Changes to the Modifier 59


The Centers for Medicare Services (CMS) recently published changes to the Modifier 59 that will go into effect on January 1, 2015.

Background Information:

According to CMS, the modifier 59 is the most widely used modifier and has been associated with considerable abuse and coding errors by providers Because it has the ability to bypass the National Correct Coding Initiative (NCCI), CMS decided to implement new modifiers that could be better describe a situation that requires Distinct Procedural Service.

The new modifiers that will go into effect on January 1, 2015 are outlined below:

1.    XE (Separate encounter, a service that is distinct because it occurred during a separate encounter).
2.    XS (Separate structure, a service that is distinct because it was performed on a separate body part).
3.    XP (Separate practitioner, a service that is distinct because it was performed by a different practitioner).
4.    XU (Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service).

CMS transmittal 1422 explains that there may be a need for modifier 59, however, but it should not be reported when a more specific modifier is available.

The transmittal link is included for you to review.

TheraOffice response:

TheraOffice is currently ready to handle new modifiers without an update to the software.  TheraOffice can also be customized by the end users to create rules associated with the use of modifiers to ensure compliance.  Hands on Technology is currently investigating other features that can be added to TheraOffice to ease the impact of the changes to the modifier 59 which will go into effect on January 15, 2015.

Physical Therapy Software – How Technology is Changing the Industry


Digital Directions

File cabinets with keys have given way to an entirely new system of retrieving, storing and sharing data

By Daniel Morrill, MPT

Ipads, smartphones, tablet PCs, ultra-mobile laptops, desktops – oh my. Health care IT is in the middle of a revolution, and it’s proving to be bigger than the move from paper billing to electronic billing. Where are we? Where are we going? And most importantly, will it work?


The Current Landscape

The digital era encompasses our entire lives, both personally and professionally, and maybe in ways we don’t quite fully understand yet. Electronic records are the hot topic, and we know they are here to stay because they have already been given acronyms.

As we all know, only the good things in medicine have acronyms, and the space of medical records has already reserved a few. EMR, HER and PM are just a few abbreviations to add to our list of medical words made smaller. Out is the file cabinet with keys taped to the side; in its place is electronic data stored for easy access.

Tasks such as faxing, note copying, and chart audits can all be done with a few click of the mouse or a touch of the screen. In fact, some systems are even intuitive enough to send a plan of care directly to a physician for a signature as soon as it is completed. The power and the potential of this new way of doing business is simply amazing – and we’re just getting started.


Future Direction

Technology companies are currently developing solutions for the health care market. Information technology companies are working very quickly to partner with health care systems to create central databases and applications to drive the health care business.

The choices are growing for any type of practice in any setting. The federal government has even passed legislation to improve health care through electronic recording and management, though most private rehabilitation facilities have largely been excluded.

The movement to improve health care communication and record organization across the country in the form of an electronic health record may be possible. The stars may need to align for a national health record to happen at a grand scale, but there has been some progress in reducing the amount of paperwork that changes hands on a daily basis.

Software and hardware developers have always looked at ways to improve the speed in which to enter data into computers and software. Early computers had keyboards, then the mouse; today we have voice recognition, touchscreens and tablets with pens. If developers can continue to improve data entry technology and speed, the impact on usability will become even more efficient, which in turn will both save time and reduce errors.

Apple products and the soon-to-be-released Microsoft Windows 8 are taking direct aim at the health care market by promising easier-to-use table devices with point and touch accuracy to deliver a better user experience. Smaller, more powerful mobile devices are beginning to help shape how health care professionals will deliver care.


Data, Data, Everywhere

Databases of patient information can be anywhere now – the cloud, hosted, onsite, or even a combination of all locations. The Speed and technology behind the internet has created possibilities that simply were not available 10 years ago.

Data can be stored onsite or online, and accessed through apps, browsers and installed client software, which ultimately gives consumers lots of choices. This will allow consumers to find the right solution that meets their business and clinical needs.

The challenge is to protect all this personal health information (PHI) that we create on a daily basis. HIPAA has given health care providers the responsibility of protecting PHI, and this task can seem overwhelming. In earlier days, we had that file cabinet with keys. Now, we have the internet, usernames, passwords, VPNs and a whole lot more. We have mobile employees with increased access to data. We also need to make sure that we have secured data, whether it’s on the premised or in the “cloud”.

