Medicare Therapy Cap Forecast Report

Chart Links, the providers of rehabilitation workflow management software, is pleased to announce availability of the Medicare Cap Forecast Report.  The purpose of this report is to aid outpatient rehabilitation facilities in managing the CMS Medicare Part B Outpatient Therapy Cap and Exceptions Process.

The Medicare Cap Forecast Report allows Chart Links Rehabilitation Software users to generate a list of patients who may be nearing the therapy cap threshold.  The report displays amount and visit utilization for occupational therapy services as well as physical therapy and speech-language pathology services combined.

To learn about the Medicare Cap Forecast Report, please contact the Chart Links Helpdesk at (877) 701-9191.

Revision to LCD for Outpatient Physical and Occupational Therapy (L26884)

In 2010, National Government Services received a request for reconsideration of the Outpatient Physical and Occupational Therapy local coverage determination (LCD) (L26884) to include International Classification of Diseases, Clinical Modification, 9th Revision (ICD-9-CM) codes V57.1-V57.89 as correct coding. Review of the ICD-9-CM manual indicated that the request was technically correct, and therefore the requirement was included in the May 2010 draft revision to the LCD. Numerous comments were received from all National Government Services jurisdictions that such coding was redundant and created additional burden for providers.

The National Government Services medical directors and policy staff agreed with these comments, and sought further guidance from the Centers for Medicare & Medicaid Services (CMS) about whether these diagnosis codes needed to be included in the LCD. CMS has indicated that although the ICD-9-CM manual does include this recommendation, contractors did not have to include these diagnoses in the LCD.

Consequently, the LCD and supplemental instruction article (SIA) are revised, effective November 1, 2010, to delete coding instructions that required ICD-9-CM codes V57.1-V57.89 be included as the primary diagnosis on all therapy claims. Furthermore, National Government Services will not require these diagnosis codes as primary or subsequent codes. National Government Services does, however, note that such a recommendation does exist in the ICD-9-CM manual. If providers use these codes, they must also include the diagnosis code of the specific medical condition for which each therapy service was provided.

To see the document on the NGS website, click on, select your Business Type and your Region and click “Go.” On the Provider Specific Portal Home Page, under News and Publications, click on What’s New from the drop down menu.

Source: Gawenda Seminars & Consulting

Therapy Documentation Software Return On Investment

January 5, 2009 · Posted in Compliance, Documentation, Reimbursement, Scheduling, Workflow · Comment 

When it comes to automating therapy documentation, funding is one of the biggest challenges outpatient rehab facilities face.

If you’re struggling to make a compelling business case for electronic medical records to your hospital board of directors, consider all of the operational areas that will yield quantifiable results.  As you build your case, marry up metrics to timeframes as a part of your formula for return on investment.

Efficiency Improvements

When you automate therapy appointments, appointment reminders, referral management, authorization tracking, evaluations, plans of care, progress notes,  flow sheets, and more; information can be called up and acted on almost immediately.  List out and quantify all of the administrative task time this saves.  Consider improvements in communications alone as it relates to time spent on referrals, authorizations and appointment reminders.    The staff productivity gained allows for major improvements in therapist work flow which, over time, allows more patients to be seen in the same amount of time.

Cost Savings

One of the greatest cost savings brought by electronic therapy documentation is the elimination of transcription costs.  Because therapists enter clinical documentation directly into the system, traditional paper-based methods are greatly reduced, if not eliminated.  Determine your current cost per therapist or per page for transcription.  Estimate, conservatively, a reduction in transcription costs.  This will likely be one of the most significant contributors to your overall cost savings with an electronic therapy documentation system.  Don’t forget to consider other paper chart costs in the ROI equation:

  • supplies for creating and storing charts (from folders, stickers and dividers to cabinets)
  • labor expenses for managing chart pulls, filing and audits
  • copying expenses for documentation to attorneys, payers and physicians

Revenue Enhancements

Electronic therapy documentation opens new doors for driving revenue that should be considered as a part of return on investment.  Consider how much more compliant, complete and accurate documentation becomes when it has the checks and balances of automation.  Coding levels and claim errors correlate directly to documentation of the encounter.  When therapy documentation occurs electronically, therapists report greater confidence levels as it pertains to Correct Coding Initiative (CCI) Edits, Medicare time tracking (or the eight minute rule), authorization tracking, and other compliance issues that can help or inhibit proper reimbursement.  Consider improvements in billing accuracy as a part of your ROI analysis.

Quality Improvements

Some of the less tangible returns of electronic therapy documentation include quality.  In most cases, electronic documentation allows for quicker, more legible, better organized and more comprehensive patient documentation overall.  Across the outpatient rehab facility, automation standardizes clinical documentation, reducing inconsistencies in structure,  poor handwriting, and lag time in documentation and approvals.  Patient education sheets are readily accessible and up to date.  Plan of care reports are auto-generated from the evaluation, able to be monitored, electronically signed, and faxed from the desktop.  These and many other improvements in quality should be considered in ROI.


In an outpatient setting, electronic therapy documentation impacts both the therapist and staff productivity.  A good business case for return on investment should focus on

  • efficiency improvements
  • cost savings
  • revenue enhancements
  • quality improvements

If you need help putting together your Return on Investment business case for an electronic therapy documentation system, please contact us.

