Investing in an EMR for Your Clinic. Selecting the right system starts with asking the right questions. By MIKE CICERO, PT and DAVID MCMULLAN, PT

Transcription

1 Investing in an EMR Selecting the right system starts with asking the right questions By MIKE CICERO, PT and DAVID MCMULLAN, PT

2 INTRODUCTION Running a physical therapy center is not getting any easier, if one judges by poll data released by the APTA and discussion online and in industry periodicals. Today s physical therapists must navigate a denser regulatory environment, more resistance to insurance claims, and new requirements for detailed evidence regarding functional improvement outcomes. ABOUT THE AUTHORS How will PT providers continue to offer the highest quality of patient care with fewer resources? How are some centers thriving in this new environment while others are closing? The answer is simple. Facilities that are growing and providing record net revenue to their owners have succeeded in six areas: 1.) Maximizing the value of available time slots on the provider s schedule 2.) Simplicity in adding new patients 3.) Use of core staffing, supplemented by part-time and per diems 4.) No waste or excessive expenses in the center 5.) Collection of revenue up front and faster 6.) Investment in technology that improves the quality of patient care and creates efficient throughput This white paper looks at the last of these points, and raises some questions you should consider when evaluating a technology investment for your center. To keep their clinics profitable, many administrators are looking to electronic medical records systems (EMR). An EMR can dramatically improve efficiencies, ensure regulatory compliance, improve patient flow, and improve collections and cash flow. Whether moving from paper documentation or from an incomplete or ineffective existing system, it is critical to make an informed decision. MIKE CICERO, PT, is the Director of Acute and Outpatient Operations for Burger Rehabilitation Systems. Burger provides, evaluates and treats for a variety of conditions; it offers physical, occupational and speech therapy. Burger services are provided in acute hospitals, skilled nursing hospitals, outpatient clinics, senior residential communities, schools and employer-based occupational health clinics. The company was selected Best in Business by the Sacramento Business Journal. DAVID MCMULLAN, PT, is the Vice President of Product Management for the Therapy division of Source Medical Solutions, Inc. He is a Physical Therapist with over 20 years of outpatient rehabilitation health care experience in both private practice and hospital settings. 1 Investing in an EMR

3 ASSESS YOUR SITUATION, ASK THE TOUGH QUESTIONS Under the direction of Mike Cicero, Burger Rehabilitation researched many EMR systems before adopting Therapy Source TM from SourceMedical TM about five years ago. Since then, we have noted improvements in the quality of documentation, QA [quality assurance], tracking of patient satisfaction, billing and collections, and reporting and statistical tracking, he says. Cicero suggests administrators weigh the following when evaluating their needs and their options: Q Will the EMR save clinicians time when documenting? You want more than a glorified word-processing system. Is the EMR you are considering designed to limit typing? Ask also: Does it automatically add CPT & G Codes as the clinician documents (saving a step and also preventing mistakes)? Is it easy for the clinician to document a patient session? Do prior tests/measures/treatments/goals carry forward automatically? Does the EMR lower average daily note time to less than two minutes? Does the application prompt the clinician for payor-specific documentation? Not all payors or payor groups have the same documentation requirements, and these requirements can change based on services being performed. For this reason, it s essential that your EMR helps the clinician manage these requirements with simple, intuitive prompts prior to the completion of patient s documentation. Q Will the EMR increase revenue? Burger Rehabilitation experienced a dramatic reduction in claim denials, thereby improving aging and collections per visit. Determine if your center can achieve the same by asking: Does the EMR eliminate giving away of care by ensuring charges are supported by treatments provided and documented? Does the EMR guarantee clean claims with required and recommended sentences by payor and note type (customizable) to make it error-proof? THE NEW STANDARDS Providers will soon be required to present evidence of why they are treating someone, how the patient is progressing and, essentially, why the provider should be paid. As a result, upcoming regulatory requirements are causing providers to re-examine how they handle documentation. These regulations were developed to control costs and limit excessive spending on patients. As the industry moves towards this new pay-forperformance model, clinicians will be required to demonstrate (and document) their ability to improve the function of a patient. Those not reporting the required data, at the right interval, will not receive payment. Without documentation software, it will become increasingly more difficult to keep up with the changes and intervals at which clinicians must report. For example, because of the frequency at which therapists see patients, it is much harder for them to report data. Without documentation software, it will be nearly impossible for providers to track every detail and requirement for each program, the corresponding codes, and reporting intervals. 2 Investing in an EMR

