Maintenance therapy focuses on preserving a patient’s functional abilities and preventing decline through skilled physical, occupational, and speech therapy services. It supports individuals with chronic conditions, ensuring safety and maintaining independence while meeting Medicare coverage requirements. Proper documentation and effective care plans are essential for achieving successful outcomes.

For many, many years, there has been this long standing myth in the therapy world that in order for Medicare to reimburse for skilled therapy services, you must show patient improvement. Essentially, it has been thought that maintenance therapy is not reimbursable because as a therapist, you cannot show improvement for certain conditions, but rather you are focusing your treatment on maintaining a patient’s current level of function, which for a long time was seen as a no-no by insurance companies.

However, thanks to the Jimmo vs Sebelius case back in 2011 – 2013, this myth was disproven. According to The Center for Medicare Advocacy, “Jimmo v. Sebelius, was a nationwide class-action lawsuit brought against the Centers for Medicare & Medicaid Services (CMS) on behalf of individuals with chronic conditions who had been denied Medicare coverage on the basis that they were not improving or did not demonstrate a potential for improvement.” In 2013, an agreement was made that Medicare coverage is solely determined by a patient’s need for skilled care, not on a patient’s potential for improvement. This was a significant win for not only patients with Medicare insurance coverage, but therapy providers as well.

Based on the outcome of this lawsuit, maintenance therapy is reimbursable by Medicare if the skilled therapy services are justified for the following disciplines: physical therapy, occupational therapy, and speech therapy. Another key thing to note is that the outcome of this settlement only applies to home health, skilled nursing facilities, outpatient therapy clinics, and inpatient rehabilitation hospitals/facilities.

Since maintenance therapy is reimbursable as long as it is justified, let’s discuss what exactly maintenance therapy is. Typically, skilled maintenance therapy is justifiable and covered in two specific circumstances:

• If the skill and judgment of a physical/occupational/speech therapist is needed to design and educate a maintenance program to be carried out by non-skilled personnel (such as  a personal trainer) or a caregiver. In this situation, Medicare will cover periodic re-evaluations of the patient to determine the efficacy of the plan of care and allow the therapist to make any necessary modifications, if applicable.
• The skills and judgment of the physical/occupational/speech therapist are required to provide skilled maintenance therapy due to the complexity of the services needed to maintain or prevent decline in a patient, or for safety reasons.

Maintenance therapy is often extremely beneficial for patients with neuromuscular disorders, such as ALS, Parkinson’s, Muscular Dystrophies, etc. which result in chronic impairments that impact their mobility and ability to function independently. In these particular cases, patients may likely benefit from ongoing therapy services to slow the decline of their condition, prevent exacerbations, manage pain and maintain their current level of functional independence.

While individuals with neuromuscular disorders will often benefit from maintenance therapy, a patient is not required to have a chronic and/or progressive disease in order for Medicare to cover maintenance therapy services. Medicare also does not require a patient to functionally decline before covering medically necessary skilled therapy. This means that if you are treating a patient with Medicare insurance, who is no longer making improvements but continues to require skilled therapy services, you can reassess the patient and develop a new plan of care which reflects the new maintenance therapy goals.

Below are some documentation tips you should consider to correctly document and show justification for skilled maintenance therapy:

• The patient’s medical condition and/or complexity of the therapeutic treatment requires the skills of a physical/occupational/speech therapist.
• Treatment cannot be safely and effectively carried out by the patient individually, or by a non-skilled person, such as the caregiver.
• The patient has the potential to functionally decline without skilled therapy services.
• The therapeutic treatment itself is reasonable and necessary, in relation to the patient’s condition, to maintain, prevent or slow down further functional decline.
• Frequency and duration of services are appropriate and match that patient’s goals.
• Make sure you are updating the status of that patient’s goals, especially as they are being achieved. Documentation should support and show the treatment’s effectiveness of achieving the maintenance therapy goals.
• Continue to utilize objective tests and measures for assessments and goals, such as BERG, 10 meter walk test, TUG, etc.
• Make sure your goals are appropriate for maintenance therapy. These goals should emphasize preventing unnecessary and avoidable complications, such as: deconditioning, muscle weakness, reducing fatigue, muscle contractures, promoting safety, and maintaining strength and/or flexibility.

Oftentimes, maintenance therapy is forgotten about, especially in outpatient clinics, resulting in patients being discharged and experiencing a functional decline, either rapidly or over time. Thanks to Jimmo v Sebelius, patients who would benefit from maintenance therapy now no longer have to worry about their therapy services being taken away or having to pay out-of-pocket for potentially life saving therapy. Remember to always consider whether or not the patient is appropriate for maintenance therapy before you discharge them so that there is no discontinuity in their plan of care! Whether you are providing documentation for progressive therapy services or maintenance therapy services, HelloNote is a therapy EMR software that will provide you with all of your documentation and billing needs.

Payment tracking and billing reconciliation are vital for financial success in healthcare practices. This article highlights the importance of these processes and how automating them through EMR software can streamline operations. Discover how accurate billing reconciliation reduces errors, improves cash flow, and ensures timely payments, contributing to the financial health of your clinic.

Owning a healthcare practice involves more than just providing excellent patient care; it also requires managing finances effectively to ensure sustainability and growth. Among the most critical aspects of financial management in healthcare is payment tracking. Proper payment tracking, combined with efficient billing reconciliation, forms the foundation for understanding your clinic’s financial health.

For healthcare professionals who may not have accounting expertise, these tasks can seem daunting. Fortunately, tools like EMR software streamline the process, saving time and reducing errors. This article explores why payment tracking in healthcare is vital and how automation can revolutionize your practice’s financial management.

