Amanda Somers, APTA board member of the Private Practice Section, tells the story of her practice’s Medicare audit success using Clinicient’s EMR
In a recent webinar with Medicare compliance expert Nancy Beckley, private practice owner and physical therapist Amanda Somers, recounts the story of a recent Medicare audit of her practice, and how they successfully passed 100%. Not only was the audit daunting in it’s potential impact on cash flow, but it verified every practice owner’s worst fear that it is no longer IF you get audited, but WHEN.
Fortunately for SSI Physical Therapy in South Carolina, they were prepared. Co-owner and physical therapist Darlene Pope is responsible for managing Medicare compliance requirements for their practice. With her thorough understanding of what Medicare requires, she set out on a six month investigation for the right EMR and practice management system. Why did they choose Clinicient?
- Therapists are no longer burdened with staying on top of what is required, and when. The system manages that for them and automatically alerts them when needed. This made the new therapy cap tracking and manual medical reviews not such a big deal.
- Therapists have a easy to use system for tracking patient goals and monitoring progress. This feature not only makes the new functional limitation reporting requirements simpler, but has always helped them to stay in front of patient progress and facilitate clinical judgement.
- Therapists can individually customize the documentation to match their style and preferences. And at the same time, management can enforce the necessary requirements to help keep them in compliance by always demonstrating medical necessity and justifying treatment.
- Therapists are presented with a pre-visit audit as they sign off on each patient visit. The system automatically calculates the correct number of units based on their documentation, applies modifiers and CCI edits appropriately, and warns them of any corrections needed that might otherwise send a red flag to Medicare. More importantly, it ensures that therapists are never giving their time away and billing Medicare the most they can for each visit. No more charge tickets or super bills.
- Co-owners Amanda and Darlene are enjoying the assurance that every visit that gets billed will always have matching documentation that supports the claim, for all therapists across both of their clinics. This is a serious audit risk that practitioners take if they use one system for their EMR system and a separate system for their billing. It is also a key factor that lead to their audit success.
- Best of all, Amanda and Darlene are enjoying increased cash flow with the embedded features of the system that prompt staff to collect patient payments up front and do whatever is needed to ensure full and prompt payment. As Clinicient billing service clients, they also enjoy unmatched efficiencies in their revenue cycle management that allow them to focus on patient care while we take care of the rest.
But don’t take our word for it, just listen to Amanda.
To hear SSI’s entire audit story from Amanda, watch the following:
Click here to download the case study.