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This application was written for a client in MD that has over 200 therapists that roam and service patients in over 30 different facilities in three states, such as hospitals, nursing homes, and assisted living centers.  They provide physical, occupational, and speech therapy for a predominantly geriatric community. This application contains over 200 screens and over 100 reports.

The focus/motivation for this application is automatic and error free billing to Medicare, as well as various carriers. There are 2 separate applications: one that is accessed remotely from the facility by the therapist, via Terminal Server; and one that is accessed by the billing department, also via Terminal Server. The software is housed on a fast server with a 9 megabit broadband at the firm's headquarters.

The Facility Side
Achieving "error free billing" is a daunting task. But it is important as errors will cause kick backs from Medicare and carriers, becoming a costly and time consuming nuisance for the company. Even the most seasoned therapist cannot keep up with all the rules and rule changes. And there are many many thousands of rules: rules that determine the amount charged for the therapy per state (this cilent services 3 states,) rules that identify illegal entries, and rules that determine and automatically add modifiers to charges when capps are exceeded and/or for unusual combinations of treatments for the patient, to name a only few of the rule types. The facility side application automatically handles all this for the technician and alerts them as necessary as they are entering their charges at the end of their shift, or when changing facilities. This makes for less frustrated therapists who have more time to provide more therapies and make more money! And it eliminates most to all entries that would cause kickbacks later, saving the company money and frustration!

While there are many screens for managing the front end facility side, click here to preview a screen shot of the main screen therapists use for entering their daily charges. And click here to see a screen shot for Patients. (Note: this application also contains a time clock for the therapists used for payroll by the billing department.)

The Billing Side
There are two main issues the billing department has to deal with: first, sending info electronically to Medicare, and then later to secondary carriers, and lastly to patients; second, receiving and processing electronic data returned from Medicare and carriers for payments made.  Click here for a screen shot of the Master Menu, for an idea of what the app contains. Click here for a screen shot for processing payments received.

Both sides provide a plethora of reports for the client as well as the facility, that may be emailed or printed locally.  The faility is interested in various statistics, and billing explanations while the client is primarily interested in therapist proficiency and facility profitability.

Prior to the development and deployment of the application the client had three seasoned billing employees that took maybe a week to put together data and bill Medicare et al, and another several days to manage payments received, and bill the next logical carrier or patient. And they used several different programs for managing same. The application processes records for a facility and auto bills Medicare in maybe 15 minutes, including a final proofing by the biller! And processing payments received typically takes about the same amount of time. All data is retained, and thus statistical info is available as for an entire year. One of the billers has since retired (30 years with the firm,) another is soon to retire, and the remaining necessary biller will only need to work part time, to her great joy. The client says the app will save them well over 100K per year! And paid for itself in less than a year!

The client reports that they looked at many software packages ranging in price from 100K to 250K, with expensive monthly and annual fees. But the main issue was that none of the packages met their needs. And custom modification costs were completely out-of-the-ballpark!

For a live demo and further explanation, please call Martin W. Cole at (972) 524-8714 or email CCP@martinwcole.com.