WebPT EMR + Billing: Self-Service Workflow Guides

For the past decade, companies have leveraged the productivity power of combining the WebPT EMR and WebPT Billing to expand and grow their businesses. We have compiled their input and observations with the goal that every company continues to be financially successful while ultimately providing the best care for their patients.

Transitioning to a new billing system can be daunting. Thankfully, we’ve successfully completed hundreds of billing onboards and have come up with some tips and best practice workflows. We’ll work with you to determine how these workflows and recommendations can be incorporated into your company’s current structure, policies, and procedures. Read on for role-specific instructions on daily, weekly, and monthly tasks you and your staff need to be successful.

The Administrative, Billing, Payment Posting, and A/R Management workflows detailed below are for illustrative purposes only. These functions may need to be adapted to fit your clinic processes. Please note that some of the links below will require you to log into the WebPT Community to access them.

Note: This guide is designed to complement your onboarding training and is not a replacement for completing your WebPT University coursework.

IN THIS ARTICLE

WebPT + Billing: Best Practices

We've put together some crucial best practices for using the WebPT EMR + Billing. Click here to learn more.


Your First Month(s) with WebPT Billing

Your first month or so should include the following additional temporary workflows.

Verify WebPT Billing Claims are Being Received

  • Electronic Claims: 3 to 4 days after submitting your initial batch of claims in WebPT Billing, call the payers directly (or check their respective online portal) to ensure your claims are being received and processed. Don’t solely rely on the clearinghouse’s sent/received report. Do this once for each payer you’ve billed until the payer states they’re receiving claims successfully. 
  • Paper Claims: 2 weeks after paper claims are mailed, call the payers directly to ensure the payers are receiving and processing your claims. Do this once for each player until the payer states they’re receiving claims successfully.

Working in Two Systems

When you transition to the WebPT EMR + WebPT Billing solution, you will continue to use your old billing system temporarily. 

Mixed ERAs

Quickly identify which Dates of Service were sent from WebPT Billing by looking at the patient’s account number; they will always start with your clinic code (i.e. MA8). See the example below.

For more information, please see Closing Non-WebPT Billing ERAs.

A/R: Divide and Conquer

Depending on the size of your team and the amount of A/R you need to collect in your old billing system, we recommend that one of two staff members be tasked with finishing out the old A/R. The remaining billing staff should focus on current claims.

Patient Account Migration

After you’ve been using WebPT Billing for a few months and have started to wind down the A/R in your old billing system, you will need to move any leftover accounts into WebPT Billing. During the onboarding process, you will be trained on migrating these accounts.

Patient Statements

During the time that both billing systems are still in use, your patients will be receiving two balance statements (one from each system). To relay this information to your patients, we will attach a message to the statements for the first three cycles. Here is an example of what is included in the message:

We are pleased to announce the implementation of a new billing system. During this transition, you may receive two statements if you have a balance in our old system and our new system. Please contact 555-555-5555 if you have any questions about your statements. Thank you for your patience during this system upgrade.

Note: If you do not want this message to be included, please inform your Onboarding Specialist.

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Workflows: Front Office (Administrative)

DAILY: Eligibility & Benefits

  • For each new patient or initial exam scheduled for the next two business days, obtain a copy of eligibility and benefits from the insurance company and these answers:
    • Is prior authorization required?
    • Is a referral required?
    • Does the patient have a copay, deductible, or coinsurance that applies to PT/OT/SLP?
    • What are the policy dates?
    • Is there an annual visit limit for PT/OT/SLP? Have they used any?
  • Enter the above details into the insurance section of the patient’s chart.
  • Upload a copy of the eligibility & benefits to the patient’s eDoc.
  • Enter the patient’s Insurance Authorization in the proper case.

DAILY: Checking Expiring Authorizations & Prescriptions

  • Check the At a Glance alerts for ending or expiring prescriptions and authorizations.
  • If a patient’s authorization or prescription is approaching expiration, make a note on the patient’s next scheduled appointment as a reminder to the provider or front desk.
  • Prepare any necessary prior authorization forms required by the insurance company.
  • Submit (fax, email, or call) all pending prior authorization or prescription requests that are ready for submission.
  • When a new Authorization or Prescription is obtained, add to the chart.
    • Make sure authorization dates do not overlap. If the previous auth spanned 3/1/19-3/31/19 and the new auth begins 3/20/19, edit the previous auth to end 3/19/19.

DAILY: Check and File Communications

  • Check faxes and email, then upload any patient records into eDoc.
    • Name, categorize, and date the files so they are easily identifiable.
  • Message any staff that needs to be alerted to the newly added documents.

DAILY: Prepare for Medicare Progress Notes

  • View your dashboard/agenda for the next business day.
    • Open the chart of each Medicare patient to check for a Progress Note Alert. This will appear above the patient records in red text.
  • While checking for the alert, glance at the Medicare Cap amounts to determine if the KX or GA modifier needs to be added. You can also run the Medicare Cap Report to determine this.
  • Navigate to the schedule for tomorrow.
    • Make a note on the appointment to indicate which OMT the patient will need to fill out. 
  • Have the patient fill out the OMT before the visit. Scan the hard copy into eDoc.

DAILY: Patient Intake

  • Add New Patients. Patients added via Quick Add will require completed patient profiles before their therapist is able to finalize documentation
  • For Returning Patients:
    • Verify their phone, address, and email on file.
    • Has their insurance changed? If yes, add a new insurance. Don’t remove or overwrite the old one.
    • Create a new case, making sure to select the proper insurance(s).
  • On the day of their Initial Exam:
    • Copy the patient’s insurance cards—front and back, both primary AND secondary insurance—and upload to eDoc.
    • Collect payment. If the member is unable to pay today, still add the charge and leave it unpaid.
    • If the patient is doing an Outcome Measurement Tool, have them complete it and upload to eDoc.
    • If you have your own internal paperwork the patient has filled out:
      • Edit their Patient Info with any supplemental info like emergency contacts.
      • Upload the paperwork to eDoc.

