“We will rebuild, we will recover, and the United States of America will emerge stronger than before.” These are the words of President Obama in his speech to the U.S. Congress last night where he called for comprehensive healthcare reform this year. The President talked about the cost of healthcare on families and businesses, indicating that reform work would begin as early as next week.
What kind of impact does Obama’s recently-passed Stimulus Bill have on physical therapists? PTProductsonline.com published this article titled “Stimulus Bill Includes Many Provisions for PTs.”
President Barack Obama is expected to outline some of his healthcare reform plans tonight in a speech he will give on the floor of Congress, broadcasted live nationwide. The President is putting healthcare and the promotion of healthcare IT among his top priorities.
Read More at Healthcare Finance News
Four Steps to Improve Your Revenue Cycle – Independent of Billing Systems or
By Jim Hammer
The threat of a 10.6 percent Medicare payment reduction captured the attention of many
therapy practices this past summer. Ultimately, the payment reduction was voted down,
but the bill had an unanticipated impact on the industry. It prompted many practices to
evaluate how they could maximize existing revenue streams and better prepare for future
One innovative approach recently implemented at many therapy practices focuses on
analyzing electronic remittance advice (ERA) to reduce denials and underpayments.
Using ERA data, as opposed to data posted in the billing system or culled from the
clearinghouse, gives therapists greater insight into denial rates, by payer, as a means of
recouping reimbursement. This wise approach allows therapy practices to:
1. Pinpoint reimbursement bottlenecks
2. Benchmark findings
3. Efficiently track and work denials to recoup revenue
4. Monitor payer contract adherence
Focusing on these four key components of the revenue cycle helps practices find missing
and overlooked reimbursements, while helping them with timely and efficient collection.
Most importantly, ERA data analysis allows practices to gain an understanding of why a
payer denied a claim so they can prevent future denials. The resulting analysis gives
power back to therapists for dealing with payers, and allows them to develop the best
possible processes to ensure the full reimbursement they are allowed with the lowest cost
The power of Web-based applications makes this type of analysis possible, even for the
smallest of practices. Subscription-based services allow practices to upload their ERA
data to a Web application, where tools are available to analyze the data. By leveraging
Web-based applications, practices do not have to hassle with licensing, implementing and
maintaining software and hardware.
Pinpointing Reimbursement Bottlenecks
Optimizing the revenue cycle depends on identifying reimbursement bottlenecks, such as
tracking the average payment delay by payer, or documenting if above-average delays
tend to result when specific procedure codes are used in claims. Identifying bottlenecks
provides therapists, billing and collection staffers with valuable information as to where
they should focus their efforts and modify processes to reduce delays. From a manager’s
desktop, numerous probes into the practice’s data offer new ways to trend and measure
bottlenecks that impact the revenue cycle, such as tracking:
• Claim summaries by reason code and/or procedure
• Denial rates by procedure
• Days sales outstanding (DSO) by procedure
• Claims summary by reason code/procedure
• Average payment lag by procedure
• Aged claims
• Patient lag by procedure
Much of the value in pinpointing bottlenecks is that it allows practices to benchmark their
findings for comparisons against other peer organizations locally, regionally or
nationally. Leading Web-based analytical tools will provide benchmarking data as part of
the subscription service. Benchmarking reports allow practices to get answers to
questions, such as how long does it take a practice vs. peers to get paid for specific codes,
and how often does a payer deny claims for specific procedures?
Tracking and Working Denials to Recoup Revenue
Part of the challenge for today’s therapy practices is tracking denials, rather than letting
them slip through the cracks and lose reimbursement opportunities. Web-based solutions
are available to help, and can include decision-support tools to assist with reworking
claims for resubmission. Actual customer experience shows that the average time to
rework a claim is 45 minutes and typically costs about $73. Applications that can
expedite this process immediately reduce operational costs.
