Infographics: Automate.Integrate.Outsource the new mantra of the healthcare industry

July 21, 2014 by Ango Mark Leave a Comment

Work smart; automate and outsource business processes!

The much anticipated Black Book survey findings are out and they indicate a strong possibility of medical practices undergoing a completer makeover! For years together physicians handled two very different and almost contradictory aspects of their workflow. It was a tight-rope walk between patient care and managing the business side of their medical practice.

The business side of medicine has almost become a catchphrase in the healthcare industry. There was no clear definition or a strategic plan to manage it. What was once regarded as a niggling pain, that one had to live with, has snowballed into a serious issue that demands to be dealt with. And dealt with immediately!

Shifting landscape makes it vital for practices to buckle up or die a quiet death!

There was a time, not very long ago, when physicians had to just take care of patients. The filing and transmitting of medical claims was something that the biller did. A cursory glance over the month’s collections was all that physicians did, as managing their medical practice’s finances was not their job.

The Affordable Care Act, which opened the doors to millions of uninsured, PQRS and Meaningful Use measures, an entirely new coding system and increased financial pressures, have shaken physicians out of their comfort zone. The alarming rate at which small medical practices shut their doors and the growing threat to the survival of independent practices, are a huge wake-up call across the entire healthcare continuum.

Desperate times call for desperate measures. The Black Book study that includes the perspectives and opinions of 400,000 respondents has indicated three emerging trends that are going to challenger the traditional way medical practices are going to function.

Upgrade, integrate, outsource…

This seems to be the magic formula that can save medical practices from drowning under a sea of reforms. Though most medical practices have finally got the hang of technology and are experimenting with different workflow models, there hadn’t be a clear sense of direction or collective change insofar.

Challenging old notions…

The Black Book survey challenges the common belief that physicians are still unwilling to let go of archaic methods of working.

There is a huge move to eliminate outdated software and about 21% of medical practices surveyed, are planning to upgrade their RCM software within the next 6 to 24 months.

91% of medical practice business managers feel that EHR systems that are not integrated with a full- fledged revenue management system can back their practices, further into a corner.

Facing the bitter truth!

The study also clearly illustrates that physicians are no longer in denial mode. About 90% of physicians surveyed admitted that their billing systems needed a facelift. There is also a huge demand for integrated systems so physicians will have to coordinate with a single point of contact. Speeding up workflow is the major objective of most medical practices and automating their workflow seems to be the perfect solution.

Utilizing system intelligence to perform business functions such as appointment scheduling, insurance eligibility checks, sending patient reminders and payment posting can quicken tasks and reduce headcount. Most medical practices still hire FTEs to perform tasks that their systems can do. Automating tasks can not only shorten the time taken to perform tasks but can also help in resource optimization.

Automating administrative functions: the way forward…

The administrative functions of medical practices can drive up efficiency. Prior to automating a process draw up a checklist of objectives and see whether through automating you actually end up saving time. Automating for the sake of automating can do more harm than good. Like investing in an automated voice recognition system and wasting productive time editing and correcting the transcripts.

Have a clear work-plan, educate staff about the software and strategy you are going to use and compare your existing process to the revised one, to make sure your switch to automation is successful. A spread-sheet that details the transition can ensure everybody in the medical practice is on the same page.

Creating a flow-map can standardize your automated processes and improve efficiency. You don’t want your staff to be bewildered by the sudden change in workflow processes. Listing out repetitive tasks is the easiest way of freezing on tasks that can be automated.

Here is what to automate…

Automating can be healthy but it can quickly turn into a major headache if not handled with caution. Medical practices should take care not to let their workflow processes spiral out of control. Though automation of tasks is common in other industries, automating workflow in the healthcare field is still at a nascent stage.

Here is a list of tasks that can be automated efficiently…

A patient portal can automate everyday tasks to a large extent. Implement a patient portal that enables patients to fix up appointments based on available time-slots. Prescription refill requests can also be sent online. Patients can also be encouraged to pay online through a secure payment gateway.