What Is Payment Tracking in Healthcare?

Payment tracking is the process of monitoring billed amounts, payments received, and outstanding balances. It enables clinic owners to have a clear picture of their financial performance and helps prevent revenue loss. Here’s what payment tracking allows you to do:

• • Monitor Billed vs. Paid Amounts: Understand the gap between what’s billed and what’s received from patients and insurance companies.
  • Identify Bad Debt: Track unpaid or partially paid invoices to recognize bad debt early.
  • Manage Partial Payments: Ensure transparency by identifying and addressing incomplete payments from insurance companies or patients.
  • Prevent Misunderstandings: Maintain clear communication with patients and insurers regarding outstanding balances.
  • Understand Cash Flow Trends: Recognize patterns that might indicate financial issues, allowing for timely interventions.

Efficient payment tracking supports better organization, improved cash flow, and a deeper understanding of your practice’s financial wellness.

What Is Billing Reconciliation?

Billing reconciliation involves matching incoming payments, particularly from insurance companies, with open invoices to ensure accuracy. This process helps confirm that your clinic is receiving the correct payment for services rendered.

Traditionally, billing reconciliation was a manual process, requiring hours or even days to compare records, address discrepancies, and calculate revenue. This method was not only time-consuming but also prone to errors.

The introduction of Electronic Remittance Advice (ERA) in 2014 simplified this task. ERA automation, often integrated with EMR software, allows clinics to reconcile payments with a few clicks. This advancement reduces manual labor, ensures accuracy, and saves valuable time.

Why Is Payment Tracking Essential in Healthcare?

Healthcare practices face unique financial challenges. Mismanaged payment tracking and reconciliation can lead to revenue loss, poor financial health, and even patient dissatisfaction. Here’s why prioritizing payment tracking is crucial:

• • Improved Financial Transparency: Payment tracking provides a clear overview of your revenue streams, helping you understand your clinic’s financial standing at any given moment.
  • Enhanced Organization: A well-structured payment tracking system keeps patient accounts up-to-date, preventing billing errors and confusion.
  • Reduced Revenue Loss: Identifying outstanding balances and bad debt promptly minimizes financial losses.
  • Streamlined Operations: Automating payment tracking frees up staff time, allowing them to focus on patient care and other essential tasks.
  • Compliance with Billing Standards: Automated systems ensure compliance with payer requirements, reducing the risk of claim denials.

Steps for Effective Payment Tracking and Billing Reconciliation

While automation simplifies the process, incorporating the following steps ensures accuracy and efficiency:

• • Organize Patient Records: Maintain consistent and accurate records for every patient. This includes billing details, insurance information, and payment history.
  • Perform Weekly Reviews: Regularly review patient accounts to identify discrepancies, outstanding balances, and denied claims.
  • Allow Time for Adjustments: Resubmit denied claims promptly, ensuring all required information is included within the payer’s time limits.
  • Track Key Metrics: Monitor cash flow, average reimbursement time, and the percentage of denied claims to identify trends and areas for improvement.=

The Role of EMR Software in Payment Tracking and Billing Reconciliation

Integrating payment tracking and billing reconciliation with EMR software is the simplest way to streamline financial management in healthcare. EMR systems automate these tasks, reducing human error and enhancing efficiency.

Here’s how EMR software supports payment tracking and reconciliation:

• • Automation: EMR software automatically tracks billed and paid amounts, ensuring accuracy.
  • Data Insights: Generate detailed revenue reports to analyze trends and make informed decisions.
  • ERA Integration: Match payments with invoices seamlessly using ERA automation.
  • Real-Time Access: Access financial data from anywhere, allowing you to manage billing even when away from the office.

For example, HelloNote’s EMR software offers a built-in payment reconciliation tool, enabling clinic owners to track payments and generate revenue reports effortlessly.

How Automation Benefits Healthcare Practices

Investing in automation through EMR software offers several advantages:

• • Time Savings: Automated systems eliminate the need for manual tracking and reconciliation, freeing up time for other priorities.
  • Error Reduction: Automation minimizes discrepancies, ensuring accurate billing and payments.
  • Improved Patient Experience: Efficient billing processes reduce misunderstandings and enhance patient satisfaction.
  • Increased Revenue: By identifying and addressing payment gaps promptly, clinics can optimize their income.

Conclusion

Effective payment tracking in healthcare is critical for maintaining the financial health of your practice. By automating payment tracking and billing reconciliation with EMR software, you can improve organization, reduce errors, and focus more on providing exceptional patient care.

For healthcare practices looking to simplify financial management, HelloNote’s EMR software offers the tools you need. From seamless payment tracking to automated reconciliation, HelloNote ensures your clinic runs efficiently while achieving financial success.

If you’re ready to take control of your clinic’s financial health, schedule a free demonstration of HelloNote today!

EMR software simplifies therapy practice management by streamlining documentation, enhancing patient care, ensuring billing compliance, and providing easy accessibility. With features like personalized care plans, secure cloud storage, and patient portals, EMR software helps physical, occupational, and speech therapists deliver effective care while managing their practices efficiently.

Starting a physical, occupational, or speech therapy practice comes with unique challenges, one of which is efficiently managing patient care and administrative tasks. A reliable electronic medical record (EMR) software is an essential tool to help you grow and streamline your practice. Gone are the days of paper records; today, EMR systems provide numerous benefits for both clinics and patients. Here are six key advantages of using EMR software in your therapy practice:

1. Personalized Patient Care

An EMR system allows therapists to access detailed patient records instantly, making it easier to understand medical histories and develop comprehensive treatment plans. This ensures that care is tailored to the individual needs of each patient. By having all relevant information in one place, therapists can provide well-rounded and effective interventions.

