Physical Therapy Billing Software Advocate Cautions Practitioners that Pre-Authorizations Are Important and Becoming the Norm
Denville, NJ (PRWEB) July 11, 2013 -- The insistence on preauthorization as part of physical therapy documentation increasingly acts as a way of second-guessing the testing recommendations of the provider, in the interests of cutting costs and payments on the part of the insurer. Service is becoming one driven by what can get approved for reimbursement, versus what should be done, or as Chhoda puts it, "preauthorization dictates payment." He observes that “verifying the client’s insurance coverage, with or without referral, allows practitioners to locate potential problems with reimbursements or special protocols that must be followed. The data will also impact the treatment provided by the clinician.”
As vital as the preauthorization become, CPT codes have become the most critical elements that must be in place and correct, before services can be provided with some assurance that there will be freedom to implement recommended course of action. In the case of physical therapy billing, Chhoda simply notes, “As more insurance carriers begin to require referrals and preauthorizations, it’s critical for any healthcare provider to obtain and verify a patient’s coverage prior to their appointment.”
He also found out that the situation holds even in emergency cases, and many clinicians may find themselves unreimbursed for non-preauthorized services rendered, but they nonetheless viewed as essential life-saving measures.
Chhoda recommends the adoption of physical therapy scheduling software that integrates EMR to reduce the prospect of preauthorization denials. Introduction of EMR (electronic medical record) documentation helps standardize the administrative protocol to match the demands of major payers within the insurance industry and the government. It also opens up the ability for physical therapy billing operations and clinicians to receive their payments in less than two weeks.
Tracking and monitoring of the claims that includes a requirement for preauthorization will help identify and solve the referral issue in most cases, permitting his patients and administrators more time to address any more complex cases that remain. EMR is the ultimate solution to the billing problems over the long-term as Chhoda says.
Chhoda’s office can be reached by phone at 201-535-4475. For more information, visit the website at http://www.emrnews.com.
About Nitin Chhoda
Nitin Chhoda PT, DPT is a licensed physical therapist, a certified strength and conditioning specialist and an entrepreneur. He is the author of "Physical Therapy Marketing For The New Economy" and “Marketing for Physical Therapy Clinics” and is a prolific speaker, writer and creator of products and systems to streamline medical billing and coding, electronic medical records, health care practice management and marketing to increase referrals. He has been featured in numerous industry magazines, major radio and broadcast media, and is the founder of Referral Ignition training systems and the annual Private Practice Summit. Chhoda speaks extensively throughout the U.S., Canada and Asia. He is also the creator of the Therapy Newsletter and Clinical Contact, both web-based services to help private practices improve communication with patients, delivery better quality of care and boost patient retention.
Nitin Chhoda, EMR News, http://www.nitin360.com, 201-535-4475, [email protected]
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