As we planned our integration with billing companies, WebPT wanted to give our members multiple options. The two certified billing companies that we launched integration with this month represent an in-house software solution (Kareo) or a third-party service solution  (BMS). Each of these approaches has its own set of benefits and ultimately will need to be assessed on a clinic to clinic basis. Here are the pros and cons of each approach.

In-house billing - (WebPT integrated option - Kareo)
Choosing an in-house billing solution means that you will use the billing software in your clinic. With an integrated system, information entered into your documentation system, such as demographics, insurance information and CPT coding flows directly into the billing software. Without an integration, this method usually requires some duplicate entry of patient demographic and financial information for each patient visit, as well as the manual charge entry of each treatment visit.

Keep in mind that an integrated, in-house system still requires that a key team member verify the information that is being transmitted. The billing clerk will have a log-in for the EMR and a separate log-in for the billing software.  In the billing software, claims must be approved by the clinic's billing clerk and then sent (either electronically or through traditional means) to the payer. A benefit of using an In-house billing software is reduced fees. Most web-based billing software systems charge a flat monthly fee for the software, not a portion of the claims paid. There may also be some extra fees added on for clearinghouse fees. In-house billing software also allows for clinic control over all claims and patient information. This can mean peace of mind for clinic owners who want to personally oversee the financial trajectory of their clinics.  To ensure maximized reimbursement and a quick turnaround on payment, hiiring a qualified billing clerk along with use of quality billing software are keys to completing your billing in-house successfully.

Third-party billing - (WebPT integrated option - BMS)
Outsourcing your billing to a third-party billing company means that your clinic has delegated the billing process to a specialty service provider, relieving your staff from the majority of billing administration. Since WebPT now feeds patient documentation information directly to BMS, a leading PT billing service provider, the charges and patient information will be sent automatically to BMS upon finalization. BMS will handle the entire cycle of the claim from that point on. The fee structure for third-party billing option is usually based on the total collections that are recorded per month. Rates can vary from 6 -12%, so research and comfort with the billing company is key in your choosing process. Lack of control is also a common barrier that should be assessed. While BMS combats this issue with access to a dashboard full of reports monitoring billing process real time, submission of claims is still an outsourced procedure. Other third-party options may not have such a detailed reporting mechanism to go along with their service. Verification of insurance eligibility and transmission of patient demographic information is still necessary if you use a third party billing service whether its integrated or not.

Learn More about WebPT- Billing Integration Services

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