For practices with multiple clinicians, EMR software enhances collaboration by allowing seamless information sharing, ensuring continuity of care even when therapists are unavailable.

2. Streamlined Documentation

EMR software centralizes all patient notes and documentation in one secure location, making it easier to maintain accurate records. This feature is especially useful when a therapist is on leave, as other clinicians can continue providing goal-oriented treatments without interruptions.

By simplifying the documentation process, EMR systems help therapists save time while ensuring compliance with industry standards. Accurate and organized records also improve coordination among team members and facilitate better patient outcomes.

3. Insurance Billing Compliance

Billing can be one of the most complex aspects of running a therapy practice, especially when dealing with insurance claims. EMR systems, like HelloNote, simplify the process by automating claim submissions and flagging missing information or incorrect codes.

With built-in features for adding necessary modifiers and ensuring accuracy, an EMR system significantly reduces claim rejections and denials. This not only saves time but also ensures consistent cash flow for your practice.

4. Enhanced Patient Engagement with Portals

EMR systems store patient records securely in the cloud, allowing therapists to access data from virtually any location with an internet connection. Whether you’re working from home, at a clinic, or on the go, you can easily retrieve and update records without disruption.

For instance, if you need to finalize a treatment note while traveling, you can quickly log into the EMR system and complete the task. This flexibility eliminates barriers to productivity and ensures that your practice runs smoothly, no matter where you are.

5. Accessibility Anytime, Anywhere

EMR systems store patient records securely in the cloud, allowing therapists to access data from virtually any location with an internet connection. Whether you’re working from home, at a clinic, or on the go, you can easily retrieve and update records without disruption.

For instance, if you need to finalize a treatment note while traveling, you can quickly log into the EMR system and complete the task. This flexibility eliminates barriers to productivity and ensures that your practice runs smoothly, no matter where you are.

6. Environmentally Friendly and Cost-Effective

Switching to EMR software supports eco-friendly practices by reducing the need for paper documentation. All patient information, including intake forms, care plans, and exercise handouts, can be securely uploaded and stored digitally.

By going green, your clinic not only contributes to sustainability but also saves on expenses like paper, ink, and storage space. Additionally, digital storage reduces the time and effort required for manual filing and retrieval, freeing up staff for more critical tasks.

Why EMR Software Is Essential for Your Practice

EMR software is more than just a tool; it’s a cornerstone for improving patient care and optimizing administrative processes. With features that centralize documentation, simplify billing, and enhance accessibility, EMR systems enable therapists to focus on what matters most—helping their patients achieve their goals.

For physical, occupational, and speech therapy practices, an EMR solution like HelloNote offers a comprehensive platform for managing patient records, scheduling, billing, and more. Whether you’re a new clinic owner or transitioning from paper records, now is the time to invest in an EMR system that supports your practice’s growth and success.

Struggling with high cancellation rates in your therapy clinic? This article offers actionable tips to help reduce no-shows and cancellations. From patient education and collaborative treatment plans to effective front desk strategies like reminders and clear cancellation policies, you’ll find practical solutions to keep your clinic’s schedule full and your patients engaged in their recovery.

In the therapy world, cancellations are inevitable, especially in outpatient physical therapy clinics. Cancellations can interrupt a patient’s treatment plan and lead to regression if a patient is canceling too often. There are several techniques that can be utilized, by both the therapist and the front desk, to help decrease the number of cancellations your clinic is experiencing. If your practice is experiencing a high volume of cancellations, here are a few techniques to try:

Lower your cancellation rate with these 7 tips!

• Educate your Patient on the Importance of Attending Therapy
  First and foremost, patient education on the plan of care and length of treatment should be discussed in depth at the initial visit. In conjunction, therapists should also emphasize the importance of patient attendance to remain on track with their individualized treatment plan and stay on the expected course of recovery at each follow-up session. Explaining each exercise and identifying the patient’s progress at follow-up sessions can also help the patient stay motivated and continue to be invested in their recovery plan.

Additional Insight: According to research, patients who understand the long-term benefits of staying committed to therapy tend to have higher engagement levels. Take the time to explain how consistent attendance directly impacts their progress, recovery speed, and overall health. Use clear language, and provide a visual timeline of the patient’s treatment journey.

• Collaboration is Key
  Oftentimes, the patients who continue attending their regularly scheduled therapy sessions are the ones who are directly involved in their treatment plan and have collaboratively set goals with their therapist. Allowing the patient to give input into the goals they want to accomplish by the end of therapy provides them the opportunity to be more invested in their individualized care plan. When a patient is invested and buys into their recovery, the likelihood of the patient canceling decreases.

Additional Insight: Consider using a goal-setting framework such as SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound). Encouraging patients to visually track their progress in the clinic can foster ownership of their recovery journey. Let them know their involvement in the process makes a tangible difference.

• Create a Fun, Welcoming, Encouraging, and Positive Environment
  Give praise, high fives, and celebrate accomplishments, whether a patient progresses with an exercise or achieves one of their goals! Building an interpersonal relationship and getting to know your patients on a more personal level has a much greater impact than you may think! The more invested you are in your patient’s recovery, the more invested the patient is likely to be in showing up to their therapy appointments.

Additional Insight: Clinical research has shown that a positive, supportive environment improves patient outcomes. When patients feel like they are part of a supportive community, they are more likely to be committed to the process. Take a few extra minutes to chat and engage on a personal level, which will build trust and help patients see you as a partner in their recovery.

