Many physicians and medical practice managers believe that their billing situation is somehow unique. That they are “different” than other medical practices. Some specialties such as Radiology and Anesthesiology stick out for obvious reasons, and have entire industries dedicated to them which cover everything from billing to dedicated systems.
One group of providers who have never received this kind of attention are the Post-Acute Long Term Care (LTC) specialists. But they should. The needs of LTC and geriatric medical practices are unique indeed, with special requirements that simply don’t fit in the standard medical practice mold. Providers in such practices generally serve patients in post-acute, long term care environments such as nursing homes – often visiting more than one nursing home in a given day. This creates a unique set of circumstances which must be taken into account when it comes to billing, EHR, and process workflow management.
- LTC providers don’t usually work in traditional medical offices. They go from one nursing home to the next, visiting with patients in their rooms, without all of the immediate support staff available in a traditional office environment. Here is the first problem with that when it comes to billing. In a traditional office, providers can manage their front office in a manner which ensures complete, accurate information. In an LTC environment, there is no such control. Instead, the practice is often dependent upon the nursing home to provide patient demographic and insurance data. The accuracy of this data is often questionable, and there is often no incentive for facility staff to forward this information to the practice in a timely or accurate manner. This can negatively affect the billing and reimbursement process.
- Appointment Scheduling. Traditional medical offices rely on appointment scheduling systems to dictate the patient work flow. Importantly, this provides a series of checks and balances for billing purposes (ie. making certain claims were processed for all patients on the schedule). It the LTC environment, providers don’t work from these same types of schedules, and therefore many of the associated checks and balances can go by the wayside – having a potentially negative impact on billing and collections.
- Traditional EHR’s often don’t cut it. Some small LTC providers try to get away with standard EHR software systems, but they are not ideally suited to the unique needs of these practices. “All in one” general EHR/billing/RCM systems are usually cumbersome for these practices and don’t maximize production which impacts revenue. LTC/ geriatric-specific EHR’s can solve these issues, and require interfacing to billing and RCM systems in order to be truly efficient.
- Physicians and other providers in long term care environments are often “on their own” in comparison to their counterparts in traditional practices. In a traditional practice, support staff is usually nearby to help with just about anything. Not so for LTC / geriatric medical providers who are often the only ones onsite from their practice while at the nursing home. That means that in order to work efficiently, providers cannot be pulled into unnecessary additional work created by the lack of support staff. Billing and EHR systems must be geared to this unique provider workflow in order for them to see patients efficiently and without interruption.
These are just some of the areas which make post-acute LTC practices unique. A proper billing and revenue cycle management (RCM) solution must take these items into account.
PractiSource is a full service billing and revenue cycle management company dedicated to maximizing medical provider revenue with the highest levels of customer service and support. PractiSource has teams and associated technologies dedicated to serving the specific needs of LTC physicians and related providers.
PractiSource provides our PBI™ Business Analytics
PractiSource provides our advanced PBI analytics and reporting tool to all clients. This gives even the smallest of practices the same resources as some of the largest healthcare entities in the country – and provides you with the business information needed to grow profitably.
The PractiSource solution involves incorporating efficient transfer of billing information methodologies for our clients. We understand that just like every patient is different, every practice is different as well. We therefore tailor our solutions not just to the specific needs of the LTC / geriatrics specialty in general, but also to each individual practice. For example, we provide a variety of options when it comes to getting the proper billing information for our clients. Some practices work at LTC facilities which still operate in the dark ages –and while not ideal, PractiSource can create work flows which ensure proper checks and balances.
For more efficiency-oriented practices, PractiSource has the ability to directly interface with LTC-specific EHR systems. For example, PractiSource has partnered with gEHRiMed™, a leading LTC EHR system. Through this partnership, providers can utilize the gEHRiMed™ system and billing information is automatically transmitted electronically to PractiSource for processing. This allows providers to simply concentrate on patient care, while PractiSource takes care of the rest.
PractiSource’s services are geared specifically to maximizing revenue and include:
- One-on-one concierge style support
- Seamless EHR integration
- All system setup and implementation
- Complete claims review (human) and claims scrubbing
- Electronic and paper claims submission
- Payment posting
- Aggressive Insurance Follow-up
- Denial and Appeals processing
- Patient Billing
- Handling of all patient and insurance calls and inquiries
- Budget and special payment plan administration
- Complete A/R Management
- Complete reporting
- Advanced Precision Business Intelligence (PBI™) practice analytics
Free Consultative Analysis.
While our service is a perfect match for some practices, it may not be the right fit for others. Therefore, PractiSource offers a free billing and A/R management consultative analysis of your practice. Even if you are not interested in our billing services, it may be nice to know how your practice stacks up and how or if you can improve your revenue performance.
PractiSource Post-Acute LTC solutions are specifically designed to maximize revenue and improve operational efficiencies. Please contact us today for a free analysis. We look forward to hearing from you!