Owners and clinic administrators need to work with their vendors, staff and other professionals to make sure their data is protected at all times. The consequences of a data breach can have a severe negative effect on your business.


Do your Homework

Plan, prepare and continue to improve processes in your facilities to protect data. Leverage resources such as your electronic medical record or practice management vendors to learn about the safeguards and security policies.

Develop your own policy and procedure manuals to guide you through and situation that may arise. Prepare your staff through education programs about security and the protection of the PHI data that we must be vigilant to protect.

The electronic revolution is well on its way. Some may have already embraced what it can do for rehabilitation practices, while others are just beginning to look at making changes.  The bottom line is that centralizing data, along with the evolution of software, will improve health care.

We are starting to see concrete evidence that the investment made in technology will improve clinical and business processes if the solutions are properly implemented and everyone is on board. The positive effects technology will have on clinical and business processing will prepare your facility for the health care changes ahead.

Physical Therapy Software: Billing Medicare


Billing Medicare Patients using TheraOffice

Medicare is the standard setter for payers throughout the country and they seem to always be changing and evolving the way that they pay therapists. One question that comes to mind is how can you effectively bill Medicare while still keeping the flow of your system quick and easy to understand? As Medicare creates new rules and gets them set into place, other insurances are quick to follow, so it is necessary to understand how to bill Medicare in the early going or you risk the chance of being left behind. The big question that you need to ask is how can my practice management system help me bill Medicare properly?

The answer was actually published in a podcast on the American Physical Therapy Association (APTA) which the title was “Improving Access to Care for Medicare Patients”. Focusing around the key issues that surround physical therapy and Medicare this podcast addresses many issues of compliance and proper process.

Danielle Haggerty, owner of Dragonfly Physical Therapy, was a guest on the podcast and went on to highlight how she uses her practice management software TheraOffice to properly bill Medicare patients. By sending out faxes right through TheraOffice alerting a physician that a patient is soon to be seen and then following up later with a progress note she is able to receive a signature keeping her compliance. Using TheraOffice’s built in PQRS feature practices are able to qualify for the bonus in Medicare claims. With TheraOffice’s built in tools billing Medicare patients quickly and easily becomes a reality.

To listen to the recorded podcast, a membership to the APTA is required and can be heard at:

Web Based EMR TheraOffice: MetroFax Integration


Our new MetroFax integration will allow you to run a completely paperless facility. Check out this video and what MetroFax can do for your clinic.

TheraOffice 2009.1.0.23 Update


We are proud to announce the release of the 2009.1.0.23 update for TheraOffice. This update added several new exciting features and laid the groundwork for several new features that will be available in the next update.

The largest new feature is the new integration with MetroFax for paperless Internet faxing. Along with the new fax provider, we’ve changed the way incoming faxes are imported into TheraOffice. This feature in the past was an optional add-on software that had to be installed separately for incoming faxes. This feature is now integrated directly into the Inbound Queue with both the MyFax and MetroFax integrations. MetroFax has a wide range of pricing options for both low volume faxing and also high volume faxing. MetroFax also offers an add-on feature called the LX Gateway that is a small hardware device that plugs into your existing fax machine and then into an Ethernet / LAN connection. (The existing telephone line is then no longer used) All outgoing faxes from the fax machine will re-route to MetroFax, and as an option all incoming faxes received from MetroFax will print to the fax machine just as it would. The advantage of the LX Gateway is that it really allows the best of both the hardware fax and the Internet faxing. This can also act as a cost savings device because the phone line provided by the phone company for the fax machine can be ported to MetroFax; with the rates of MetroFax typically being cheaper than that of the regular line, you are bound to save money! For more information please visit or for more information on the LX Gateway, please click here.  IMPORTANT: To signup with MetroFax, please create a new account from the MetroFax website, then contact our technical support or sales department.  We will need the email address and fax number provided when the MetroFax account is created.  MetroFax will need to enable the integration between TheraOffice and MetroFax.

