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Physical Therapy Software | How to Estimate Your Real Visit Documentation Costs

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physical therapy documentation costIf you are trying to increase the profitability of your physical therapy practice only by adding new patients you may find yourself suffering from increased anxiety at the end of the month.

Although patients are the lifeline of your business, you also need to focus on increasing your efficiency along with your patient flow. But before you can make any kind of improvements to your practice performance with physical therapy software or other tools, you need to determine the status quo.

One of the Key Performance Indicators for your practice performance is documentation. Do you know how much your current physical therapy documentation software is really costing you aside from the fees charged for usage or purchase price? Since you are only getting paid for seeing patients, every minute you spent on documenting a visit results in lost income. As a result, the fees for your physical therapy software dwarf when you compare them to the real cost of your documentation.

It is important to know exactly how much income your practice is losing due to time spent on physical therapy documentation. If you replace the assumptions below with your own numbers you can calculate your estimated documentation loss per month, just like in the following example.

Assumptions:

  • Your average monthly revenue: $20,000.
  • Your average patient visits per month: 280.
  • Your monthly hours of operation: 180.
  • Your average documentation time per patient: 10 minutes.

Calculations:

  • Your average time per visit: 180 hours/ 280 visits = 39 minutes
  • Time with patient: 39 minutes – 10 minutes= 29 minutes
  • Your efficiency: 29 minutes/39 minutes = 74%
  • Your hourly value: $20,000/(180 hours x 74%) = $150
  • Total Monthly documentation time: 280 visits x 10 minutes = 47 hours
  • Monthly value of 47 hours spent with patients: $150 x 47 hours = $7,000
  • Annual documentation time: 47 hours x 12 = 560 hours

=>Annual loss due to documentation: Hourly pay x # of annual documentation hours:

$150 x 560 = $84,000

So if your practice is generating $20,000 in income per month and it currently takes you 10 minutes to document one visit, you are essentially losing $84,000 a year. Over ten years, that’s $840,000 in missed opportunity! If you need help figuring out the real cost of your current physical therapy documentation software you can request an Individual Practice Evaluation here to get help from one of bestPT’s profitability specialists.

bestPT

G-Codes: Another curve ball from Medicare

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Physical Therapy Billing | medicare-g-codesBy Rebecca Harwood – SWAT

Medicare is now requiring that G-Codes and C-modifiers are included on your physic claims and in your documentation. Not only do you as the provider need to change the way you bill but also the way you document. This change is very complex and can not be done from your memory alone. If these requirements are not met, you will not get paid by Medicare and these claims will be denied. We are here to help and have upgraded bestPT in several ways to handle these new requirements.

The G-Codes are used on your Initial Evaluations, Progress notes/Re-evals and Discharge visits to track the patient’s progress in reaching their goals. These codes are used to demonstrate medical necessity and ensure that the patient is getting better. In addition to billing out these G-Codes, you also have to add C-modifiers depending on the severity of their condition. You also need to document these codes in your documentation and ensure that it is supported with functional testing (e.g., Dash, Tinetti, etc). Any claims submitted after July 1, 2013 that do not have G-Codes on the required visits will be denied. If these findings are not documented, you are at risk for an audit.

The G-Codes and C-modifiers have been added to all procedures for clinicians with the PT, OT, and/or SLP specialty code. These can be found in your Procedures list in the Billing and EHR screen. We have put in several validations that will flag any claim missing the G-Codes and C-modifiers. These claims will be sent back to your provider workbench for review. We have also created a new xDoc template that allows you to document the Initial Evaluation, Progress Note, and Discharge Summary all in one xDoc template so you will be able to track the overall progress of the patient. This template also has the Functional Assessment Tools (e.g., Dash, Tinetti, etc) complete with automatic calculations to support your G-Code and C-Modifier reporting. To add this xDoc template to your account, please open a ticket to your SPOC.
We have held two webinars on these updates this month and will be publishing a downloadable version in the next couple weeks. If you have any questions or concerns regarding these new requirements, please do not hesitate to open a Vericle ticket to your SPOC. We also run Live Help Sessions, 1-3 times a day. Check your bestPT Live Help Calendar for information on how to join these sessions.

