In what features/business areas can managers save money/time? (What software features can be used differently or combined?)

Industry Experts

• Robert Brooker, Director, PTOS Software, Effingham, Ill
• Bill Cummins, Cypress Product Director, Accu-Med Services, Milford, Ohio
• Ricky Gomez, VP Sales & Marketing, Planetrehab, Lafayette, La
• Derek Greenwood, CEO, EON Systems Inc, Clearwater, Fla
• Jim Hammer, COO, Chart Links, New Haven, Conn
• Charles Lee, National Director - Sales and Marketing, Raintree Systems Inc, Temecula, Calif
• Dan Morrill, PT, MPT, CEO, Hands on Technology Inc, Hindsdale, Ill
• Drew Palumbo, Principal, TherAssist Software LLC, Highland Park, Ill
• Steve Petrie, CEO, SpectraSoft Inc, Tempe, Ariz
• Jim Plymale, CEO, Clinicient, Portland, Ore
• Steve Presement, President, InTouch Practice Management Software, Buffalo, NY
• Gerry Stone, President/Clinical Advisor, The Rehab Documentation Co, Nashville, Tenn

Brooker: We're finding that most clinics are entering remittances by hand. This is a huge labor waste. PTOS will allow you to import remittances automatically. If you are a large or busy clinic, this will affect the size of the billing team you need. If you are a small clinic, you will have more time to follow up with collections.

Cummins: This can vary by treatment setting such as Med A / PPS Assessment and treatment planning tools for SNF services to scheduling and direct billing features for outpatient clinics. Managers across all settings are also looking for efficient yet comprehensive clinical documentation, integrated outcomes tracking across all disciplines and enforcement of regulatory requirements and local coverage determination (LCD) guidelines. Therapists and managers also want to take advantage of technology to have improved mobile access to information.

Gomez: Redundancy is a productivity killer and major expense, so eliminating repetitive tasks is paramount. With current software, there is no need to, for example, fax billing sheets to one central location. But the biggest money saver is consolidation of billing and collections activity. If an owner/manager were to calculate the actual cost of how much their business is spending to bill and collect claims, they would be surprised. The accounting industry has proven how much more cost efficient it is for a business to outsource redundant tasks than to do them in-house. There are firms in the physical therapy field that can consolidate redundant tasks and save a therapy practice money.

Greenwood: In almost every area of a practice, costs can be reduced with better software. Better, smarter billing systems with automated insurance follow-up can increase collections and reduce the costs to collect. Fast, provider-specific customized documentation can greatly reduce documentation time and increase accuracy. Electronic document storage reduces filing time and improves access. Full integration between billing, documentation, and document storage will greatly increase efficiency and thus reduce costs even further.

Hammer: By using software to reduce the phone calls and faxing associated with physician approval of therapist-generated plans of care, both time and money can be saved. At one of our hospital-affiliated outpatient centers, both therapists and physicians were documenting electronically. However, the authorization process between the two systems required manual intervention with printing, sorting, bundling, faxing, scanning, and data input. Chart Links created a real-time interface to eliminate the manual paper chase in the workflow. By eliminating backlogs of unauthorized paper plans of care, the client has delivered quicker continuity of care (time) and has reduced billing delays (money).

Lee: Managers can save money and time by using a software product that has the following functions: An integrated scheduling, documentation (EMR), billing/collects with full suite of management tools (reports); A comprehensive digital documentation system that is fast and user friendly for the providers; and an EMR system that must have the integrated billing system where the providers are able to "click" on the CPTs for services rendered. The CPTs, along with diagnosis, should seamlessly flow to the billing department without anyone manually posting charges; collections worksheet should be able to maximize efficiency for the user. This component is critical for cash flow.

Morrill: Improving efficiencies with customizable workflow rules, tasks, and reminders should be key features in practice management software. Many times clinical and office processes are the results of many years of doing business in a certain way. Some of these processes are adequate and get the job done, but many processes are out of date and increase costs. Defining processes and having software that is capable of monitoring the execution of the processes is a great way to have a 360-degree view of your business.

