Revolutionizing Physical Therapy Billing: A Thinkitive EMR Success Story

Overview

The client is a renowned organization based in the United States, specializing in the field of physical therapy and managing several clinics in different locations. Supported by a committed group of physical therapy professionals, the clinics handle a substantial weekly patient load ranging from 200 to 300 individuals. The facility prides itself on a well-rounded team comprising 15 physicians, 20 staff members, and five administrators, collectively ensuring the smooth operation and delivery of top-notch care to patients.

Business challenges

The client has identified a significant challenge in the area of medical billing. The existing processes have proven to be cumbersome and time-consuming, leading to inefficiencies in billing operations. The client is now in search of an Electronic Medical Records (EMR) system that specifically addresses the medical billing challenges they are facing. The desired solution should streamline billing processes, minimize errors, and expedite reimbursement cycles.

Thinkitive Solution

Thinkitive business analyst team and SMEs connected with clients to get complete requirements for software development. After connecting with the client multiple times, the team finalized the requirements. Based on the gathered client requirements, the team has developed a feature list that describes the project scope.

Our team has developed several essential elements that assist medical practitioners in streamlining their medical billing procedures. Here are some key elements

Solution Highlights

1. Physical therapy-specific CPT codes

Our team has developed a feature that assists in customizing to include physical therapy-specific Current Procedural Terminology (CPT) codes. To ensure accurate coding for billing, we have implemented a dedicated section within the system for physical therapy regarding treatments, procedures, and services. Also, we have implemented a code lookup database, which helps ensure quick and accurate code selection. It will auto-populate the code as per the provided services. Biller can easily map ICD codes with CPT docs.

2. Integrated Billing Module

The Integrated Billing Module in the existing Physical Therapy Specialty EMR involves seamless patient records and billing information integration. This module connects treatment plans to billing data within a unified platform using interoperable standards, eliminating manual data transfer. The integration ensures real-time synchronization between clinical and billing systems, minimizing errors and streamlining the workflow.

3. Real-Time Insurance Eligibility Verification

Eligibility Verification in the existing Physical Therapy Specialty EMR involves integrating a secure interface with insurance databases. Utilizing standardized APIs, the system queries insurance providers in real-time to instantly verify patient eligibility, coverage details, and benefit information. Upon patient registration or appointment scheduling, the EMR triggers automatic eligibility checks, ensuring up-to-the-minute accuracy. The system interprets the response data, flagging any potential issues.

4. Automate ERA posting

Once payment is received from the payer, the biller can easily map it with the patient's invoices. With the help of a clearinghouse integration system, the EOB (Explanation of Benefits) is automatically posted. After the primary insurance claim is posted, it becomes easier to apply for secondary claims.

Value Delivered

• Efficiency gains

  Significant reduction in manual efforts, leading to increased efficiency in billing processes. Also, it helps focus on other activities in healthcare, which is essential.

• Error Reduction

  Automated data entry and validation mechanisms significantly reduce errors in billing codes and claims.

• Accelerated Reimbursement Cycles

  Expedited reimbursement cycles through automated processes and proactive claims management.

• Data-Driven Decision Making

  Robust reporting and analytics tools enable data-driven decision-making for continuous process optimization.