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Four Areas Directors of Rehabilitation can Automate to Drive Outpatient Rehabilitation Revenue

An important benefit of electronic charting in outpatient rehab is that it helps clinics accurately bill for all the care they deliver.

Besides helping to increase revenue and reduce claim rejections and denials, electronic charting can help organizations improve their clinical documentation to support compliance with regulations. In the event of an audit, electronic charting solutions can also improve the access to the documentation necessary to defend coding practices.

Here are four areas where automation of the outpatient rehab charting process can drive revenue:

1. Correct Coding Initiative (CCI) Edits
Correct Coding Initiative (CCI) Edits can be quite difficult to track manually.

With an electronic charting solution, users can load the CCI Edits and their quarterly updates into the system, which helps coders comply with regulations and avoid claim errors. Such a system can alert coders when a service or code is payable by the payer, and notify the coder when an appropriate modifier should be added to two distinctly separate services.

Clinics evaluating electronic charting solutions should make sure that systems can accommodate CCI Edits.
  2. Time Tracking
In May 2000, CMS issued a transmittal notifying the provider community about the implementation of what is commonly known as the "eight-minute rule." The rule governs the billing of a service unit for timed codes, with each unit being defined as 15 minutes. It's important that therapists are fully aware of these rules when they document care delivery.

Electronic charting solutions can help with the tracking of this by not only including a time field for therapists to input their care delivery, but by also alerting them when the field is incomplete. This helps create accurate documentation to support coding, and also helps coders take the guess work out of creating claims.

Another benefit of electronic solutions is that they help therapists document their treatment time to generate the correct billing unit, as well as help them comply with commercial payers that adopt time-tracking rules in the future.
  3. Account Tracking
To help track individual episodes of care, many rehabilitation clinics are now including patient account numbers on all documentation. Typically, the patient account number has been used primarily by the billing staff and less frequently on documentation.

The benefit of using the account number on all documentation is that it provides yet another tool for the staff to track charges by individual episodes of care. Clinics can use a patient account number to more easily reconcile charges per episode of care in the event of an audit. In contrast, reconciling charges using just the patient record number can be cumbersome, since the patient record contains many episodes of care. In addition, tracking episodes of care using the patient account number sets the stage for clinics to measure patient outcomes and participate in pay-for-performance initiatives.

Rather than manually writing the account number on multiple forms, electronic charting solutions can perform this task automatically.
  4. Authorizations
A large percentage of administrative resources at outpatient rehab facilities are consumed by tracking authorizations - whether it's contacting insurance companies to authorize care delivery or having physicians authorize plans of care. These authorizations are necessary for rehabilitation clinics to obtain reimbursement, and clinics failing to gain the necessary authorizations are leaving money on the table.
    For insurance authorizations, an electronic charting solution can help therapists and schedulers quickly view if authorization has been obtained and for how many visits, as well as track the number of visits consumed and when the authorization will expire. Although this type of functionality is sometimes available in billing systems, therapists and schedulers do not typically have billing system access. Clinics evaluating electronic charting solutions should make sure the system can be configured to support the insurance authorization rules from multiple payers.
    For physician authorization on plans of care, it's important for the system to alert therapists when a plan of care needs to be signed by a physician to comply with payer rules, as individual payers require physician authorizations at different intervals. The system selected by a clinic should allow users to send, receive and track the signed plans of care from physicians. Clinics possessing a clear record of physician signatures on plans of care can readily supply proof of authorization in the event of an audit.
To learn more about the Chart Links electronic charting solution for outpatient rehabilitation, click here or call (888) 369-0707.