CSM with the Physical Therapy Documentation Software TheraOffice

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Starting tomorrow on February, 8th 2012 Hands On Technology will be setting up a booth at the Combined Sections Meeting (CSM) show at the McCormick Place in Chicago, Illinois. We will be booth #655 and will be trying to promote our current software, as well as new features we plan to bring out this year. CSM 2012 will have a great deal of companies at the show, and will be a great place for physicians to see some exciting new feature of the industry. The McCormick Place is located at 2301 S. Lake Shore Drive, Chicago, Il 60616. The HOT team at the show will be taking pictures and videos of the show, so if you cannot make it out, don’t worry, there will be many more blog articles after the show is over about what you may have missed. If you are at the show, stop by our booth to find out news about TheraOffice and what new feature we are introducing this year. Check in after each day of the show and I will have an update posted about what we saw and thought you should know. Stop by our booth and you will be excited with what you see. We look forward to seeing you there!

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Physical Therapy Documentation Software EMR/EHR TheraOffice: How Can You Get Connected?

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Hands On Technology is launching a social and internal effort to help boost our two way communication with our customers. From now on we will be taking the initiative to update our blog, Facebook, Twitter, and Linked-In with relevant information regarding TheraOffice frequently. We will also be posting various surveys that will poll our customers about different features and upcoming changes in the industry. There are different ways to get in the loop with this communication effort. First you can follow me on Twitter @HandsOnTechnolo where I will update regularly about different blog posts and will re-tweet many interesting articles on the matter of EHR, EMR, or physical therapy issues. Next you can like the Facebook page Hands On Technology, Inc. as well as friend request Andrew Howley (the one in a blue shirt and tie since there are quite a few.) Finally, you can connect with Andrew Howley (again blue shirt and tie) on LinkedIn and follow the Hands On Technology Inc. account on that same website. We look forward to increasing our helpful information to you as well as receiving feedback via surveys and comments.

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Physical Therapy Software

TheraOffice Prepares for 2012: ANSI 5010 and Updates

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As the end of this year draws to a close, 2012 has on the horizon a few changes that should be attended to.

5010 Readiness

ANSI 5010 will replace the ANSI 4010 format January 1st, 2012 and all payers will be required to accept claims in the new 5010 format.  Most clearinghouses will still accept claims in 1500, UB04, and ANSI 4010 formats and then convert / upgrade them to the ANSI 5010 format.  If you are submitting directly to a payer / insurance, please make sure you have tested claims in the new 5010 format.  If you have not installed the new ANSI 5010 batch output maps, please view this page.  If you are submitting to a clearinghouse in 1500, UB04, or ANSI 4010, chances are no chances will be needed, however it’s recommended that you contact your clearing house to verify.  All ERA’s in 4010 and 5010 format will be read properly from TheraOffice.

$1880 Medicare Cap

Medicare has raised the cap for physical therapy another $10 in 2012 to $1,880.  Any clinic that re-verifies benefits in the new year will want to update the financial cap to $1,880 from $1,870 in the patient’s case in TheraOffice Documentation, Scheduling or Accounting and also update the therapy paid to date to $0.  Another option is to download the Financial Cap Reset Add-In from the Add-In Manager located in TheraOffice Administrator which will automatically update any Medicare patients financial cap to $1,880 and set their therapy paid to date to $0.  To download this, log into TheraOffice Administrator, click System from the main menu, then click Add In Manager.  Next, click the Download Add Ins button from the toolbar, then click the Other Add-Ins link from the left side.  Next, click the Install button.  NOTE:  Do NOT run the add-in prior to January 1st otherwise all Medicare patients will have a cap for 2012 and therapy paid to date of $0.

Routine Maintenance

Typically most clinics will see a slow down in patient appointments around the holidays – this can be a great time to do a little routine maintenance.

  • Backups:  Please check to make sure your TheraOffice database backups and your server backups are running.  It is often a good time to make a copy of everything and store it off site on a portable hard drive for disaster recovery.
  • Deactivate & Archive Patients: For any patients that haven’t been seen in 2011 or have completed treatment, they can be deactivated from the Patient Information window by unchecking the Is Active checkbox.  If patients haven’t been seen for over a few years, then they can be archived out of TheraOffice.  This frees up database space, and makes it easier to see only active patients.  When archiving patients, their notes from Documentation will be cleared out, and they will be set to Inactive.  Their Accounting and Scheduling data will remain though.  It is recommended to make a backup before archiving.
  • Batch Cleanup: The Batch Cleanup utility in TheraOffice Administrator clears batches in a given date range.  Any visits in the batch that are completed, and have a balance of $0 will be removed from the batch.  If the batch has no visits then left in it, it will be removed.  This is helpful to double check any visits that still have outstanding balances, and will save database space.

