Starting a virtual therapy session during Covid-19

Advice for Therapy Clinics During the Covid-19 Crisis

At TheraPlan and our sister company, Edwards Electronic Processing, our business has been significantly affected by the threat of Covid-19. We know it’s likely that yours has too. Because we have far-reaching connections within the Florida therapy community, we feel we have a responsibility to compile and provide you with pertinent updates as we become aware of them.

Thus, this is a bit of a different blog post. Following is a bullet-point summary of the advice that Stephen Edwards, our CEO, has been releasing to our Florida therapy community via YouTube video updates over the past few weeks. Please see the end of this post for links to resources that contain the most up-to-date information about this crisis and any new regulations that affect your business.

With this post, we aim to give you realistic answers to your most pressing questions, and we are guiding our community with a conservative approach. The following advice is from a business standpoint, not a patient care standpoint.

  • If your therapy clinic is still treating patients on-site:
    • Implement a no waiting room policy.
      • Use TheraPlan’s text messaging feature to allow patients to wait in their car. This helps you avoid a waiting room scenario and gives your therapists the ability to notify a patient the moment they are ready.
    • Disinfect your entire facility at least once per day, and each treatment room between patients. 
  • If you are transitioning to telehealth:
    • Make sure your platform is HIPAA compliant. Here are some options:
      • TheraPlatform
      • Skype for Business
      • Zoom (*you must have a business associate agreement with Zoom in order to make this a compliant platform)
      • Doxy.me
      • TheraPlan is looking to add a video platform in the next 30 days. Be sure to follow both TheraPlan and EEP on Facebook for regular updates.
    • If you do not already have a list, by therapist, of patients that are eligible for teletherapy, create one! This will require having your admin staff or therapists contact every patient to have them sign a teletherapy acknowledgement and verify that they are willing to proceed. However, this does not mean the payer will pay for therapy in this form. (See below.) Add a patient to your schedule only after you have confirmed these details.
    • Consider one patient per payer and see if claims are going through or being denied. If they are denied, you will have to bankroll that payer.
      • Medicaid announced that they are going to cover teletherapy for speech, physical, occupational, and Early Intervention therapy services. This means that MMAs will have to cover it.
      • Florida Medicaid is also going to cover teletherapy.
        • Medicare does not yet cover teletherapy for your provider type. 
        • If you are going to treat Medicare Type B patients, they need to be private pay and you must have an ABN (Advanced Beneficiary Notification).
    • Start collecting for self pay patients. One way to do this is to have admin staff call those patients that were seen in a given day and take payment over the phone later that same day, not at the time of service. It’s much easier on families to do this on a per session basis rather than to send them a big bill at the end of a month. Billing every day will also help maintain your clinic’s cash flow.
    • We advise that you roll out teletherapy strategically and keep a couple things in mind about how this transition is working for insurance companies:
      • Start immediately with Wellcare, MMA, Title 19 and Title 21, because we know that teletherapy goes through their underwriters. You will get paid during the normal billing cycle. If a claim does not go through underwriting, it is not going to get paid.
      • These new billing systems that cover teletherapy could take awhile to be officially set up. It could take 45-90 days to go through an appeal if your initial claim does not go through the correct underwriting process.
      • Many payers have cut down their admin staff.
        • Expect your secondary claims, appeals, and claim status calls to be much longer than normal. We have gotten reports of two-and-a-half-hour wait times already.
        • Expect that payments from secondary insurance providers will also be delayed.
  • Measures for keeping your therapy clinic afloat during the Covid-19 crisis:
  • Additional FAQs:
    • Can Speech-Language Pathology Assistants (SLPAs) treat patients via teletherapy?
      • From FLASHA, we learned that the answer to this question is yes. 
    • Where can I get valid information about what’s happening in the therapy industry?
      • To get the latest information about the medical piece of the puzzle, visit www.cdc.gov.
      • For Florida-specific updates, visit the Florida Department of Health’s Covid-19 page.
      • Look to your licensing board for clinical updates.
      • Get insurance updates directly from any payer that you are in network with.
      • Do not seek out information from groups or comments on social media (such as Facebook).
      • Make sure that you comb through any communication to make sure it’s relevant to your provider type. If it is, understand the system still may not be set up yet to pay for that service.
    • What should my self pay rate be?
      • We recommend charging $1 per minute for teletherapy, so this can be split 50/50 between the therapist and the providers. Your therapists are likely going to need to take a cut if you are going to reduce the amount it costs for teletherapy. That might not be popular, but it is a reality of having to make payroll.

We encourage you to compile all the information we are providing you with and make the decision which is best for your clinic. 