Setting up error prevention alerts and a thorough claim scrubbing tool or software can eliminate denials.

Charge review alerts can reduce no-charges.

E-prescribing allows physicians to communicate directly with pharmacies and can save medical practices from the tripwire of misplaced prescriptions.

Setting up an email reminder or automated call reminders can reduce no-shows and late appointments.

The ability to gather the financial performance data of a medical practice and track metrics will result in actionable and current financial being just a click away! This will help set targets and benchmarks.

There is no magic wand that can wipe away manual efforts completely!

Great! So now all physicians can just shop for software, or tool that can automate practice functions and go back to taking care of patients. But it is not as simple as that. The heterogeneity of workflow processes in a medical practice demand different methods of working. Automating completely, a practices business functions can prove to be counterproductive. As many as 90% of small medical practices and 95% of independent physicians are planning to outsource their medical billing and revenue cycle management functions and that could be because relying on tools alone cannot deliver the goods.

An increasing number of medical practices are downsizing to cope with financial bottlenecks and processes that were previously handled in-house are being outsourced. The increased need for outside expertise has been the major driver behind the shift to outsource business functions.

The bottomline…

It is the survival of the fittest out there! Healthcare organizations that successfully, integrate, automate, and outsource processes, will come out at the other end, more streamlined, productive and compliant.

How to increase the productivity of your practice by hiring an EHR expert!

July 1, 2014 by Ango Mark Leave a Comment

Hire an EHR expert to manage workflow complexities!

For most physicians EHRs are the monster under the bed they were scared of as children. The amount of data fodder an EHR needs to function has reduced physicians into an army of data entry professionals. Every day at work, becomes one long process of, learning, unlearning, relearning and feeding data into a system that is becoming more difficult to handle by the day…

Dangerous learning curves ahead!

One reason, why physicians hate their EHR, with a vengeance is that, learning the ropes of an electronic medical record is tiresome and frustrating. There are tripwires and smoky mirrors everywhere. The worst part of working with an EHR is that it eats up large chunks of time that could have been spent on interacting with patients.

According to a survey by the MPI group as many as 67% of physicians were planning to switch to another system. About 63% of doctors wouldn’t choose the same system again if given a chance! What could be the reason for such high levels of physician dissatisfaction? Is it because EHRs are not designed to be handled by physicians? Or are doctors unable to work efficiently with their EHRs?

Designed for whom?

Can a bunch of template designers truly understand what a physician truly wants? There is a huge dissonance between the everyday workflow of medical practices and the template structure of EHRs. They are rigid, demand huge amounts of unwanted or repetitive data and make pulling out pertinent information a herculean task.

It has become a tug of war between physicians and EHR vendors as worried policy makers watch over the chaos that a well-meant change can bring.

Physicians are not ready as yet…

Any change can bring about widespread distrust and confusion. Throw in a completely new model of working; you have a disaster waiting to happen. Unwilling or reluctant physicians are partly to blame for the entire digitizing effort becoming a fiasco.

A lasting solution!

Move over phoney experts! There are several EHR experts who can help physicians resolve technical issues, come up with customization plans and help physicians understand complicated EHR architectures. Despite the bickering and disagreements a huge number of medical practices are dependent on EHRs to store, access and transmit vital medical information.

To be able to work more effectively with their EHRs, physicians will have to hire an EMR expert to handle hardware and software snags. There are several remote EHR tech support consultants who can finally bridge the divide between physicians and their EHRs…

Simple ways to maximize the ROI of your EHR!

May 29, 2014 by Ango Mark Leave a Comment

Are you working towards increasing the ROI of your EHR?

An EHR can cause havoc. It is a well-documented fact. There is widespread disruption to workflow and your staffs are preoccupied in getting the system up and running. So how do you come out at the other end unscathed and most importantly profitable? There are a few ways to increase the return on investment of your electronic health record.

