1) PTP: What are some recent software/technology trends that PTs should know about?
1) Business Intelligence
2) Reimbursements and Referrals
3) Key Business Metrics

PTP: What are some recent software/technology trends that PTs should know about?

Brooker: Most PT practices are still entering remittances by hand. The productivity boost you will get from dispensing of this tedious routine is similar to the boost many practices got from moving from paper to electronic billing. The ability to monitor therapist productivity for incentive purposes is also a critical trend as PTs are so hard to find and hire and good incentive programs are becoming very popular. Those reports are becoming increasingly important for the organizations that provide physical therapy. Finally, we see a significant trend toward workflow automation. For example, PT practices can realize a productivity boost from software tools that take you in easy steps from patient scheduling to therapist worklist; then to note creation and charge submission; to charge auditing, billing, and payment/remittances; and finally to reporting, all in one integrated experience.

Greenwood: The digital office is the new trend that PTs should look for. We are going with the "less-paper" concept starting with an electronic appointment book. Documentation software electronically stores notes, and e-billing saves lots of paper. An insurance follow-up center can do away with lots of insurance paper files. With a digital document manager, any documents can be scanned and stored, but also e-mailed, and faxed without having to print the document first. This can include digital x-rays. Of course, digital sign-in is a paper- and time-saver. All it takes is one time that the office has to find and block information out on sign-in sheets, for digital sign-in to pay for itself. Getting all these integrated products from one source is the key to having it all work together smoothly.

McMullan: The key recent software/technology trends that physical therapists should know about are the growing adoption and integration of: evidenced-based practice (EBP), pay-for-performance (P4P), and regional health information organization (RHIO).

One trend that PTs should know about is the growing need for evidence-based practice and the access to that research and information from within clinical documentation software solutions for the treating clinician. The ability to have real-time access to evidence-based research to appropriately define the course of treatment for each patient and to provide the treating therapist with the most beneficial interventions to incorporate into their treatment program in order to get the maximal functional outcome for the patient will soon become standard.

Another trend that continues to emerge is the need for your software system to be able to capture and provide electronically essential data to support the growing P4P programs. In an effort to consistently justify the efficacy of physical therapy services and their positive impact to the functional outcome of the patient population, information technology solutions have the capability to easily capture the necessary data at the time of each patient encounter to facilitate outcome-based results over the course of a patient's episode of care.

A final software/technology trend is the increasing and the continued growth of RHIOs and the requirement for practice-management systems to support interoperability. To build a national network of interoperable health records, the effort must first develop at the local and state levels. This in turn suggests that practice-management systems must have interoperable capability to exchange pertinent data and outcomes with other information systems in use by other health care providers within the same community health network.

Morrill: Software interfaces and hardware mobility have probably been the most recent trends that directly impact therapists using technology in the clinical setting. Interfaces have become more intuitive to allow quicker access to information as well as improved speed in data entry. Touch screens, tablet PCs, ultramobile PCs, improved voice recognition, and faster processors have all contributed to recent advances.

Petrie: First, Data Visualization will revolutionize the way practice owners manage their business and collaborate with one another. This technology takes in all the data siloed in various software systems in your office (scheduling data, patient information, billing, accounting, etc), crunches all that data together, and displays it in easy-to-understand dashboards. Now, you won't have to have an MBA to understand how your practice is performing. You can identify problems and take action quickly to boost your revenues. And, you will have the irrefutable information you need to implement changes officewide with less resistance.

Second, as more therapists adopt data-visualization tools in their practices, virtual communities on the Internet will become even more important and valuable. Currently, many therapists ask questions and share ideas among fellow practitioners via chat forums and blogs. Soon they will be able to exchange in-depth information and establish benchmarks that will make these conversations even more productive.

Quirk: WiFi and wireless networking definitely has tremendous potential to alter the way practices gather, collect, and use information. Consider it in two ways, inside and outside the clinic. Inside a clinic, it is easy to envision wireless point of care documentation and understand the cost-savings of not having to hardwire your network when expanding or opening a new facility. As always, though, new technology always has its potential pitfalls. With wireless networking you should always start with laptops first before investing in tablet PCs to see if they will perform as needed and that they are used appropriately. For example, will there be dead spots? Will your therapists actually carry them from area to area or just leave them in a room and never become as portable as you had hoped? Will they be charged between uses? It should also go without saying that your network security will need beefing up as well. Outside the clinic, with Internet hot spots and wireless air cards becoming increasingly affordable and available, WiFi can basically expand your network infinitely. If you're going into a meeting with a referral source, you can instantly retrieve the amount of patients he has sent in 6 months. Documentation can be completed from a client's worksite and entered into your billing system immediately.

Welty: The most significant software/technology trend in recent months has been the focus that therapy clinics have on finding a complete practice-management, billing, and clinical documentation system. There are a number of clinics that use a practice-management system that is separate and distinct from their clinical documentation system and may also be separate and distinct from their scheduling system and/or document-management system. There are some software vendors out there that provide one of these functional areas very well, but customers are increasingly demanding fully integrated solutions.

Arati Murti is the editor of Physical Therapy Products. For more information, contact .

Reimbursements and Referrals

Is your software working for you?

McMullan: There are three key ways that software technology can specifically help improve reimbursements. The first is by efficiently capturing and tracking the patient's responsible portion of the care provided. A good software solution should easily accept and monitor the co-payment or co-insurance amount due by the patient at the start of each treatment session.