Palumbo: Integrated Billing. Managers are looking for one program that can meet their needs and more than ever, there are a lot of practices who have had software experiences already and they understand the pitfalls and issues when you try to synch and share data between programs that are compatible but have two distinct databases. Two or more programs in a clinic means many more people/companies are needed to address issues. As a result solving problems by committee can prolong the processes. One program with one database that manages your clinic from front desk through therapist to billing means your vendor can address any concerns across the spectrum of your practice regardless of who it affects. Furthermore, if the software is web-hosted by your vendor, you significantly decrease time and costs associated with network related issues such as upgrading, troubleshooting, training, as well as securing and backing up your data.

Petrie: The Internet and other technologies have eliminated the need for a practice to settle for a low-end software suite simply to integrate key functions. You can now pick and choose the best offerings and easily bring them together, making your practice more productive.

Plymale: One of the biggest ways is to lower their total cost to collect (a measure of the percentage of payment that is allocated to billing and collections activities) and by reducing the number of manual transactions. Transactions cost time and money. There are a few areas to target for improvement:

• Reduce manual entering of charge information. There is no need to do this as all modern systems allow therapists to capture services at the point of care and automatically make that information available to the billing staff without re-entry. They'll save time, errors and reduce underbilling due to therapists forgetting to document services.
• File as many claims as you can electronically. This saves paper handling and postage costs, but also helps provide an "audit trail" and gets you paid faster. With Electronic Remittance Advice you can now post remits electronically, eliminating the time and errors associated with manually keying in EOBs.
• Limit the total number of patient statements by collecting in the clinic.
• Go paperless. Make sure everything about a patient is available online so your staff doesn't spend time filing and retrieving information when they need it to respond to a payor or a referral source. If you are going paperless, you also better make sure that system is highly secure, highly available, and backed up continuously. This kind of infrastructure could be expensive to build and maintain. You can save a lot on servers, storage, and IT costs by using a Web-based system where you essentially share the costs with other companies like yours.

Presement: Referral Tracking: Clinics spend untold dollars on marketing, but typically do not ever measure the results of their efforts. How much business do you get from your Web site, how many patients found you in the Yellow Pages, did that flyer you mailed last month have any effect? Clinics need to use their software to track how patients came to hear about their clinic and not just the physician who told them to get physical therapy. It's important to track both revenue generated from each referral source and not just a total number of referrals. Watching trends, month after month, is also a way to watch costs and spend your marketing dollars more wisely.

Staff Productivity: Are your clinicians booking effectively? Are they filling their schedules? Do you have one therapist with a higher cancellation/no-show rate than another? Do you have one provider billing less per patient on average than their peers-perhaps they are billing incorrectly? These are all key indices that good software should be able to provide. Stone: After working with therapists and their staffs for almost 14 years now, we've come to believe that there are misconceptions about time savings in the transition from paper to electronic medical records. Documenting electronically may actually require more time for initial evaluations, but when a good EHR carries forward appropriate data from IE's to daily notes, re-evals, and discharge summaries, those tasks can be more efficient. What many therapists find, however, is that they document much more comprehensively than they ever did on paper, and this can offset some or all of the time savings. This results in a much better (and more compliant) set of documentation, but doesn't necessarily save substantial time. There are other two areas where a typical practice can almost always see some substantial time savings—but they're often under-appreciated:

• Chart pulls. In an EHR, patient's charts are accessible to anyone (therapist, supervisor, case manager, billing person) with several clicks of the mouse. In a paper-driven environment, how often are staff members running down missing charts or disrupting their work because they can't access a chart?
• Manually entering billing information. When the billing information (CPT and ICD-9 code, treating therapist, date of service, etc) is a by-product of the documentation process, and when that information is communicated automatically and electronically from the EHR to the billing system, both the time and the potential for human error associated with manual entry are eliminated.