phone calls.
- Two way messaging and patient portals that provide the communication platform.