As always it begins with starting out with a clear-cut agenda. This will help in keeping you on track as it is a long drawn out process. Losing the plot mid-way is not going to be feasible off course.

Customize because a system that doesn’t work the way you do is a costly mistake!

The major reason why doctors don’t see an increase in revenue after an EHR is a part of their practice, is because the system guzzles up time and effort. Blame it on unnecessarily complicated systems that have a zillion options and templates for one single task. Or on vendors who are never around when you need them the most.

Fortunately, several EHR experts offer template customization services. Practice-specific EHR templates can instantly speed up workflow and cut short the time wasted on locating information.

Manage appointments better!

As everybody is busy complaining about how difficult it is to document medical information the upsides of using an EHR is forgotten. It allows physicians to cull out patient information like never before! Club patients who share a common denominator like patients who are covered by workers compensation, patients who come in for regular wellness checkups, etc. and meet them on a, scheduled day.

This will streamline your scheduling process and help you meet more patients? How does it increase your ROI? Well, if you can meet just two more patients per week, at an average of 150 dollars a patient, you can earn 1200 more dollars every month.

Work steadily towards the Meaningful Use incentive…

A medical practice can increase the ROI of its EHR by achieving Meaningful Use. Experts across the healthcare industry agree that achieving Meaningful Use is the ultimate ROI for medical practices. Work towards achieving MU and for tips click here.

And above all, encourage your staff members to throw in their two cents about increasing the productivity and profitability of your practice, post EHR implementation. The fact that you can think of new strategies to increase profitability, work collectively towards a single goal and create more structured workflow processes is possibly the best return on investment you can get from your EHR.

Five Common Gaffes of Healthcare Providers in an EHR selection

March 5, 2014 by Ango Mark Leave a Comment

Hunting for a right EHR?

Partnering a vendor for your electronic medical/ health record (EMR/ EHR) journey is no easy task for your medical practice. Based on the views of industry experts, I have something to advice you about the common flaws that you might make while selecting an EHR.

The deciding factors:

Various factors including practice size, type of medical specialty, adeptness in adopting advanced technologies, budget, etc. determine the choice of a perfect EMR/ EHR for your clinic or hospital. Keep these criteria in your mind along with awareness on the common mistakes in selecting an EMR/ EHR for your care center.

Errors and Points to consider:

#1: Selection of an EHR vendor with restricted support:

Most of the EMR/ EHR vendors get you tethered through their software selling, but they may direct you to procure the compatible hardware or support from a third party. Don’t get entrapped! Once you encounter a problem one vendor points out the other one, finally putting you in dilemma.

Always prefer a vendor who can provide you the full-scale solutions for your Revenue Cycle Management (RCM) process along with the EMR/ EHR support.

#2: Selection of interfaced systems:

Industry experts state that it is best to go with the fully integrated system with EMR or EHR, practice management and interoperability modules rather than interfaced systems. Handling dual systems for sharing common data like ICD-9/ ICD-10, CPT and HCPCS codes, record templates, etc. mayn’t practically feasible as the vendors state. Inbuilt ticklers and essential clinical alerts in one system can fail to be produced in the other system.

#3: Ignorance on hidden costs:

When choosing an EMR/ EHR, it is crucial to estimate the cost involved in the EHR/ EMR including software purchase, monthly subscription, annual maintenance, software upgrades, hardware costs, installation, implementation, training and any pertinent third-party charges.

So, don’t choose an EMR/ EHR just looking at the initial price label.

#4: Overlooking the worth of specialty templates:

Though self-designed clinical documentation templates fit best for your medical practice, it has several disadvantages:

A. It is an arduous and time-consuming task.

B. All other providers perceive your templates as strange designs.

C. Incorporating the in-house template ideas into software (designed by an external vendor) can be difficult.

Thus, the wiser option is to purchase the customized systems with inbuilt template libraries that best suit your specialty practice needs.