For the video version of this advice and the latest updates from TheraPlan and EEP (our partner billing agency), subscribe to our YouTube channel.

Using an EMR When Credentialing for Therapists Using CAQH Account

How the Right EMR Can Help Therapists Keep CAQH Accounts Current

If you are a therapy clinic owner, we would venture a guess that you are no stranger to the Council for Affordable Quality Healthcare (CAQH) and what membership means for the continuity of your team’s credentialing experience. It is essentially a central application hub for various insurance credentials, and seems like a no-brainer. Of course, there is also the fact that many insurance companies actually require that all credential submissions happen via CAQH. These choices by the movers and shakers at large insurance companies have certainly made this almost an industry standard in 2020.

Mandating CAQH membership for your entire team can therefore be helpful as you continuously balance rolling expiration dates and bringing on new hires. However, fully implementing clinic policies that support accurate and consistent credentialing is easier said than done. Keeping an up-to-date account that is attested every four months is not light work and needs to be a priority for everyone involved.

Despite the fact that credentialing is technically the responsibility of individual therapists, it ultimately falls on you, the clinic owner. That’s largely because not keeping up with it can present a sizable risk and potential revenue loss for your business. Whether you have admins or you’re managing on your own, it’s overwhelming to keep up with therapist credentialing for CAQH (personal data, current documents, and list of insurances, to name a few items). 

If your office does not already run like a proverbial well-oiled machine, this type of paperwork nightmare could overtake your administrative processes. In our experience overseeing the admin side of countless therapy clinics, many make credentialing more difficult than it needs to be. Like any other small business responsibility, efficiency in this area is very much about standardization. Have a central place (preferably digital and easily accessible) to house all the important data for each person in need of credentials, and you’ll immediately cut down on the time spent searching for correct info.  

No surprise, we highly recommend an EMR for this! As you may have already discovered, though, not all EMRs are created equal.

In the same way that we focused heavily on building user-friendly documentation templates into our software, we also designed TheraPlan to make getting organized for credentialing easier. In each user’s profile within User Maintenance, there is an accordion (section) specifically for keeping credentialing data and uploading a therapist’s pertinent documents and personal data. Here, you will see that it’s possible to add expiration dates for board certifications, which allows our application to work with you in making the process seamless. 

This section is only accessible by you as the owner, and any admin users you specify. Every move inside the system is traceable, so there will never be a question about who made changes to a user’s file. Once you’ve input all the necessary information the first time, the designated person in charge of credentialing for your office can then update it as necessary with just a few clicks. One additional benefit: TheraPlan is web-based, so it’s accessible from any device anywhere. 

Even if you are already a TheraPlan user or have implemented some processes for therapist credentialing with CAQH, you may need some additional guidance to avoid costly mistakes. For this reason, we’ve partnered with the credentialing pros at Clinic Connection and several other companies specializing in Florida therapy to help clinic owners like you. 

We invite you to reach out to us before making any changes to your credentialing processes. Not only can we get you set up with a modern, therapy-specific EMR, but we can connect you with our network of Florida therapy experts.

Therapy Industry Trends Discussed at ASHA’s 2019 Convention

The TheraPlan team recently attended the 2019 American Speech-Language-Hearing Association (ASHA) convention in our home city of Orlando, Florida. We always love interacting with therapists and clinic owners like. At this event, there was ample opportunity for us to discuss industry trends with members of the speech therapy community. Along with our partner companies, EEP billing agency, Clinic Connection, and EligiPro, we personally addressed providers’ major worries regarding documentation, billing, and more. Here is a summary of some of the themes we heard.

It was no surprise that several therapy practice owners told us that their biggest challenge is keeping up the flow of their revenue cycle. Dealing with the complications presented by insurance reimbursement can make this feel impossible. Since TheraPlan was founded by therapy billing experts, we fully understand how it feels to spend hours on the phone with insurance companies and to always be frustrated about things like appeals. Industry regulations and commercial insurance requirements seem to be constantly changing, and it can be hard to keep up. This is precisely why we work so closely with EEP billing agency. We know you need experts on your side, and specifically those who specialize in Florida therapy billing. 

In addition to general revenue concerns, many providers approached us with curiosities about how to keep accurate records for specific billing requirements, such as grant programs and Early Intervention treatment. TheraPlan has designed its documentation templates to satisfy the requirements of your local Early Steps programs. You can feel confident that your annual audits will go smoothly when you use TheraPlan’s documentation templates.