• Continually Progress the Patient’s Treatment Plan
  Another good way to keep the patient engaged and invested in their therapy is to continually progress the patient’s treatment plan. As the patient progresses and continues to be able to do more activities and exercises, the therapist should adjust the treatment plan so that the patient is always being challenged. By keeping the treatment session fresh and interesting, the patient is more likely to show up for their session and less likely to attempt to finish up their plan of care at home. If the therapist is not providing cues or does not frequently switch up the patient’s exercises, then what’s to prevent the patient from canceling and just completing their exercises at the gym or at home?

Additional Insight: Progressive challenges are key to keeping patients motivated. Research indicates that patients are more likely to stick with a program that progressively pushes their boundaries while remaining attainable. Use a step-by-step approach to show the patient their improvements. Celebrate each milestone, no matter how small, to keep them engaged.

Techniques for the Front Desk:

• Create and Enforce a Cancellation Policy
  If you don’t have one already and you are seeing a large number of cancellations, enforcing a cancellation policy may be the way to go. It might help to charge a fee if a patient cancels less than 24 hours prior to their appointment time. Explaining and emphasizing the cancellation policy at the patient’s first appointment is crucial to ensure there is no misunderstanding.

Additional Insight: Be transparent and empathetic when enforcing the cancellation policy. Some clinics have found that automated reminders combined with the cancellation policy can significantly decrease no-shows. Ensure your front desk team is consistently reinforcing the policy and that patients understand the reasoning behind it – namely, to maintain high-quality care and service.

• Remind Patients by Phone or Email
  Many patients often forget about their appointments, especially if they are only attending therapy once or twice a week. Therefore, sending out an appointment reminder 24-48 hours prior to the patient’s appointment may help reduce cancellation rates. This also provides the patient with an adequate amount of time to cancel and reschedule if an emergency or conflict of interest has occurred. Be sure to check with each patient at the first appointment to determine which communication method works best for them!

Additional Insight: Automated SMS and email reminders have proven to be highly effective in reducing cancellations. Research suggests that patients are more likely to show up when they receive a personalized reminder that includes details such as the therapist’s name, session goals, and any preparation needed for the session.

• Provide Wallet-Sized Appointment Cards
  While it may seem outdated, providing wallet-sized appointment cards—especially for those patients who are not as tech-savvy—can do wonders. The appointment card should have the date and time along with the clinic’s phone number and address on it, so that should the patient need to reschedule, they can easily contact the clinic.

Additional Insight: For patients who prefer physical reminders, a wallet-sized appointment card can also be a great conversation starter, and can increase engagement. It is essential to align this with a digital confirmation system that provides patients with multiple channels for managing their appointments.

Final Note

Cancellations will always be present in therapy clinics, but by implementing the above techniques and improving the soft skills of not only your front desk workers but your therapists as well, you will likely see a decrease in your clinic’s cancellation rate and overall improved patient outcomes. Just remember, as Dr. Francis Peabody once said, “The secret of the care of the patient is caring for the patient.”

HelloNote would love to help you create, grow, and scale your therapy business! Sign up for a free demonstration to see all the features we have to help you at Hellonote.com.

As healthcare professionals, particularly physical and occupational therapists, we’ve all experienced the frustration of patient cancellations and no-shows. A simple and effective solution to reduce patient cancellations is using appointment reminders. When patients are reminded of their appointments, they are more likely to show up, allowing for continuous care and reducing unnecessary disruptions in your day.

While cancellations are sometimes unavoidable—due to family emergencies or other conflicting events—many patients cancel or miss their appointments simply because they forgot. Did you know that approximately 81% of missed appointments are due to forgetfulness or miscommunication? (Optional: Add source if available) This brings up the important question: how can we reduce patient cancellations and no-shows from happening so frequently? The answer is simple: leverage automated appointment reminders, often via SMS through your EMR system, to communicate effectively with your patients! Implementing these automated appointment reminders can have several positive benefits for your patients and your clinic as a whole.

Here are 3 key ways automated appointment reminders help your therapy practice:

Improved Patient Outcomes with Appointment Reminders

First and foremost, as healthcare providers, our primary goal is to help patients achieve or regain their quality of life. Isn’t that why most physical and occupational therapists go into this field—to help people feel better and get back to doing what they love?

Several studies have shown that usingautomated appointment reminders via SMS can significantly improve patient outcomes. Why? Because when patients are reminded about their upcoming therapy appointments, they are more likely to attend. This ensures consistent care without any disruptions, which directly supports better results as treatment plans are followed more closely.

How Do Appointment Reminders Reduce Cancellation and No-Show Rates?

This might seem intuitive, but sending automated appointment reminders places their therapy appointments at the forefront of their minds. By providing these reminders, you not only remind patients about their upcoming session but also give them time to cancel or reschedule if an emergency has arisen.

Studies show that sending automated appointment reminders one to two days before a scheduled appointment can reduce cancellation and no-show rates by as much as 16% . This proactive communication helps patients prioritize their healthcare and ensures they make it to their appointments on time.

Save Time and Money with Automated Appointment Reminders

In outpatient physical therapy clinics, front desk staff often juggle multiple responsibilities—insurance verifications, patient intake, scheduling, and answering patient inquiries. With so many tasks at hand, having to manually remind patients about their appointments can become overwhelming and may even lead to overtime.

Here’s where automated appointment reminders come in. By setting up automated appointment reminders, your front desk staff can focus on more critical tasks. This system reduces the burden of making reminder calls and eliminates the need for overtime, saving your clinic both time and money. HelloNote’s practice management software includes a fully automated SMS appointment reminder system, simplifying this process. With Hellonote appointment reminders, all you need is the patient’s cell phone number and the time you want the reminder sent, then click schedule, and you’re all set. It’s that simple!