#5: Missing point-of-care modules:

Most EHR/ EMR systems are not focused on point-of-care documentation. The patient data can get duplicated at the pharmacy, frond-end or laboratory – leading to medical errors and even medico-legal complications. This may pose risk to your ROI of EHR/ EMR and intention to adopt the technological advancements like using a tablet or smart phone.

Purchase the exact EMR/EHR and ramp-up the productivity and profitability of your medical practice.

Why are physicians disillusioned with their EHRs?

February 13, 2014 by Ango Mark Leave a Comment

40% of physicians are unhappy with their EHRs! The reason behind their disillusionmen

The healthcare industry is poised for change. Archaic paper records are making way for svelte, new electronic medical records that can transform the way physicians work. Sounds like a perfect dream.

Except for the fact, several physicians find working with EHRs a nightmare and would rather go back to paper records. Critics say that it is a passing fad. A case of “I hate my EHR too”. But there is a screw loose somewhere…

Point, click and wait till patients lose their cool!

Having to put up with bad hardware, cumbersome templates and poorly designed interfaces are one reason why physicians hate their electronic records with a passion. And God forbid if there is a power outage or fluctuating bandwidth. Stuck with a workflow that doesn’t work or flow is the reason for such widespread dissatisfaction.

Qualifying for Meaningful Use is a huge task in itself. EHRs that do not match MU requirements compound the problem further.

Doctors don’t belong to the stone ages…

Contrary to what people think physicians are not averse to using technology. From, using lasers, fiber optics and scanners to iPhones, physicians have always been tech savvy. The argument of healthcare professionals falling behind times doesn’t hold any water.

Physicians find EHRs clunky and the fact that they are not mobile. Most EMR systems have been frustratingly slow in going mobile and some of them haven’t even taken the first baby steps towards mobile technology. It is not technology but how complicated and expensive it is that is the major problem.

Well-intentioned but the outcome counts as well!

There is no doubt that healthcare technology is liberating, more integrated and super quick. The major shortcoming of EHRs is that that they are not centered on the needs of physicians. It is on the other hand governed by federal mandates.

EHR vendors should stop playing by the rules of bureaucrats and develop systems that benefit their end users. Healthcare professionals are consumers of HIT. And should be given the kind of importance, consumers of other products enjoy. That could probably be the only lasting solution to the problem of disgruntled EHR users.

Is you EHR customized to your needs?

February 6, 2014 by Ango Mark Leave a Comment

EHR templates and why it makes little sense to work with them!

EHR templates are getting a lot of bad press. They are being blamed for poor documentation and reduced patient engagement.

Template generated notes are reducing patient data into a series of boxes to be ticked and blanks to be filled out.

At the end of the day, relying on templates is not just lazy documentation, but can also have a negative impact in the medical decision making process.

Missing the forest for the trees…

Point and click templates consume a lot of time thanks to the extensive output they generate. Information that has no clinical relevance, unnecessary, redundant data leads to note bloat. And a frustrated physician who cannot find what was documented during the patients’ previous visit. Cloned notes and upcoding add another layer of complexity to an already complex tale.

Templates that are not well designed can be hazardous to patient health & if overused can cost lives. The death of a patient in Manhattan, due to a template that limited information and narrowed down diagnostic choices, is an example of how hazardous templates can be. Instead of being comprehensive and informational, most EHR templates are complicated and of little use.

Which box do I tick?

There is another more dangerous charge thrown at EHRs. It is that they limit the physician’s ability to think and interfere with open diagnostic thought.

Improper diagnosis poses several medical-legal problems for medical practices.

Structured and inflexible data inputting options can put medical practices at risk.

Less rigid data platforms that give physicians enough space to explore varied diagnostic and treatment, plans and options are the need of the hour.

Limiting and cumbersome!