Ann W. Kummer to Speak about Speech Therapy Software at ASHA

November 18, 2008 · Posted in Compliance, Documentation, Scheduling, Speech Therapy, Workflow · Comment 

We’re happy to announce that Ann Kummer, PhD, CCC-SLP, ASHA-F, will speak at the 2008 Annual American Speech-Language-Hearing Association (ASHA) Convention on November 22, 2008 in Chicago, IL from 8-9am. The presentation, entitled “It’s Not IF You’ll Computerize, It’s WHEN and HOW,” will cover 10 things that speech-language pathology (SLP) clinics should consider when evaluating speech therapy software to automate their documentation and administration. Dr. Kummer is the Senior Director of Speech Pathology at Cincinnati Children’s Hospital Medical Center (CCHMC) and Professor of Clinical Pediatrics at the University of Cincinnati Medical Center.

“More than a decade ago, we embarked upon a mission to reduce the documentation and administrative demands within our organization,” says Dr. Kummer.  “Today, we leverage information technology to automate our processes, streamline workflow, reduce billing errors, increase coding compliance, and improve the quality, consistency and turn-around time of our documentation.”

In 1995, Dr. Kummer chose Chart Links Rehab Software to meet the unique documentation needs of a speech pathology department that couldn’t be met with a generic clinical documentation or electronic medical records system. Within a year of launching the system, the Speech Pathology Department at Cincinnati Children’s started realizing the benefits of automation, which included:

  • 1-2 hours of increased billed time per week per full-time equivalent therapist
  • Increased reimbursement resulting from consistent processes
  • Decreased support staff costs
  • Improved net revenues
  • Improved staff and patient satisfaction

The cost reductions in computerizing the documentation and administrative processes continue to deliver a financial return to the organization each year.

Dr. Kummer’s department has been computerized with Chart Links Rehab Software since 1995. She is the author of Business Practices: A Guide for Speech-Language Pathologists published by ASHA.  She is also the author of Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance published by Delmar Cengage Learning, 2 Edition (July, 2007).

To learn more about Chart Links’ Rehab Software, visit booth #962 at the American Speech-Language-Pathology Association (ASHA) Annual Convention in Chicago, Illinois on November 20-22, 2008, call 888.369.0707, or visit our website.

Article: Chart Links online at Executive Healthcare Management

August 8, 2008 · Posted in Compliance, Documentation, Workflow · Comment 

Ron Miller, M.D., our President and Chief Medical Officer, and Betty Esposito, our Vice President, were asked to contribute an online editorial to Executive Healthcare Management magazine.    The article is entitled “Rehabilitation Clinics Can Level the Playing Field: Leveraging Electronic Charting Solutions to Improve Documentation, Coding Accuracy, and Billing Processes.”

The article covers the ways in which rehabilitation clinics can use software to track and bill for care in order to compete effectively and earn a profit in today’s market.  The article delves into how electronic charting solutions help therapists to comprehensively and accurately document patient care, reducing human error and complying with regulatory requirements. 

It covers four areas where electronic charting can help level the playing field with technology-enabled resources:

  • Correct Coding Initiative Edits (CCI Edits)
  • Time Tracking
  • Account Tracking
  • Authorizations

Version 5 to Launch in June

Chart Links is advancing its product offering.  With a new management team in place and a renewed focus on software enhancement, our interface will be fresh, our workflow management capabilities broader, and our rehabilitation-specific content deeper.

The new version will better meet the demands scheduling, documenting patient care, driving revenue and reporting outcomes for multi-disciplinary therapy care in an outpatient setting.

Features of the new therapy software will include:

  • flow sheet documentation
  • a new user interface
  • enhanced Medicare Time Tracking features
  • automated patient appointment reminders

Watch for a release in the coming month.

FOTO Partnership for Data Exchange

February 7, 2008 · Posted in Compliance, Outcomes · Comment 

Chart Links has partnered with Focus On Therapeutic Outcomes, Inc. (FOTO), the nation’s largest independent outpatient database and reporting service for physical rehabiliation providers, to develop a data exchange between FOTO’s Patient Inquiry(r) software and Chart Links Rehabilitation Software.

“Chart Links is expanding its outcomes and analytics offerings to aid patient care and ensure compliance requirements,” says Ron Miller, MD, Chart Links Presdient and Chief Medical Officer.  “Our partnership with FOTO offers providers a convenient way to get at functional and demographic data that will support decisions to maximize their clinical efficiency.”

“Our first goal is to eliminate any duplicate data entry,” says FOTO CEO Ben E. Johnston, Jr., PT.  “Once that is complete, we will investigate other ways that we might benefit our mutual clients.”

FOTO has been gathering functional outcomes data since 1992 and is currently installed in approximately 1,800 clinics in the United Satates and Israel.  FOTO’s 24 month comparative data set includes approximately 180,000 completed patient episodes from orthopedic, neurologic, industrial, and pain management programs.  FOTO’s Patient Inquiry Software was recommended by CMS in Transmittal 63. 

To learn more, visit the outcomes page on our website.