Important Reminder About SMS Appointment Reminders

While appointment reminders via SMS can be incredibly effective, it’s important to remember that standard texting is not inherently (Top HIPAA Compliance Essentials for a Successful Practice) without specific safeguards. Text messages can be stored insecurely, and there’s always a risk of a patient losing their phone or having it stolen. Therefore, never send Protected Health Information (PHI) via standard SMS unless you are certain appropriate safeguards are in place or patient consent is properly managed.

That said, automated appointment reminders, when used appropriately can significantly improve patient outcomes, reduce patient cancellation rates, and lower operational costs, leading to increased revenue for your clinic!

Frequently Asked Questions about Appointment Reminders

Q: When is the best time to send appointment reminders?
A: Sending reminders 1 to 2 days before the scheduled appointment is often cited as most effective, as mentioned in studies showing significant reductions in no-shows. This gives patients adequate notice without being too far in advance that they forget again.

Q: How much do no-shows actually cost a physical therapy practice?
A: Costs vary, but no-shows lead to lost revenue from the missed appointment slot, wasted staff time, and disrupted schedules. Over time, this can add up to thousands of dollars annually, making efforts to reduce patient cancellations financially crucial.

Q: Are SMS appointment reminders HIPAA compliant?
A: Standard SMS messaging is not inherently HIPAA compliant due to security risks. However, appointment reminders can be used compliantly if they only contain basic information and are sent using secure platforms or with proper patient consent. Platforms like HelloNote (How to use the Chat Feature in HelloNote EMR I Tutorial) often have features built to help practices meet compliance needs. Always consult HIPAA guidelines or legal counsel for specifics.

Conclusion

In conclusion, automated appointment reminders are an essential tool for improving patient care and minimizing disruptions in your clinic. By implementing these reminders, you can significantly reduce patient cancellations and no-shows, improve patient satisfaction, and decrease your clinic’s operational costs. Start using automated appointment reminders today to enhance the efficiency of your clinic and ensure your patients receive the care they need.

To learn more about how Hellonote appointment reminders can help reduce patient cancellations and improve your clinic’s efficiency, reach out to our team at HelloNote and schedule a free walkthrough of our system.

Managing a physical therapy clinic goes beyond providing quality care—it requires a sharp focus on business metrics that drive success. To ensure growth and sustainability, clinic owners must track and analyze key performance indicators. This article outlines the top five business metrics that are crucial for optimizing operations, improving patient outcomes, and increasing revenue in a physical therapy clinic.

Running a physical therapy clinic requires a lot of hard work, and while you may be an exceptional therapist, unless you’re keeping track of key business metrics and completing monthly, quarterly, and annual reports, your practice may struggle to succeed. Since business reporting isn’t emphasized in many physical therapy programs, here are the critical metrics and reports to track in your clinic:

1. Clinical Productivity

Why It Matters: Clinical productivity is often considered the most important metric measured each week in a physical therapy clinic. By calculating the clinical productivity for each therapist, you can assess their efficiency and pinpoint areas for improvement in time management. Tracking productivity within an EMR system like HelloNote allows you to see each therapist’s performance at the click of a button, ensuring you’re operating as efficiently as possible. If you’re not using an EMR system, productivity is determined by the number of billable activities completed by each therapist divided by the hours worked during that week.

2. Net Revenue Per Month

Why It Matters: Net revenue represents the actual money collected by your physical therapy clinic, not just the amount billed. Tracking this metric enables you to evaluate how effective your billing processes are and predict future revenues. It also provides insight into your clinic’s growth and any unexpected fluctuations that may arise. HelloNote allows you to easily analyze your clinic’s monthly, quarterly, and annual revenue, offering a comprehensive view of your clinic’s financial performance.

3. Cancellation Percentage

Why It Matters: Cancellations and no-shows have a significant impact on the overall productivity of your physical therapy clinic. By tracking your clinic’s cancellation percentage daily, weekly, and monthly, you can identify trends and take action to reduce them. A good cancellation rate to aim for is under 10%, but if it’s higher, it’s essential to dig deeper into the reasons behind the cancellations and take measures to address them.

4. Referral Metrics

Why It Matters: In a private practice physical therapy clinic, referrals are crucial for business growth. Tracking referral metrics can help you determine which marketing efforts are yielding the best results. Start by tracking where your referrals are coming from, and also measure how many of those referrals convert into actual patients. The higher the conversion rate, the better your clinic’s overall financial performance will be.

5. Billing Metrics

Why It Matters: Billing can often be a tedious and complex process in physical therapy clinics due to insurance requirements, which can lead to claim denials. Keeping track of billing metrics such as Days in Receivable Outstanding (DRO) and Denial Rate will help you assess the efficiency of your clinic’s billing practices. A good DRO is under 35 days, and a high denial rate indicates areas where your documentation may need improvement to avoid delays in payment.

Managing a physical therapy clinic involves more than just providing great care; it requires actively tracking and analyzing important business metrics. By leveraging a robust EMR system like HelloNote, you can streamline reporting and ensure that you’re on top of the numbers that matter most.

To learn more about how HelloNote can help streamline your clinic’s business metrics, reach out to our team for a free walkthrough: HelloNote 

Selecting the right EMR features software is crucial for running a successful therapy practice. This article highlights the essential features therapists need in an EMR system, including ease of use, HIPAA compliance, patient reminders, built-in billing functionality, and reporting tools. Learn how the right EMR, like HelloNote, can streamline operations, improve patient care, and enhance productivity in your outpatient clinic.

