Are You Being Scammed By Your Billing Software, Service, or EMR?

Watch out for this guy.

You’re buying software not a car. If a consultant (aka “salesman”) is needed to figure out how it works, maybe it should go back to the drawing board and be more intuitively designed.

emr and billing software

A lot of so-called “consultants” have been crawling out of the woodwork recently spewing out advice on EMR and billing software and services, mainly for the purpose of ripping you off with their systems. Our industry is ripe for the picking and many are cashing in on our ignorance and fear. Many PT/OT’s are paying way too much only to find themselves with headache and frustration. Remember, all you are doing is scheduling, creating a bill, making notes and applying payments.  That’s it! Not rocket science…you should not have to pay rocket prices.  All the “bells and whistles” only complicate a very simple set of tasks needing to be accomplished.

I want to shed some light on the grave issues at hand.

I hope to prevent you from potential costly mistakes. Who am I, you might ask? Let me qualify myself a little…

  • Ive used about 5 different systems in my practices over the past 15 years in private practice.
  • I’ve demo’d over 40 systems.
  • I am a coach to over 2000 PT’s worldwide and have been privy to all the glitches and headaches associated with all the main softwares.
  • Im also one of only a few PTs who serve as an expert witness and consult on documentation audits and billing cases.
  • I consult software developers on metrics, security, pathways and protocols for $10k-$20k depending on their needs.
  • Here’s my LinkedIN profile

Most of the EMR and billing softwares out there are inadequate but some are less inadequate then others depending on your personal situation. How many claims do you generate per month on average? Do you get good aging reports every two weeks? Do you have other apps that get some of the job done quickly and easily? What’s your accounts receivable (A/R) percentage each month?

If your current system of scheduling, billing, and documentation is bad then ANYTHING will be better.

But if your current system is not that bad (and doesn’t really need “fixing”) then theres an 80% chance that if you try to change, you will be met with frustration and regret.

Be wary of…

  • Bells and whistles. Keep it simple.
  • PQRS: Don’t waste your time. The time, energy and money you expend on it isn’t worth it. Pay the fine and you still make out way better than falling into the “Medicare Trap”. While the rest of the world is fed up with medicare rules and regs, cuts in reimbursement, refund requests, RAC audits…and opting out, why would you want to pay more per month on bells and whistles for something that doesn’t add to your bottom line but takes from it?
  • G-Codes and C-Modifiers: It’s not that hard. Even if you do everything correctly, there’s nothing you can do if your claim is the one that happens to pass through the “Cut” list anyways. Just rebill it and it will get paid. Medicare is trying to hold on to their money longer and stay afloat so it’s likely they will not pay if they don’t want to anyways. It’s a game, don’t fall into it.
  • No download of all your data: If you can’t take your data with you, don’t use that software. It’s software. They should be able to give you your data so you can take it and run when wanting.
  • Paying more than $100 per provider or $500 per month: That’s ridiculous. Software is software and we are talking about cyberspace after all. It shouldn’t be that expensive; It’s really not that expensive. If the company is spending a ton of money on advertising and hiring copywriters and other people acting like an advertising agency, that drives up their expenses, which you in turn are paying for. Don’t get caught up with the hype. All you are wanting (and needing) is to schedule a patient, generate a bill, make a note, and log payments. Please…
  • Contracts: Never get yourself caught into one. A software company should keep you as a customer on the merits of a good product at a good value with good services. Not with a ball-n-chain.
  • Billing services charging more than 4% of Gross Receipts: All you are paying for mainly is data entry. It’s not that highly skilled. What gets me is that in some cases you, the customer, are the ones putting in the data for them…then what are you paying them for? Now, I know that some services offer appeals and collections and patient invoicing, but once again…not rocket science. You shouldn’t pay more than 4%.

VERY IMPORTANT: When you pay 5% of gross receipts, you are in essence giving away over 15% ownership of your business. How’s that? Well, let’s say your practice operates at a 33% profit margin. That means you as the owner gets 33% of gross. Someone who gets 5% of gross translates into over 15% owner or stake in your company. Do not be deceived. Do not give your business away.

  • Do not pay a percentage to a billing service for cash services directly paid to you: If they don’t do any work, why should they get a portion of the money? If no claims are generated, no collection or appealing efforts have been provided, why should they get a portion of the money? It’s beyond me. A notorious offender of this rip-off scam is a company with five letters in their name. Beware.

Remember…all you are trying to do is schedule patients, create a bill, make a note, log payments. It’s not rocket science.

Life is short, start success today.

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James Ko

I believe... "It's not the strongest practices that survive and grow, nor the most intelligent, but the ones most adaptable to change." I'm a physical therapist, private practice owner, and founder of IndeFree Association. I like reading James Patterson, Nicholas Sparks, enjoy golfing and playing guitar. I love playing with Mac and Cozy! For over 15 years, I've helped thousands of practices grow and succeed. This is my dedication.

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