The second key way software can assist with accurate and timely reimbursement is by ensuring that the clinical documentation is complete and accurate for that treatment encounter and specific to the needs of the payor. A good software system should provide the necessary prompts and information in real time while the clinician is completing the clinical documentation to adequately support full reimbursement on first claim submission.

The third key way that software can improve reimbursements is by leveraging electronic data interchange (EDI) between the physical therapy business owner's practice software and the payor, either directly or through a clearinghouse. The ability to automatically transmit and receive patient claims, payments, eligibility, and benefit information using existing EDI ANSI X12 standards ensures accurate and timely reimbursement. Software solutions can deliver near 100% pass-through on first-time claim submission by strict attention to detail and enforcement of application rule-based edits.

There are several ways that software can assist with improving referrals. Here are two key ways that software assists the practice owner to improve referrals. The first is the ability to measure the value of a referral. Practice-management software has the ability to track and measure a referral and provide critical information to the practice owner regarding revenue and cost associated with each referral type and from each referral source. The access to this information allows the practice owner to focus on leveraging the most profitable referral types and referral sources, and minimize those referrals that are the least profitable. Examples of the information that can be provided regarding a referral are: length of time between when a referral was received and when the patient began treatment, number of visits per referral, revenue per referral, net revenue per referral, and cost per referral.

The second way software can help improve referrals is by monitoring referral trends and enhancing communication between the practice and the referral source. Practice-management software gives the practice owner the ability to know exactly where their referrals are coming from at any given moment, and alerts them to new referral sources as they arise. This information is critical to support the overall marketing effort of the practice and assists in measuring the value of specific marketing programs designed or targeted to specifically increase referrals.

Morrill: Software can improve reimbursement by improving the legibility of notes, creating reminders and billing edits, and having a system in place to proactively check for common errors in documentation and claim submission. Practice-management software will improve the communication between clinical and billing staff, which will decrease human error and increase the speed of reimbursement. Referrals can be improved when software provides clinics with data that can look at referral patterns and revenue as well as geographical and marketing strategies. Software can track referral trends to help create marketing campaigns. Reports can be graphical with time parameters. For example, a report could be run to look at patients that have been referred to the clinic within a specific month from a specific physician. The referral report could also tell which diagnosis trends are being referred from a particular physician to guide future marketing and/or staffing.

Petrie: Three critical steps to improve your reimbursements are: 1) comply with insurance requirements when treating the patient, 2) code treatment properly, and 3) submit documentation that matches the claim. A template-based documentation system can help with all three. It ensures that treatments follow established best practices—that treatments are coded based on insurance requirements—and that the claim matches the documentation. By integrating your documentation and scheduling systems, you can further improve reimbursements by ensuring that every scheduled visit is documented and billed, so that nothing falls through the cracks.

A rigorous patient-intake and reporting system is the best way to increase referrals. You will want to track the number of referrals you receive each month not only by physician, but by zip code. This will allow you to focus your efforts on the most profitable areas of your community, and/or work to generate additional referrals and sources in neighborhoods where you are getting less business. High-quality professional evaluations generated by your documentation system are invaluable tools for obtaining new referral sources and increasing referrals from those sources. Those reports are a reflection of your practice, and comprehensive reports illustrate the quality of care you deliver.

Quirk: With reimbursements, the key is to know and understand your revenue cycle, which starts from the time the patient's first appointment is scheduled and is completed when all balances are collected. A good scheduling program will facilitate the collection of demographic information essential to the billing process. Most registration systems provide for the storage of helpful insurance information such as the patient's copay, benefit levels, and deductible limits. Electronic documentation software plays a key role in facilitating reimbursement because it can facilitate proper assignment of diagnosis and treatment codes. Although billing and collection software have been around for some time, recent enhancements allow for electronic claim submission, which speeds up payment and reduces errors.

Software can improve the referral process in two important ways. First, regular tracking of referral sources in your database will allow for focused business- development efforts. Second, providing a well-organized treatment report containing data stored in your computer system will impress your referral sources and distinguish you from competitors.

Welty: The reimbursement cycle should be managed with a software application that will track reimbursement per charge based on a number of factors including rendering provider, date of service, insurance, location, etc. Reimbursement improvements are directly related to improvements in marketing and productivity, which should result in increased cash flow. The ultimate measure of your organization's financial success is your bottom-line profitability.

Software tools and reports can be used to verify that your company is realizing your desired results. These tools should answer the following questions: Are we being paid in accordance with our payor contracts? What types of services are the most profitable for our organization? What patient financial classifications represent the best sources of revenue? How effectively are we collecting our outstanding AR? Are we actually utilizing the authorized visits we've been granted?

There are a number of key questions your software tools and reports should be answering in terms of improving referrals, such as: Which referral sources are providing us with our best patient-volume totals? Where does our patient population with the best reimbursement rate reside? If we were to open a new site, what areas should we consider? Can we identify target populations for our marketing campaigns? What marketing campaigns should we establish and maintain based on the answers to these questions?

Your software should help you build and maintain your referral network. To the extent that the software can record specific values such as zip code, service code, date of service, location, line item referral source, line item diagnosis, charge, payment, adjustment, and all other relevant information, and then have a robust reporting engine to define reports that organize and sort this information into decision support manuals, your rate of referrals will improve accordingly.