For those therapists who are considering starting or who have just started their own outpatient practice, one of the most important features of running a successful clinic is having a PT documentation software that stands out from the rest. However, with so many therapist notes software out there right now, how do you decide which one is best for your practice?

Let’s discuss the most important EMR features you should be looking for, specifically as a therapist, when purchasing a PT EMR system to ensure you have a software that works for you.

1. EMR designed specifically for therapists:

To start, the most important feature of a physical therapy electronic medical records system is that it was created specifically for therapists and if it was designed by other therapists, then even better. Why? Simple, because when you purchase an EMR software that was created by a fellow therapist, you are ensuring the physical therapy software will have all of the specific features you need as a therapist, since it was created by a fellow colleague, which will make your job that much easier. Did you know HelloNote was built by a team of therapists, meaning their EMR system has the needs and wants of therapists at the forefront.

2. EMR that is simple yet robust:

Another key feature of selecting an appropriate EMR for your clinic is ease of use and HIPAA compliance. The last thing you want when starting a practice is having to take a bunch of time to learn a complex documentation system, time which could be better spent marketing or treating patients. By selecting a therapist notes software that is simple and easy to use, not only will it be easy to learn, but you can also focus on what matters most during sessions…your patients. HIPAA compliance is another consideration when selecting a physical therapy documentation software because as healthcare providers, HIPAA must be followed at all times to protect the privacy of the patients. If you are not following HIPAA, you are setting your practice up for all kinds of legal issues. HelloNote is not only easy to use and self-explanatory, but it also has templates built-in for different notes, to improve efficiency and efficacy during your work day.

3. EMR with built in patient reminders:

If you have worked in an outpatient therapy setting, then there is a good chance you have encountered patients who fall under the “no call, no show” category with the number one reason being they missed their appointment because they forgot about it. Not only is that a disservice for the patient, but it also decreases your productivity and prevents you from potentially seeing a different patient during that time. The simplest way to reduce the number of “no call, no shows” you experience at your outpatient clinic is to have an EMR system that sends out appointment reminders after a patient has scheduled his/her next appointment. That way, even if the patient forgets, he/she receives a friendly reminder 1-2 days prior to the upcoming appointment and if the patient is unable to make it, he/she can cancel instead of just not showing up.

4. EMR with built in billing functionality:

Depending on the type of outpatient practice you have and whether you accept insurance or plan to be cash-based, another crucial documentation software feature is the billing capabilities. As a physical therapist, you do not want to have to worry about a claim not being submitted or a claim being submitted incorrectly because it is missing a modifier, which will ultimately cause a delay in when your practice is reimbursed. To avoid this, seek out a physical therapy documentation software that has modifiers and insurance coding already built into it. This way, in case you forget to add a –59 modifier to a Medicare claim, your EMR will prompt you to add it or at least re-check what you entered. HelloNote not only has these features already built in to their system, but they also have a one-click billing and claim generation to make billing as easy as possible.

5. EMR with reporting functionality:

Last but not least, you want to ensure your therapist notes software can run reports so you can see how the clinic is doing, productivity-wise. From tracking the number of patients being seen each day or week, to the number of billing units per patient, having the ability to run reports is crucial to identifying areas of weakness and ultimately, being able to run a successful practice. If your EMR does not already have a built-in capability of generating reports, not only will you waste time trying to put your own reports together, but those reports might not be as accurate, due to the possibility of manmade error. EMR software’s, such as HelloNote, have the ability to create custom reports, both numerically and with the use of graphs/charts, so that you can plot data and track productivity with minimal to no effort.

Selecting an appropriate PT documentation software can be difficult and challenging but buying the software that is best for you and fits your needs from the beginning, will save you a lot of time and hassle in the long run. HelloNote is a very robust EMR software made by and for rehabilitation therapists and not only has all of the above features, but so much more which you can learn about on Hellonote.

This article highlights the role of telehealth in modern therapy practices and its benefits, including improved patient satisfaction, flexibility, and accessibility. It provides a guide to delivering effective virtual therapy sessions and explains the importance of EMR software with built-in, HIPAA-compliant telehealth features. Tools like HelloNote help streamline operations, enhance patient care, and ensure compliance, keeping therapy clinics competitive in the evolving healthcare environment.

In this day and age, the virtual world and online businesses are absolutely booming. Since the pandemic began in early 2020, if people have the option to stay home vs going out, many are choosing to stay home. For therapy practices, this has required a pivot in the way sessions are conducted and held. Telehealth is here to stay and this article will walk you through why you are missing out a huge opportunity within your practice if you have not yet pivoted to add a telehealth treatment service to your therapy business.

When patients started having increased fears of being in-person at clinics, due to increased risk of exposure to COVID and social distancing requirements, many practices saw a drop in their caseload. To combat this decline, several therapy clinics began heavily relying on telehealth for continued patient care and services. Since telehealth was not widely utilized prior to this, unless in very specific instances, many practices scrambled to find a way to provide these services while still abiding by HIPAA. While our country begins to adapt to its new normal, it appears telehealth is a treatment option which will be sticking around for the foreseeable future, especially when it comes to physical therapy.

Several patients might not understand what telehealth therapy is or how it works so patient education will play a crucial role in portraying how effective telehealth therapy can be to ease any concerns the patient may have. Many patients will likely wonder how telehealth therapy appointments, through a computer, are going to help their condition improve, especially since physical therapy has been thought of as a very “hands-on” profession for several years.