Another new exciting feature that we are releasing in stages is TheraOffice Web Services.  TheraOffice Web Services is a website that will provide Internet based applications and services to both TheraOffice and TheraOffice Web.  The first integration that is completed is an appointment invitation email.  The idea is that patients who have smart phones will normally add the appointment to their calendar on the phone the appointments for therapy when scheduled at the front desk.  With TheraOffice Web Services and the appointment invitation email feature enabled, as soon as an appointment is created in TheraOffice Scheduling, the patient will instantly receive an email containing an invitation.  The invitation can be accepted and then put onto their phone’s calendar.  This will remind the patient on the phone prior to the appointment reducing no-shows or late patients.

There are a few minor feature additions as well.  A new feature on the insurance screen allows for the method that suggested charges in TheraOffice Documentation should be performed.  Typically there will be 2 ways – either the 8-23 logic for Medicare and other federal insurances, or the 1-15 logic for commercial insurances.  This drop down will allow the method to be set per insurance when the insurance is the primary for the patient.  Another minor feature is the required fields on the patient information screen.  This feature has been available for a while, but we added new fields such as address, city, state, and zip code.  Another small feature is a new warning prompt that will be displayed when creating a document in TheraOffice Documentation.  If the currently logged in user isn’t the rendering provider then a prompt will appear.  For most documents, this won’t appear, however for times when using the Document Organizer and creating documents for another therapist, then it will display just as a double check to make sure that the note is being created under the proper therapist.

TheraOffice will now fully support Microsoft SQL Server 2008 R2 as the database engine.  We’ve been hard at work testing the new database engine with TheraOffice and creating a new setup that has many improvements.  Any facility using Microsoft SQL Server 2005 can stay on 2005 or can upgrade in typically 20-30 minutes.  All new installations of TheraOffice will default to SQL Server 2008 R2 Express 32 bit or 64 bit.

We’ve also been hard at work updating our new website.  We’ve received a lot of good feedback from our blogs, and social media and have now integrated this into our website and our clinic navigator.  These additional communication methods are helpful for new announcements, tips on using the software, and allow us to hear feedback.

To download the 2009.1.0.23 update, please click Yes when the Update Manager appears, or click Start, All Programs, Hands On Technology Inc, TheraOffice, Check For Updates.  If you have any questions, please feel free to contact our technical support team.  Thanks.

Web Based PT EMR TheraOffice: What Sets Us Apart!


Why TheraOffice Web?
By: Erik Ziemer

For the 12 years that Hands On Technology Inc. has been in operation, we’ve helped hundreds of start-up practices grow from a simple idea on paper to multi-facility organizations employing dozens of staff.  The essential component to staying competitive and efficient when starting a practice is a fully integrated practice management system such as TheraOffice, with the hardware to run it on and the staff to setup and maintain it.

For most small practices, there’s no need for a server or any expensive IT equipment – TheraOffice is typically installed on a front desk computer and/or laptops. However, many practices reach the point where it makes sense to purchase a server to run TheraOffice, share documents, share printers, secure access via a domain, centralize backups, and other tasks.  This is generally when an IT consultant or company is brought in to purchase, setup, and maintain these assets.

What is the difference between an Internet application and a Web application?

Web applications have been around since the 1990s and are typically operated from within an Internet browser.  Although browsers have been making great improvements on the user experience for years, they still lack a lot of features standard in most desktop and mobile applications.

A new trend toward Internet applications has grown steadily due to mobile applications that run on phones and tablets needing to run on the device while sending and receiving data back over the Internet.  Internet applications will usually run faster than most browser-based applications because the data transferred is less than what a Web application needs.  Internet applications are generally more secure as well – this is due to the fact that a browser-based web application is open to the world to view and access.  The data in Internet applications are only available if the application is installed.

These days, Web applications have to contend with a wide array of compatibility issues such as screen sizes, browsers (Internet Explorer, Firefox, Chrome, Safari, etc.), popup blockers, virus scanners, spyware blockers, and other software and hardware that can change the experience from device to device. Internet applications normally don’t have the same computability issues since there are less variables when running an application on Windows.

TheraOffice Web Simplifies IT

The main goal of TheraOffice Web is to reduce the costs and tasks necessary to purchase hardware used to run TheraOffice.

We have back-up plans positioned to ensure proper protection of your data, with a reliable and secure network infrastructure in place that allows our users to have a smooth and fast-working environment without worrying about hardware and IT consultants.