If you have any questions, please contact support.  Otherwise happy holidays!

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Sneak Peak – TheraOffice 2009.1.0.22 Patient Responsibility Estimator

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Great cash flow and low accounts receivable balances are key to successful practices.  Government programs such as Medicare and Medicaid are reducing reimbursements and searching for overpayments while commercial insurers are also taking cue and doing the same.  For most practices, keeping ahead of the trends has been difficult and has tightening up cash flow.   TheraOffice’s technology is positioned to improve processes to increase revenue cycle management even as trends make it more difficult to maintain and grow your business.

Start With The Patient

We surveyed practices using TheraOffice and ZirMed and on average we found that clean claims were being processed by the payer in an average range 13-17 days.  The time however to turn around and send a statement to a patient for their balance could be several weeks, couple that with high deductible plans, increased coinsurance, and increased copays and a majority of your AR will be on the patient side.  We all know patient collections can be costly and difficult, especially in difficult economic, so more upfront “smaller” amounts seem to be more successful than a patient receiving an overwhelming bill.

In TheraOffice 2009.1.0.22, collection of deductible, copay, and co-insurance is simplified to increase front desk collection of patient responsibility.  TheraOffice utilizes payer algorithms to accurately estimate the patient responsibility to increase patient revenue capture while reducing the need to refund patients for overpayments.  TheraOffice Co-Insurance/Deductible Estimator is designed to improve upfront patient revenue collection while avoiding costly collection expenses on aged patient balances.  Your practice deserves to get paid for the high quality healthcare you provide, TheraOffice can help.

How it works?

At check in TheraOffice Scheduling will total the copay due and then estimate patient responsibility for the days visit.  This is then collected and applied to the visit.

  1. First TheraOffice will check if the patient has an active case, with insurance and that benefits have been verified with the network status set.   From the Verification of Benefits the Deductible, Current Deductible Paid, Therapy Cap, Therapy Paid to Date, and Co-Insurance amount will be used for the estimate.
  2. Next, TheraOffice will estimate an allowed amount for the visit.  This can be done 2 ways:
    1. By the charges from a previous visit.  EX: if the patient has been seen 5 times, then most likely the 6th visit will have similar charges as visits 2-5.  To estimate the allowed amount:
      1. First look to previous payments, coinsurance and deductibles in the patient’s active case.
      2. If not found in the active case then check in the patients other case(s) if available.
      3. If not found in the patients cases, then it will look for charges of other patients with the same insurance and charges and estimate the allowed amount.
      4. If not found in other patients, then TheraOffice will check if the insurance has a contracted fee schedule.  If so, then use the allowed amount from the contracted fee schedule if entered.
      5. If no contracted fee schedule then use the charge amount for the standard fee schedule.
    2. If the visit is the first visit in the case, then use a fixed amount that is set per discipline.  This fixed amount can be set in TheraOffice Administrator, and is a general allowed amount that is typical for the evaluation visit.
    3. If the visit is the second visit in the case, then use a fixed amount that is set per discipline.  This is done since the charges from visit #1 (which is typically the evaluation visit) will differ from visit #2.
  3. Next, TheraOffice will estimate responsibility for each allowed amount for each charge or for the entire visit based off the variables set in the Verification of Benefits.
  4. Finally total the responsibility for all charges.

Implementation

The beginning of the year is a great time to review policy and procedures for all areas of the practice as well as collecting up front when deductibles haven’t been met.  When reviewing your policy for collections at the front desk, this new responsibility estimation tool can be implemented in one of the following ways:

  1. Collect the patient’s responsibility upfront for all patients for all insurances based on the estimation completed by TheraOffice.
  2. Collect the patient’s responsibility upfront for all patients with a given insurance and gradually phase in other insurances as allowed amounts become more accurate.
  3. Estimate patient’s responsibility but don’t apply the payments to the copays or patient responsibility.  Collect the payment once a week or another time frame and apply at once to all visits in the date range.

Video Demonstration

The below videos will demonstrate the new patient responsibility estimator in action.

Part 1 of 2

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APTA Optimal Form and the Physical Therapy Software TheraOffice

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Using the Documentation Designer feature in TheraOffice Documentation, I was able to build into the initial evaluation, progress note and discharge note the APTA OPTIMAL form to measure patients progress during treatment. The below video is a quick demonstration of the OPTIMAL Form in TheraOffice.

The TheraOffice 2009.1.0.22 update is required to automatically score the grid. If you would like help building in the OPTIMAL form, please contact technical support.

Thanks to the folks at the APTA for giving us permission to use OPTIMAL.