In a better world EHR templates will give physicians easy access to healthcare information, reduce data entry tasks and increase patient engagement. But going by the number of people complaining and riling against EHRs, most EMR systems leave a lot to be desired.

Going back to paper?

Several medical practices use paper records to document regularly performed procedures, patient history and progress notes.

It is impossible for EHR vendors to create a unique template for every single disease or medical condition.

And that is why it is essential that physicians do not depend blindly on their templates’ parameters and work within its framework.

Customizing EHRs according to the patient population, treatment options and the most commonly performed procedures, of a medical practice. Can trim the fat, save up on time and lead to better medical decisions.

EHR Usage and Good Medical Practice Congruence

February 4, 2014 by Ango Mark Leave a Comment

The Charismatic Scenario:

Going paperless was a formality or fashion and pointless saddle earlier in the medical practices. But now, the picture has changed and the adoption of electronic health records (EHR) is becoming increasingly obligatory. Many small practices and even hospitals are in the right move towards EHR espousal. This is due to the federal coercion and improved understanding of EHR implementation benefits by the healthcare providers.

Patient Centered – Interconnected:

The electronic medical/health records are no more the property of an individual care provider and EHR is no more the physician-centered tool. The involvement of various providers in proffering the comprehensive patient care is compelling the providers to make EHR – the patient-centric tool.

The modern clinical workflow pattern in small practices and hospitals involves the healthcare data sharing across the practices. This sort of interconnection provides fast, easy and accurate medical information exchange through HIPAA-compliant and professionally secured conduit.

“Charts” & EHR:

The shift in healthcare delivery pattern from single practice to widespread care delivery across small clinics to large hospitals, both physicians-owned and hospital-owned gave rise to community charts and enterprise charts. These charts enable interconnected health data access by multiple care delivery settings within hospital departments and also between assorted care centers.

Enterprise EHR like Epic has its widespread utility across the hospitals and the practices affiliated with them. Kaiser EHR makes a single chart accessible everywhere.

Good Medical Practice – The Further Take:

Despite medical data storage, large Enterprise Charts (e.g. Kaiser) could be used to gain insights into disease trends, epidemiology studies, clinical care quality and good medical practice (GMP).

Missed-out health records of patients, maladroit diagnostic data and specialty consult notes, hidden operation notes, obscure insurance information – Won’t these displease your patient care?

American Medical Association (AMA) says “Good physicians care for patients” as the primary domain of competency.

For a perfect patient care, the clinical documentation is more than crucial. Is it right?

Thus, EHRs with no ‘note bloat’ would buttress the physicians to follow Good Medical Practice through adequate essential medical documents:

Good clinical documentation
Good knowledge on patient health
Good patient care
Good Reimbursement & Good Medical Practice.

“Next Generation”:

Even the best EHRs available in the healthcare market have not addressed certain vital features:

Rapid encounter documentation: Physicians busy with the encounters find less time to create electronic health records. The “next generation” EHRs must have in-built medical transcriber and the physicians could avert spending much time in creating documents.

Unified patient portal: A modern EHR must ease the patient’s ingress into the electronic health records through unified patient portal. It must support easy access of various documents, reports, messages and other communications by all interconnected provider settings.

Open API access: EHRs must allow the vendors to access appropriate internal documents through application program interface so that the practices could accomplish the resource demands, clinical quality measures and disease trends.

Thus, current era EHRs need further “optimization” to satisfy the stakeholders of healthcare ecosystem.

Medical Billing Strategies of 2014 – Sink-in to Amplify Your Funds

December 16, 2013 by Ango Mark Leave a Comment

Decide Here – Whether to Dwell-in or Leave the Page!

This article is especially designed to meet the needs of the physician practices and other healthcare delivery organizations that are looking for the tactics to revamp their medical billing process so as to boost your cash inflow.

Where the healthcare billing is travelling?

Though, physicians aren’t tethered to the aged technology and strategy, circumambient healthcare milieu may revoke your cerebral cortex due to diversified growth in healthcare information technology (HIT).

