What variables drive EMR ROI for therapy clinics?

Time saved on documentation and billing, avoided per-claim fees, and fewer preventable denials. For many clinics, direct-to-payer routing, ERA auto-posting, in-chart AI, and real-time eligibility reduce rework and days-to-pay.

How accurate is the calculator?

It’s an illustrative model. Enter your own numbers. Your results will vary by payer mix, staff workflows, and local rates. This is not billing, legal, or financial advice.

EMR ROI Calculator for PT, OT & SLP

What drives EMR ROI for PT/OT/SLP

Less clerical time: Streamlined documentation, eligibility, routing, and auto-posting return hours to care and capacity.
Fewer preventable denials: A scrubber that flags coding conflicts, missing auth, and common errors before submission reduces rework and keeps A/R clean.
Avoided tolls and delays: Where available, direct-to-payer connections help clinics avoid per-claim pass-through fees and extra hops.
Eligibility ≠ payment: Benefits screens are helpful but not a guarantee; confirm details with the payer when in doubt.

Education only; not billing, legal, or financial advice. Your results will vary by payer mix, panel policies, and clinic workflows.

ROI Calculator

Billing providers (or FTEs)

Include therapists and any staff who document or bill.

Admin hours saved per provider per week

From faster notes, eligibility, routing, and ERA auto-posting.

Avg loaded hourly wage ($)

Fully loaded (wages + taxes/benefits) for time saved.

Monthly claims submitted

Per-claim fee currently paid ($)

Enter 0 if you don’t pay per-claim tolls.

Initial denial rate (%)

Use your own baseline data.

Share of denials you can prevent (%)

From scrubber checks, cleaner auth, and routing.

Average value per prevented denial ($)

Typical net allowed per claim you’d otherwise lose or delay.

The calculator is illustrative. Update the inputs to reflect your clinic. See assumptions below.

Assumptions & simple math

Admin time value = Providers × Hours saved per week × Loaded hourly wage × 4.33 weeks/month.

Fees avoided = Monthly claims × Per-claim fee.

Prevented denials value = Monthly claims × Initial denial rate × Preventable share × Average value per prevented denial.

FAQ

Does eligibility verification guarantee payment?

No. Payers routinely note that eligibility/benefits information is not a guarantee of payment; final payment depends on the plan, member status, and the submitted claim. When in doubt, call the payer’s provider line.

What should I use for my denial rate?

Use your own baseline. If you don’t have one yet, start with a conservative single-digit estimate and refine from remittance data.

Where do time savings come from?

In practice, clinics report fewer clicks and less duplicative work when documentation, eligibility, routing, and ERA posting are integrated. Reducing that load returns hours to patient care and throughput.

How do I compare to cost?

Take the calculator’s monthly value and compare it to your subscription cost. Also include any per-claim or mailed-statement fees you avoid with PBS EMR.