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New York Worker’s Compensation: OT/PT-4 Form

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by Nick Austin 29. November 2011 12:04

Many clinics in the state of New York are now being required by the Worker’s Compensation Board to submit their claims using the OT/PT-4 Form in place of the standard 1500 form or ANSI claim file. With the goal of minimizing work for our customers, we have implemented this form into TheraOffice.

Through a new feature added in the 2009.1.0.20 update, our claims are now able to directly access the information that was filled out in the corresponding note in Documentation. This gives us a completely new level of customization that we did not have before. Not only can the claims access the notes, but we can customize the notes so that the claims can access anything that is needed.

If you get the OT/PT-4 implemented, we will start by modifying your documentation. Fields will be added for the information on the form that is not regularly found in TheraOffice. If the therapist fills out these sections while doing their note, it will automatically populate on the claim as that is printed. If they skip any of these sections, the form will still print out with as much information as it knows, allowing your billing staff to fill in the rest as needed.

In our initial testing of this feature, we have found that claims submitted with our OT/PT-4 are being accepted (this is dependent on full completion of the documentation or completion after the form has been printed). The end result is much like we hoped in that our customers using this form will see a decrease in time spent on claims compared to filling out the paper or PDF copies of this form.

If you are a New York based clinic and would like to see this feature implemented in your software, please contact support to start the process.

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TheraOffice 2009.1.0.21 Update

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by RyanH 3. November 2011 05:42

The TheraOffice 2009.1.0.21 update will be available today via the Update Manager – so please check for updates and install them when they become available.

The goal of this update was mostly for completing the changes required to TheraOffice for the upcoming ANSI 5010 migration.

In addition to the client update we also posted a new add-in that is available from the Add-In Manager in TheraOffice Administrator for the ANSI 5010 Update. Prior to downloading, please make sure the 2009.1.0.21 client update has been downloaded and installed. To download this add-in, please follow the below steps:

Log into TheraOffice Administrator.
Click System from the main menu, then click Add-In Manager.
Click Download Updates from the top toolbar.
Click Batch Output Maps from the left explorer bar.
Locate and select the ANSI 837 5010 Professional (TESTING V2) map, then click the Install button.

We will complete the ANSI 5010 Migration in early December by releasing 1 final 5010 related update (2009.1.0.22) and the final ANSI 837 5010 Professional Batch Output Map via the Add-In Manager. As of now, we’ve tested claims with various payers and clearing houses with the .21 update, and are successfully accepting the claims.

Many improvements have been made to the ANSI 5010 Professional Map including:

12 charges
Secondary claims support
Medicare Secondary claim support (MSP)
Workers compensation claim support for most states
Bill To / Pay To Address features for P.O. Boxes

More information is available about ANSI 5010 at this blog post. If you have any questions or need assistance

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Running TheraOffice On Tablet PCs

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by Tom Kero 26. October 2011 11:13

With the recent success of Tablet PCs, a large number of TheraOffice clients have switched from the standard laptop or desktop computer to the more mobile Tablet PC. Due to this increasing use of Tablets, many features have been added into TheraOffice Documentation to improve speed and efficiency on the Tablet PCs. The handwriting recognition features available with many of the Windows 7 Tablets will also work within TheraOffice.
Over the past year, we have listened feedback from multiple clinicians on the functionality of TheraOffice on different Tablet PCs and we encourage you to continue to send us your feedback. TheraOffice is currently a Windows-based solution, so TheraOffice can only run directly off of Windows based PCs. Questions about running TheraOffice on the iPad do get mentioned from time to time and the only way to use the iPad with TheraOffice is to remotely connect the iPad to a PC. We have also found that the iPad is not well built for this type of data entry because of the lack of pen capabilities and the only input option being the on-screen keyboard.

We’ve compiled a list of our own feedback of the tablets we’ve purchased and tested with:

Slates (No Physical Keyboards)
1) Asus EEE Slate: This has been the top slate Tablet PC because of the fast processor, pen and multi-touch features, Blue-Tooth keyboard attachment, and decent-sized 10 inch screen. Handwriting recognition is available with pen/Stylus option.
2) HP Slate: Slower than the Asus EEE Slate, but still offers the pen and multi-touch capabilities. Handwriting recognition is available with the pen/Stylus option.
3) Viewsonic ViewPad 10: No handwriting capability with the pen. Multi-touch with Dual Boot (Windows and Android).

Convertible Tablets (Laptop converts to Tablet PC)
4) Lenovo ThinkPad: Fast Processor, full Tablet capabilities with pen with handwriting recognition and a 12.5” touchscreen.
5) Motion Computing: Offers healthcare specific models that have pen and touch capabilities. Very comfortable to hold in your hands during treatment with excellent design for increased mobility. More expensive.
6) HP Elite Book: 12.1” touch screen with pen and touch capabilities along with handwriting capabilities. Decent Speed.
7) Dell Inspiron Duo: Decent speed, no pen capabilities. 10.1” HD display screen.