Security of protected health information (PHI) is one of the biggest issues surrounding practice management. All data stored in TheraOffice Web is protected within a secure datacenter that has 24/7 security with extremely limited access.  All data being transferred to our secure servers is also being encrypted and audited. Network and software design play a key role in the speed and responsiveness of TheraOffice Web. Every action that a user takes within TheraOffice Web sends a request for data to our network. As soon as this request hits our network, the network then transfers data at speeds of 1 gigabyte per second! This means a real-time work environment for your practice. With TheraOffice Web, a multi-facility practice is now possible without the use of a VPN connection, so TheraOffice can expand with your ever-growing practice!

TheraOffice vs. TheraOffice Web

TheraOffice and TheraOffice Web are nearly identical in most facets – we’ve taken years of design based on user feedback from the thousands of practices using TheraOffice and built it on top of a technology that securely transmits the data to and from the server over the Internet.  TheraOffice Web is considered a Web Application and runs on any Windows-based desktop, laptop, or tablet, and only requires an Internet connection.

Data Transferrable

TheraOffice Client and TheraOffice Web use almost identical data, making it seemingly effortless to take data from Client to Web or vice versa. With the ease of transferability, Hands On Technology now offers many different options for evolution as your practice grows with TheraOffice. The process of switching from one to the other is as easy as a backup and an hour while our live technical support team transfers the data. These capabilities offer a multitude of TheraOffice options for your practice.

What is the future of TheraOffice Web?

TheraOffice Web has shown huge interest from many new and existing customers, and we are excited about the future of the product. Currently, TheraOffice Web is available on a trial basis for smaller new clinics that aren’t currently using TheraOffice. The next phase will be to add existing TheraOffice customers who are interested in migrating to the web.  Additional testing is required before this phase launches, which will likely be during summer 2012.  A browser-based web application of TheraOffice Web is also currently in development. The goal of the browser-based web application is to allow for broader mobile device support.  This will allow any user of TheraOffice Web to use the fully functional and interactive Internet Application installed on the office PC to then go home and access the same data via an iPad, iPhone, Android device, or any other device with a browser.

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Please feel free to contact us for more information:

Hands On Technology Sales: (866) 562-8413 x 1 or Contact Us


Physical Therapy Software TheraOffice: Document Organizer


Have you ever wanted to be able to manage what your therapists do in the clinic, and have them reminded about each note that they need to complete? The document organizer will allow you to do just that. With this feature in TheraOffice Documentation you will be able to see what notes need to be completed by what therapist and also for specific patients. Watch this short video explaining how this can change the management perspective of your clinic.!/HandsOnTechnolo

Physical Therapy Software TheraOffice: Sneak Peek: Web Version


This video will show you a little bit of how TheraOffice can now be accessed from any place where there is an internet connection. Check it out and let us know what you think!!/HandsOnTechnolo


Physical Therapy Software TheraOffice: PQRS Questionnaire


This short video will show you the capabilities of TheraOffice to be able to do the PQRS questionnaire right through our software. This can help you receive a bonus from Medicare and will help you save in the future when it becomes a penalty for not reporting the PQRS.


If this is something that you think may help your clinic feel free to access our sales line at 866-562-8413 and schedule a demo!!/HandsOnTechnolo

Physical Therapy Software TheraOffice: Web Version


Hands On Technology ® will soon be introducing its newest and most cutting edge application TheraOffice Web®. At our headquarters we are currently testing TheraOffice Web and getting everything tested for our future launch date. With the ability to access your notes, schedule, and billing from any Windows based device with an internet connection, TheraOffice Web® promises to change physical therapy practice management. By sticking to what our customers like and not changing the interface we have created an almost exact copy of TheraOffice, only we host the data and you can access it just about anywhere.

Testing is going well and will be putting the final touches on what will be an amazing option for our customers. The clinic that Hands On Technology® has across the way has been live with our web version for 20 days now and things seem to be running very smoothly. Others that have been helping with the testing have given TheraOffice Web® very positive feedback.

TheraOffice is a fully integrated system which offers a practice management system that can run your clinic from the time a patient enters your facility, to the management of their payments. With scheduling, documentation, and accounting, TheraOffice® promises to help effectively manage your clinic. Now with access from anywhere your therapists have the option to work from home, meaning that you have more notes completed on time, and more effective billing. TheraOffice Web® will change the way you run your clinic.!/HandsOnTechnolo

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