Ultimately, the biggest frustration we found amongst ASHA attendees was something that is reflected in many of our interactions with therapy clinic owners every day: a desire to focus on the therapy and patient aspect of the business and spend less time on the admin. We believe you deserve to do so because your practice serves the community in a meaningful way, but also because you became a small business owner in order to experience some of the freedom that implies. In this industry, it can be difficult to leave work behind and have a life of your own, difficult not to spend every moment after hours doing paperwork or trying to make sense of claims, credentialing, etc. 

We know it’s possible to feel you are dedicating yourself to providing the best quality therapy possible while also running an efficient business and keeping it in the black. The detailed nature of TheraPlan’s documentation templates and the convenience of features like the to-do list were our response to real-world clinic owners who came to our booth to discuss their general sense of overwhelm. Our EMR users, who are not limited to the speech therapy discipline, have transformed their practices and we know you can too.

You may want to check out what the EEP billing team encountered at this year’s convention. Missed ASHA and want to chat with us about your own concerns? You can contact us any time. Click here to shoot us an email.

insurance authorizations

Insurance Authorizations 101

When a new patient arrives at your therapy clinic, there are several bases to cover before he or she can be treated. Along with standard intake forms and insurance verification, we recommend checking benefits and requesting an authorization. Following these best practices will protect you from the dreaded scenario in which you perform treatment and do not get paid. Although therapy clinic owners and admins are generally most familiar with the process of obtaining an authorization from an insurance company, it’s wise for therapists to understand the process and act as another set of eyes. Let’s go over the basics: What is an authorization? Insurance authorizations are determinations by a patient’s health insurance carrier that treatments are medically necessary. Since commercial insurance plans consider therapy a specialty, authorizations are required in many cases. Florida Medicaid requires authorization for all therapy disciplines. While an authorization is not a guarantee that the insurance will pay, it is much more likely that benefits will be honored when the authorization is on file. Why should I worry about authorizations as a therapist? You may feel that your responsibilities follow the paperwork process that your admin team normally takes care of. However, if you unknowingly treat a patient without an authorization on file, you could risk spending valuable time treating a patient and not getting paid, or experiencing a lengthy delay in payment time. In addition to the risk of lost revenue for you and your clinic owner, lack of an authorization can throw off your plan of care. Since the details in your plan of care depend upon your expectation of when a patient will meet certain goals, the amount of benefits and number of pre-approved treatments can impact whether you will be able to follow the plan. Keeping an open line of communication with your owner and admins can help you avoid any miscommunication about the type and quantity of treatment you provide your patients. Though you may not be responsible for requesting authorizations or attaching them to a patient’s file, TheraPlan advises that you check to see if there is an authorization assigned to every patient case, especially for new patients. A few moments of due diligence go a long way towards making your treatment plan and payment process as smooth as possible! Want to learn more about insurance authorizations? Check out how TheraPlan eases the job of a therapist by tracking authorizations for you!
audit-guided documentation

Protect Your Florida Therapy Practice with Audit-Guided Documentation

Insurance audits are a reality for therapy clinic owners. Getting audited can be one of the most stressful things to happen to you as a business owner. After all, if you don’t pass an audit, it could mean returning large sums of money to the insurance company. So, what will you need to guarantee compliance? That can vary. Some audits cover your entire practice, while others are specific to a few patients or providers. Here are a few examples of documents you could be expected to provide:  
  • Financial records
  • Daily progress notes
  • Evaluations
  • Plans of care
  • Billing logs
  • Appointment calendars
  • Provider documentation
In short, the more detailed history you keep, the better. Be ready to produce any records that pertain to your practice at any moment. But don’t panic! There are a few things you can do to prepare and, in turn, ease your worries about an insurance audit. First, keep your admin team organized. It is of utmost importance that you and your administrative staff know where to find everything in the event of an audit. This way, you can easily identify if any records are missing or incomplete right away, rather than spending the days allotted trying to locate the pertinent files. This is especially important if your clinic uses paper records. Get those filing cabinets in order! It’s also wise to spend the extra time it takes to set your therapists up for success. This may mean training them on a better way to complete notes or hiring extra admin help to answer their questions and keep an eye out for holes in the system. Review your billing logs in detail to identify areas in which your team of providers could improve. By far the best way to be ready for the dreaded audit is to use electronic medical records (EMR) software. However, just having an EMR is not enough. It should be an EMR that will house everything you need when an audit notice arrives. This way, you’re not referring to the EMR for some details and searching around for others. Unlike generic EMRs, TheraPlan has your back during an audit. Using our 25 years of experience consulting with and billing for therapy clinics of all sizes, we designed TheraPlan according to the audit requirements of Florida Medicaid, Medicare, and Early Steps. If your therapists completely fill out our audit-guided documentation, you’ll have less reason to worry! Want to know more? Read about our audit-guided note templates and other features of our efficient documentation system.