One of the best ways to ease the patients’ concerns is to provide them with research as to the benefits of telehealth and how satisfied previous telehealth physical therapy patients have been. Based on a recent research article from The Musculoskeletal Journal of Hospital for Special Surgery, telehealth for outpatient physical therapy clinics has shown to be successful. After data was collected and analyzed, there did not appear to be a statistical difference between in-person and telehealth patient satisfaction, meaning patients have been just as satisfied with their results from telehealth physical therapy appointments, as they have been with in-person care. By providing thorough patient education, re-assurance, and research articles, patients are likely to have decreased apprehension or fears about the effectiveness of telehealth therapy.

Why patients choose tele physical therapy over in patient care:                                                                                                                               There are many reasons why patients may choose telehealth over in-patient care.

1. One reason is less stress on the patient’s end, as the patient does not have to worry about leaving work at a set time or running late due to being stuck in traffic. 
2. Another reason is increased flexibility of scheduling appointments as patients can attend their physical therapy session from wherever they are, even if they are just on their lunch break at work. 
3. A third reason why telehealth is often favored over in-person appointments is the benefit of saving money on transportation costs as patients do not have to worry about paying for gas, parking, etc.
4. Finally, telehealth appointments decrease the chance of contracting an illness as patients are no longer having to sit in a crowded waiting room for any period of time.

As the popularity of telehealth continues to increase and trend upwards, both at in-person clinics and online therapy businesses, it is important to have a PT EMR system which allows for increased ease and access to telehealth appointments.

Quick checklist of how to provide tele therapy services:

To successfully provide telehealth services to patients, you want to make sure your therapy note software has the capabilities and functionalities to host a telehealth appointment.

1. HIPAA Compliance Software such as HelloNote: Apart from having telehealth capabilities already integrated into the software, the single most important feature is that telehealth appointments can be completed securely. If you are not hosting your telehealth sessions through a secure EMR system, then you are not in compliance with HIPAA which can result in several legal issues, especially if the patient’s information is leaked or the session is hacked. Before offering telehealth appointments to your patients, be sure you have the correct capabilities and access to host this treatment option within your EMR. One PT documentation software that has an integrated and secure telehealth feature built into its platform, to maintain HIPAA compliance and prevent any worries or concerns on your end, is HelloNote.
2. You need to have professional lighting and video capture via a webcam.
3. Make sure you can find a quiet and clean room to perform your tele-therapy session in.

And it’s really as easy as that!

Telehealth therapy appointments are likely to continue increasing in popularity, based off of trends in 2020. If you are just starting or have recently begun a private practice outpatient therapy clinic, then make sure you purchase a PT documentation software with telehealth capabilities built in, otherwise you will miss out on several potential patients.

This article provides a detailed overview of commonly used modifiers in physical, occupational, and speech therapy billing. It explores essential modifiers such as the 59, GP/GO/GN, KX, and GA, with a focus on their application in Medicare and commercial insurance claims. Understand how these modifiers affect reimbursement and ensure accurate billing. Additionally, it discusses how EMR software like HelloNote can simplify billing processes and support proper documentation for compliance.

We have officially arrived into 2021…woohoo, we made it! While a new year may have arrived, some things in the therapy world continue to remain the same. Most, if not all, therapists, whether physical, occupational, or even speech, have entered this career path to improve patients’ lives and make a difference in the lives of those around them. However, it becomes increasingly difficult to continue improving patients’ lives, if you are not billing insurance correctly, resulting in decreased reimbursement and overall profit.

In our last blog post, we discussed the 8-minute billing rule for Medicare, and this time we are going to touch on therapy modifiers for physical, occupational and speech therapy services. What exactly is a modifier? I am glad you asked. A modifier is a code which is added to your billing and provides additional information to the insurance company when diagnosis and procedure codes are not enough for reimbursement. There are two different categories of therapy billing modifiers:

1. Therapy modifiers– two-digit codes applied to CPT codes and are typically included when billing both Medicare and commercial insurances
2. Level II HCPCS (Healthcare Common Procedure Coding System) Modifiers– two letter codes which are included when billing Medicare, Medicaid and only some commercial plans (such as United Healthcare)

Let’s start by discussing CPT modifiers as there is really only one commonly used modifier for therapy services, which is the 59 modifier. This modifier is used to differentiate between two common or similar services that were provided during the same session. When using the 59 modifier, you are indicating to the insurance company that each service was medically necessary and performed independently of the other. One typical example of when to use this modifier is if you bill for manual therapy (97140) and therapeutic activities (97530), in the same session. As long as you performed each service during separate 15-minute increments, then you would add the 59 modifier on CPT code- 97530 to ensure you receive reimbursement for both codes.

As for level II HCPCS
modifiers, there are three frequently used modifiers, especially for
specific insurances, such as Medicare/Medicaid and more recently, United
Healthcare. Let’s take an individual look at each modifier:

Reference chart below (some common CPT codes if 59 Modifier is allowed. For a full list, please go to National Correct Coding Initiative (NCCI) or consult the official CMS guidelines.