 

The original G-codes webinar is no longer available.

Historical notice: CMS discontinued outpatient therapy functional-reporting G-codes and severity modifiers for dates of service on or after January 1, 2019. The requirements described in this 2013 article are no longer current. See current CMS guidance.

Tom Jorno

Physical Therapy Practice Profitability | Real Cost of EMR

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Calculate physical therapy practice profitability by discovering the real cost of documentation and EMR.

“The real problem is that even with a 20-minute SOAP note, I need a tremendous amount of time just for documentation. Peter wearily continued, “If I had 4,000 visits a year, I could make $312,000 a year. But even with the best documentation system I would need an hour to document 3 visits. That’s 1,333 hours a year just for documentation!”

“Wait a minute, Peter,” Alicia said, raising her voice. “those 1,333 hours ARE the evenings and weekends you miss with your family. When you see patients, your average revenue is $156 per hour. But when you document their visits you make zero, nada, zilch! Peter I think our mistake is that you only focus on increasing the number of patients you see. I understand you must invest time for documentation compliance. But we should find a way to reduce that unproductive time which pays you nothing.

“I do understand your rational Alicia, but the best documentation system only gets us down to 20 minutes per note. That’s still a problem. It places us in a dilemma to either spend 1,333 hours documenting or see fewer patients and lose revenue. What should we do?”

“Peter, let’s first figure out the REAL cost of your current documentation system. Alicia continued, “Let’s see if the computerized documentation system is better. Then we can think about our next step. Does it sound like a plan?” Peter relented and agreed with Alicia.

“So, if your average revenue for patient care only is $156 per hour, then that’s the best you can do. Every other activity dilutes the revenue. Now lets estimate the COST of other activities in terms of the best value you could be getting by seeing the patients. Does that make sense Peter?”

“First, let’s see how long it takes you to write an average note with your current system. An hour? So you see Peter, you are spending that time writing a note instead of seeing a patient for $158 per hour. How many notes do you write per year? 2,000? OK, then your current manual documentation system costs you $316,000 every year. Do you care to know how much that is in 10 years? Right! Three million, one hundred and sixty thousand dollars . . . That’s a very expensive compliance requirement, would you agree Peter?”

“Next, let’s estimate the documentation cost of your 20 minute notes. One 20 minute note will cost you a third of your best performance revenue, or $52. If you multiply $52 by your total annual visits, which is 2,000, that’s $104,000 in annual documentation costs. Care to extrapolate that into a decade? That would be over One Million and forty thousand dollars. That’s better than three million but still VERY expensive.”

“So, what can we do? Where can we find a documentation system that costs less?” Peter sounded discouraged as he felt his rosy plans being crushed by the cold hard facts of Alicia’s reasoning.

“Well Peter,” said Alicia, relieved that she was able to get Peter to finally think about the business side of his practice, “We must find a documentation system that does not take more than 3 to 5 minutes for a single note. Just imagine, if we had a system that took 5 minutes per note, you could do 12 notes an hour. In other words, your per note cots would be “only” $13 per note. Therefore, documentation of your entire year would cost you $26,000, or $260,000 over a decade.” chimed Alicia. “Now that’s a cost we can live with!” exclaimed Peter.

“And in terms of hours,” added Alicia, unable to hold her excitement, “you would only need 167 hours to spend on visit documentation for entire year. That’s just a tad over 3 hours extra a week! Imagine being able to work almost regular hours and still see 2,000 patients a week.”

“So, Peter,” concluded Alicia, “until we find such a system, you have to choose between your family and your practice.”

What do you think? Is Alicia right in her calculations?

Do you know of a PT-specific documentation system that could make Alicia’s and Peter’s dreams come true?