Monitor Payer Contract Adherence
Each practice loses $30,000 on average per year due to underpayments. Practices that can
systematically track payer compliance have an opportunity to substantially increase
reimbursement. To accomplish this, practices can load payer-specific fee schedules into
Web-based systems to monitor payer compliance by comparing reimbursement to
The capabilities of Web-based solutions tailored for therapy-based practices continue to
advance. The best thing is, with no new software, hardware, long-term maintenance
contracts, or lengthy implementation projects, therapists can quickly drive more cash to
their bottom lines with these new tools. And, unlike relying on billing systems, these
new-generation Web-based tools are looking at payer-generated remittance files –
analyzing data that never even makes it into the billing software.
In this day of cutting costs and maximizing productivity, it pays to look at simple, Web technologies
to augment investments, instead of creating more capital expenditures. It’s
anticipated that future generations of these solutions will even be able to provide
practices with tools to determine the expected profitability of specific procedures based
on patient diagnosis. These solutions provide practices with powerful tools to avoid lost
revenue opportunities and identify processes that can be modified to support long-term
Jim Hammer, Chief Operating Officer of Chart Links, can be reached at
President Barack Obama, today, signed the American Recovery and Reinvestment Act of 2009, H.R. 1. The legislation provides $19.2 billion for health IT to help stimulate the economy, increase investment in health IT, build a strong IT infrastructure for healthcare, and expand job growth.
As reported by HIMSS, the American Recovery and Reinvestment Act of 2009 is intended to achieve widespread adoption of health IT and enable electronic exchange of health information. The Act offers incentives through Medicare and Medicaid to reward providers for demonstrating the “meaningful use” of certified EHR technologies. The Medicare incentives for eligible professionals become available beginning 2011 and for eligible hospitals FY11 and are available only to those providers that demonstrate use of certified EHR technology as defined by the Act. Beginning in 2015 (eligible professionals) and FY15 (eligible hospitals) the incentives end, and eligible professionals and hospitals who are not “meaningful users” of EHR technologies will begin to see a reduction in their applicable Medicare percentage increase.
The Centers for Medicare & Medicaid Services (CMS) issued Transmittal 1678 on February 13, 2009. This transmittal describes the policy for outpatient therapy cap exceptions for 2009. It also updates the dollar amount of therapy caps.
The 2009 allowed dollar amount for outpatient therapy limits, except outpatient hospital services, has been updated to $1840 for physical therapy and speech-language pathology combined and $1840 for occupational therapy separately.
The newly revised material is effective on January 1, 2009 with an implementation date of April 6, 2009.
The American Physical Therapy Association (APTA) launched a new branding campaign last week at the Combined Sections Meeting in Las Vegas, Nevada. The new campaign, “Move Forward: Physical Therapy Brings Motion to Life,” positions physical therapists as specialists who can help improve mobility without the expense and pain of surgery or the side effects of prescriptions.
The APTA has launched a new website section for is members called Brand Beat. It has also unveiled a consumer Web site at www.moveforwardpt.com that serves as a source for information about how physical therapy can bring motion to life. The consumer website includes information on
- Why Physical Therapy?
- Finding a physical therapist
- Improving mobility and motion
- Avoiding surgery
- Eliminating paint without medication
- Consumer tips
Let us know what you think of the new brand campaign by posting a comment.
The final stimulus bill will allocate $19 billion to accelerate the adoption of health care information technology by medical groups and hospitals.
The funds are aimed at saving billions in medical errors and at improving quality. It is said that thousands of jobs will also be created in the high-tech sector to promote and impelement the use of technology in health care.
Robert Stafford and John Rea are reporting great attendee interest in our rehabilitation software at Booth #654 at the American Physical Therapy Association Combined Sections Meeting in Las Vegas, Nevada.
A big thanks to all of our current and future customers who stopped in to see a therapy documentation software demonstration.
We appreciate your interest and look forward to automating the workflow of your outpatient rehabilitation facility.
Popular former senate Majority Leader Tom Daschle has withdrawn from the process to become Health and Human Services secretary due to distractions ensuing from his failure to pay $146,000 in back taxes.