If column 2 shows “Not allowed”, then the CPT code cannot be billed with the code in column 1. If column 2 shows “Yes”, then the 59 modifier can be used to bypass the code edit:

1. GP/GO/GN Modifier- This modifier is often used in an interdisciplinary setting where there may be confusion about who provided the services, such as a hospital or outpatient clinic in a physician’s office. When billing for therapy services, be sure to include this modifier so that insurance companies are able to accurately reimburse, based on the type of therapy and in accordance with that member’s group benefits. For physical therapists, use -GP, occupational therapists, use -GO, and speech language pathologists, use -GN.
2. KX Modifier- Patients with Medicare insurance have a threshold for therapy services, and once the patient exceeds that threshold, Medicare does not usually reimburse for provided services. In 2021, for PT and SLP services, the combined cap is $2,110 and for OT services, the cap is $2,110. If a patient who is receiving therapy services exceeds this cap, then you would add the KX modifier. Adding this modifier indicates continued treatment is medically necessary and that necessity has been sufficiently justified in your documentation. If using the KX modifier, you do not want to use it before the patient has reached their therapy cap, as that could cause a red flag and lead to a decreased likelihood of approval or reimbursement from Medicare.
3. GA Modifier- Last, but not least, is a modifier which is often used once patients have reached a functional plateau, but still wish to receive therapy services. As you know, maintenance therapy is not considered medically necessary so this modifier allows you to bill secondary insurances or bill the patient directly, for non-Medicare covered services. If you end up in a situation where you have to use this modifier, make sure you have communicated with the patient that should they not have any secondary insurance, they will be responsible for paying out-of-pocket for therapy services. By communicating this upfront with your patients, it decreases the likelihood of any confusion or miscommunication.

**One last quick tip, for therapy businesses who have PTAs or OTAs, Medicare now requires that you use an assistant modifier, CQ for PTAs and CO for OTAs, for services performed.

Sometimes insurance is confusing, time consuming or flat out disheartening, but it is important to remember that billing correctly is essential. Modifiers are used to ensure therapists are receiving the appropriate reimbursement from insurance companies so that they can continue to put the patient and their needs first. While modifiers and insurance, in general, can be tricky, consider buying an EMR software that will assist you with your billing, such as HelloNote. As always, remember to support your billing with your documentation, if your notes are not supporting what you are billing insurance for, then you should not be billing for it!

Medicare Part A and B deductibles discussion for 2021, including coverage details, patient responsibilities, and how out-of-pocket costs affect physical therapy services.

It seems as if therapy services are an ever-evolving world. Not only is there constantly new research and studies out there proving which exercises you should and should not be having patients perform based on their injury or diagnosis, but it appears as if every time we turn around, there is some new insurance change. This year is no different in that patients who have Medicare insurance, either Part A or Part B, have a new deductible they must meet before their coinsurance will begin.

Before treating your patients, it is extremely important they understand their benefits and why physical, occupational, or speech therapy is important for them, especially as their deductible increases. When a deductible increases, it means the patient is having to pay more out-of-pocket costs until their deductible has been met. Given the current state of the economy and everything going on in the world, paying more out-of-pocket might be a hardship for some patients, so ensuring patients understand what they are responsible for is crucial.

Medicare Part A

Medicare insurance has several different parts to it. The main ones we tend to focus on for therapy services are Part A and Part B. The reason for this is because Part A covers hospital, home health services, hospice, and skilled nursing stays while Part B covers outpatient physical therapy services.

In 2021, the deductible for Part A services is $1,484, which is an increase of $76 from $1,408 in 2020. This amount covers the patients’ share of costs for the first 60 days of a Medicare-covered inpatient hospital stay during a benefit period. In addition to the $1,484 deductible, the patient will also be responsible for coinsurance charges, depending on how long and where the patient is staying.

The nice thing about Medicare Part A is that 100% of the costs are covered for up to 60 days in the hospital and 20 days in a skilled nursing facility. However, when patients require a longer stay, the costs can quickly add up. If a patient stays more than 60 days in the hospital, from day 61 to day 90, the patient will be responsible for paying $371 coinsurance each day. If a patient has to stay longer than 90 days, starting on day 91, the patient is responsible for paying $742 coinsurance per day.

If the patient is transferred to a skilled nursing facility for more long-term care, the patient can stay in the SNF for 20 days before having to pay coinsurance. Beginning on day 21 of the individual’s stay, the patient is responsible for paying $185.50 per day. While there are benefits to having Medicare Part A, hospitals and skilled nursing facilities can be quite expensive.

Medicare Part B

Focusing on Medicare Part B, which covers outpatient physical therapy services, the 2020 deductible was $198, just under the $200 mark. For 2021, the annual deductible for Medicare Part B has increased by $5 and is now $203. Once the $203 deductible is met, patients typically pay 20% of the Medicare-approved amount for most doctor services, including all therapy services.

In more layman’s terms, once a patient has had enough doctor and/or therapy visits in 2021 to where they have paid a total of $203 out-of-pocket, Medicare will cover 80% of the cost of their remaining services for the year. Once the Medicare benefits kick in, the cost of therapy services will reduce significantly, and patients will be paying far less out-of-pocket.

The Threshold for Outpatient Therapy

Another unique change with Medicare is that there is no longer a cap on outpatient therapy, speech therapy, or occupational therapy services. Instead, the cap has been renamed as a “threshold,” and if the therapist can prove that continued care is medically necessary through their documentation, and Medicare approves, then you, as a therapist, can go over the threshold for that patient.

The 2021 thresholds for outpatient physical therapy and speech-language pathology, combined, is $2,080. The threshold for occupational therapy is also $2,080.

Importance of Patient Education

Insurance itself can be a very slippery slope, and many patients do not fully understand their benefits or what they mean, which is why your physical therapy office plays an important role in ensuring each patient understands their specific benefits. As a physical therapist, depending on someone’s insurance, it might come down to you placing a greater emphasis on patient education during the initial evaluation so that your patients will continue to show up, especially if the patient has not met their Medicare Part B deductible for the year.

While insurance tends to not be a highlight of being a physical therapist, it does play a vital role in making sure our patients are receiving the correct amount and level of care they deserve

Here is an update about Medicare Part A and Part B.