4 Does it have a billing engine that selects the best CPT code (for highest reimbursement), so the therapist or administrative staff doesn t need to guess? Do EMR users see an average increase in per-visit revenue of percent? Q Does the EMR force compliance? The highest-ranked EMRs feature tools to easily track authorizations (script, health insurance authorization, Plan of Care status). One of the best ways to ensure payment is to track authorizations and benefit limits. The system should be able to require signatures of administrators for any outliers. Federal guidelines require a tracking of Plan of Care statuses, G-code reporting and tracking, and ADL assessment. The simplest and fastest way to get a claim paid in a timely manner for the expected amount is to ensure that your documentation supports the charges and billing codes associated with each visit. The optimum way to accomplish this is through your EMR system by providing the clinician with real-time clinical auditing for all charges and billing codes. This should include those codes that are both payable and non-payable (G-codes). This allows the clinician to make any adjustments and edits before the billing codes even get to the claim. Your EMR system should provide this real-time coding information both by insurance type and/or payor. When evaluating compliance-readiness, ask: Are there required sentences by payor/note type that allow a clinician to sign a note only after it is compliant? This dramatically decreases errors and also assists with your QA/chart audit process. Does the EMR track Plan Of Care status (sent to physician, waiting on signature, etc.) Does it remind the clinician when functional limitation reporting is required and streamline the documentation process (automatically adding G-code when documented)? Regarding functional limitations, facilities that don t report on the correct interval won t receive payment. The technology selected should offer automated reminders about what data to capture and when to capture and submit information. 3 Investing in an EMR

5 Q Is the EMR designed by a company with experience and a solid reputation? Implementation and training mark only the beginning of the relationship you will have with your EMR provider. You will have greater confidence when you ask the following: How long has the company been in the therapy industry? Does the company have a full end-to-end solution (EMR/ scheduling/billing software and optional outsourced billing service) so you don t need to use multiple providers? Does the company provide both client-hosted as well as cloud-hosted (SaaS) applications? If cloud-hosted deployment is available, does the application auto-save? Is there potential for losing data? What is the provider s reputation for downtime and service outages? Does the company work with clinics of all sizes? Does the software provide comprehensive reporting that large groups need, and is the software competitively priced for clinics of all sizes? Does the company have a training team that provides one-onone training and optional onsite training (as opposed to training with other clinics or just a manual)? Does the company offer a variety of learning opportunities, including instructor-led workshops, best practices coaching, webinars, and other web-based training? BURGER S EXPERIENCE Mike Cicero reports that Burger Rehabilitation has benefitted from the implementation of TherapySource EMR and several related modules. The company is currently using the system in its entire capacity, from centralized scheduling, centralized authorization, electronic billing, QA assessment and tracking, patient reminder calls and electronic measurement of patient satisfaction. We have demonstrated a reduction in cancel/no-show rates, an increase in collections per visit and clinician efficiency, improved quality of documentation, and decreased aging, Cicero says. SUMMING UP When considering an EMR solution, asking the right questions is critical to finding the system that best benefits your practice. This includes researching the types of support offered by the EMR provider. Asking for information about features that save time, increase revenue, and assist in compliance can help you make a well-informed decision. To learn more about EMR technology from SourceMedical, please see the contact options on the next page. 4 Investing in an EMR

6 To learn more about TherapySource, the EMR designed by PTs for PTs, call or SourceMedical TM is the leading provider of software and billing services for Rehabilitation Clinics, Ambulatory Surgery Centers and Specialty Hospitals nationwide. For nearly 30 years, SourceMedical has been the trusted brand for innovative applications, industry expertise and unsurpassed customer service. Last year, our software and billing services processed over 14 million outpatient transactions via 21,000 therapy professionals. For the past 11 years, SourceMedical has earned a position on the Healthcare Informatics list of Top 100 healthcare information technology companies. In 2013, SourceMedical ranked among the largest revenue-cycle management firms, as tracked by Modern Healthcare magazine. 100 Grandview Place, Suite 400, Birmingham AL Source Medical Solutions, Inc. SC7612