MONTHLY: Check WebPT EMR Reports

  • Lost Patient Log: Call patients who haven’t completed their POC to encourage them to schedule more follow-ups, or remind the PT to discharge the case.
  • Medicare POC Report: Re-fax or call physicians’ offices as needed to ensure plans of care are returned.

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Billing Workflows: Billers

DAILY: Review Yesterday’s New Patient Details

  • Check the patient’s eDoc to ensure you have copies of the front AND back of their insurance card(s).
  • Verify that eligibility and benefits have been checked and a copy is on file (in eDoc or Chart Notes)
  • Make sure insurance details, such as ID #, policy visits, policy dates, and copay are entered on the patient’s chart in the WebPT EMR (See Step 6).
  • Make sure proper insurance(s) is/are assigned to the proper case (See Step 7).
  • If required by the insurer, verify prior authorization is obtained and entered into the chart.
SOAP 1.0 Workflows
  • For SOAP 1.0 members, check the WebPT EMR’s Missed Notes Report. Were all patient visits documented and finalized? 
  • For SOAP 1.0 members, check the WebPT EMR’s Claim Feed Report. Were all transmissions successful? Only Daily Notes that use the NORCM protocol should be listed as “NOT SENT.” Note: The NORCM code is for SOAP 1.0 members only. For SOAP 2.0 utilize the Do Not Bill checkbox within the Charge Summary section.
SOAP 2.0 Workflows
  • For SOAP 2.0 members, run the Missed Notes Report within Analytics. Were all patient visits documented and finalized? 
  • For SOAP 2.0 members, run the Documented Units report in Analytics to look for No Charge Codes.

DAILY: Billing Claims

DAILY: Claim Rejections

  • Log in to your clearinghouse account and work all rejections.

WEEKLY: Unbilled Claims

WEEKLY: Balancing

SOAP 1.0 Workflows

SOAP 2.0 Workflows

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Workflows: Payment Posters

DAILY: Check and File Communications

  • Paper Mail
    • Open, sort, and date stamp your mail into two piles: Paid and Unpaid.
      • Paid: Includes EOBs with payments attached, patient payments, and any additional insurance payments.
      • Unpaid: Includes correspondence from insurance companies, EOB denials, and letters from patients regarding their monthly statements.
    • Give the Unpaid stack to the employee(s) that manages A/R.

DAILY: Post Payments

  • Paper Payment Batches
  • EFTs
  • Credit Card Payments
    • Obtain a copy of the recent deposits made into the business’ bank account.
    • Reconcile payments posted in the WebPT EMR to those in your WorldPay IQ portal.
    • If you use a different payment processor, obtain the previous day’s transaction report and ensure each payment was entered into the EMR.
    • Reconcile posted payments to bank deposits using the Payment Posting: Balance Reports.

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Workflows: A/R Team

DAILY: Follow Up

MONTHLY: Collections

  • Are accounts being worked and sent to collections? Check out this example policy.
  • Are accounts over 90 days making regular payments or in the process of being sent to collections?

MONTHLY: Credit Balances

MONTHLY: Close Month 

  • Verify using the Released 835s Report that all ERAs have been worked.
  • Ensure all payments and adjustments have been posted prior to closing the month. The month can be closed up until the 14th day of the next month.
  • Follow the Month End Procedures to close the month. You will be able to continue your monthly tasks the following business day.

MONTHLY: Patient Statements

Depending on your company setup, statements are either generated when the month is closed or on the day originally picked during setup.

  • Create and export your Patient Statement files once per month. You should run and review the following report and hold any statements you do not want to be sent.
  • Once statements have been generated, log into Waystar, upload your Patient Statement file, and approve the statements for release. Statements will not be printed and mailed until you release them.
    • During this process, you will have the ability to remove any patient statements that you may have missed previously.

MONTHLY: Month-End Reports

  • WebPT EMR: The Productivity Report displays productivity by documentation type.
  • WebPT EMR: The Referral Report allows you to see which physicians are referring the most patients.
  • WebPT Billing: The Aging Summary allows you to view outstanding balances for patients and payers.
  • WebPT Billing: The Provider Summary Report allows you to see billed visits and units, their associated charges, payments, and adjustments, and the average reimbursement per claim per provider.

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Productivity and Quality Control

Measure Productivity

You should have specific key metrics and productivity goals for your Payment Posters and A/R Specialists. Here is an example Productivity Log that our own RCM staff fills out weekly. Click here for an A/R Productivity Log template. Formulas have been added for ease of use.

The following WebPT Billing reports can also be used by Admin users to measure staff productivity:

Quality Control

On top of daily and weekly productivity goals, your staff’s accuracy should also be measured. Admins can use the following reports to help determine employee metrics:

Staffing

To determine appropriate staffing, use the following table.

1 Full-Time Employee Monthly Threshold
Payment Poster $600,000+ Monthly Receivables
A/R Specialist 3,500 Monthly Visits

Important: If a Payment Poster or A/R Specialist has additional responsibilities that are not in our workflow guides (i.e. covering lunch breaks, verifying eligibility and benefits), then these staffing thresholds will need to be adjusted. Additionally, if your payer mix includes a high percentage of out of network payers, you'll need to adjust the thresholds down as these are more time-intensive workflows. 

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