If you haven’t heard or see – Microsoft released a public developer beta release of Windows 8. We’ve installed this and are extremely impressed. Unfortunately Windows 8 is not due to be released until next year, but we will be continuing to test our products with the future updates to Windows 8 as they come out.

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TheraOffice Web

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by RyanH 26. October 2011 02:35

As the world of cloud computing evolves – we at Hands On Technology Inc. have been carefully watching and analyzing what are the benefits of hosting data in the cloud versus locally hosting TheraOffice in office. We have concluded that the TheraOffice can safely be hosted in the cloud while providing anytime, anywhere access.

Over the last year – Hands On Technology has been working to build it’s cloud infrastructure to host TheraOffice in the cloud, and has been building the next version of TheraOffice which we will name TheraOffice Web. The current locally hosted version of TheraOffice will be named TheraOffice Local, and we will still offer the same service and support to the TheraOffice Local version as we always have.

Under the hood TheraOffice Local and TheraOffice Web are vastly different. TheraOffice Local was designed to work over a secure local area network where connection speeds are typically faster and connections are typically very reliable. TheraOffice Web was redesigned to work with unsecure, lower bandwidth and less-reliable connections. Security was our #1 focus with TheraOffice Web and with that 2 layers of encryption were added and the backend database was hardend – along with many other security enhancements. Most of the user interface and close to 98% of all the features that are standard in TheraOffice Local are available in TheraOffice Web.

TheraOffice Web is an Internet Application – which means that the TheraOffice Web client software is installed on any Windows XP, Vista, Windows 7, Windows 2008 Server, or Windows 2011 Server, and then the data and the database reside somewhere in the cloud hosted by Hands On Technology Inc. There is no need to install the database software, purchase or maintain servers, or worry about backups for TheraOffice. So long as there is a high speed Internet connection, TheraOffice Web takes care of the rest.

Currently we are beginning early beta testing and the results are very positive – very fast performance and a user interface that is the same as TheraOffice Local. (No need to retrain staff) Once our initial testing is complete, we will extend an invitation out to new customers that would like to test, and then to existing TheraOffice Local customers that would like to test TheraOffice Web. Early in 2012 we will then be releasing a companion browser based version of TheraOffice that will work with TheraOffice Web to allow users to either use the installed Internet Application version of TheraOffice Web or a no-install browser based version of TheraOffice Web – both of which will access the same data in the cloud. This allows for a rich desktop user experience which is fast, and responsive and then allowing for anywhere access on other mobile devices with the browser based version.

We will continue to post updates throughout the next few weeks and months as test TheraOffice Web.

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ANSI 5010 Testing

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by RyanH 25. October 2011 16:21

As the end the year is closely approaching, more insurances, payers, and clearinghouses are putting together final plans for testing for the transition to ANSI 5010. TheraOffice will be going through a series of updates to prepare for ANSI 5010. The goal is to have everything in place so that as payers go online with 5010 prior to Jan 1st – claims can be outputted in 5010 format from TheraOffice and accepted so that the transition is as smooth as possible.

The first update happened in the summer to prepare for the initial testing with clearinghouses and payers. Although TheraOffice outputs a standard ANSI 5010 professional claim – we found that many payers and clearinghouses needed additional changes that were different from 4010 or were slightly different that the standard. Overall this process went fairly well.

The second update will come with the release of the 2009.1.0.21 update. This update enhances a few features of TheraOffice to make the transition easier and will also be compatible with the ANSI 5010 Professional Version 2 Output Map. The goal is to be able to have all claims in the 5010 format pass all major clearinghouses and payers.

The final update will happen mid December which will be a final update in the 2009.1.0.22 update along with the final ANSI 5010 Output Map. This map will be available via the add-in manager for existing TheraOffice 2009.1.0.x users and will be inlcuded in any new installs or TheraOffice.

For testing if claims are submitted to a major clearinghouse such as ZirMed, and the output format is 1500 print image format or UB04, typically all claims will transition automatically, however, this doesn’t mean that there could be some claims that will be rejected by the payer. If claims are being submitted to a clearinghouse and the output format is ANSI 4010, then it’s highly recommended that the 5010 batch output map be downloaded from the Add-In Manager in TheraOffice Administrator and some testing be done as soon as possible to ensure that claims will be compatible with 5010 by Jan 1st, 2012. For more information about how to begin testing, please view the ANSI 5010 Testing knowledgebase article.

If you have any questions about this process – please call technical support.

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