Do you have numerous “wh-questions” on your mind – pertinent to the funds management in your revenue cycle management (RCM) process? Then, this is the go-to technique to enliven your cash coffer.

MEDICAL BILLING STRATEGIES – 2014

Hoard your revenue in each phase of RCM!

Physician Credentialing and Contract Negotiation:

The federal payers have already fixed your reimbursement rates for the patient care services. Despite this, there is a dire need for the providers to negotiate with the payers to get lucrative reimbursements for the service rendered by you. Besides, abiding the payers’ rules during credentialing process brings you more savings.

Front-desk Collection:

Start collecting payments from the scratch – don’t let your staffs ignore the front-end tasks:

1. Point-of-service (POS) payments (Co-pays, deductibles, etc.).

2. Collection of dues well before patient encounter.

3. Thwarting denials through accurate eligibility verification.

4. Gathering insurance accurate data to avoid reimbursement disappointments.

Charge Capture:

HITECH Act, ACA’s “performance based payment” and other federal mandate are the driving forces that accentuate the ideal EHR implementation.

Charge capture must be done accurately for each encounter, procedure and surgery. Evolving ICD-10 guidelines call for the renovation of your super bills in sync with your clinical practice so that charge capture will be immaculate.

Claim Scrubbing:

This is the vital phase in the medical billing process that aid abridged AR process. AAPC/AHIMA certified coders must be a part and parcel of the claim scrubbing process – so that revenue loss due to underpayment and overpayment issues could be avoided. Concentrating on this phase greatly mitigates the claim rework cost.

Electronic Transmission:

Timed Clearinghouse transmission for fresh claims is one of the overlooked approaches in most practices. Large practices may need to file the scrubbed, “clean” claims daily.

Delay in addressing the rejected/denied claims with the remedial action may also hamper your cash in-flow.

eRemittance:

Interpretation of the remark codes and timely payment posting after the receipt of EOBs/ERAs is very essential for a successful RCM process. Besides, prompt cash inflow/ AR feed into the practice management system (PMS) or electronic medical/ health records (EMR/EHR) is mandatory to avert payment miss-outs and pointless follow-ups.

Denial Follow-up:

The denials must be addressed with an immediate effect to avoid delayed payments or re-denials. While working out on denials, the obligatory documents must be attached during re-submission or appeal. Though the cost involved in denial appeals or re-submissions is an additional burden, ignorance of denial management would be a serious pecuniary loss.

Patient Billing:

Don’t load your dice against yourself! Precision in the patient billing is a crucial point in the bill settlement. Inaccurate and difficult-to-read billing statements ensue in patient discontent, consequently culminating in bulldozed physician – patient relationship. Above all, a clear statement supports timely payment.

Resource Utilization:

Exploiting the resources like human resources, infrastructure, funds, technology, etc. to run a practice profitably is a master skill. Among that, leveraging the technology to satisfy patients and enhance practice profits is the challenging task. The following technology platforms ameliorate your patient experience, accelerate revenue cycle process and thus perk-up your business.

Practice Website:

Patient portal
Online forms and statements
Online EHR access
Online lab and imaging reports
e-Payment support
mHealth support (iPad, iPhone, Tablet, etc.)
Chat support
Healthcare News
FAQs
Social media (e.g. Facebook, twitter, etc.)
Patient Blogs & forums

Benchmarking:

Setting a yardstick and working towards its accomplishment must be the prime goal, if you are attempting to reach your vision and mission.

What functions of the billing process that must be set in the yardstick achievement program?

1. Follow-up and retrieval of underpayments.

2. Averting penalties due to the breach of laws and audit policies (RACs, HIPAA, HITECH Act, etc.).

3. Aggressive follow-up of accounts receivables/bad-debts.

4. Evaluating and making small balance write-offs.

Besides, regular evaluation of your practice, process and finance must be done through the following reports:

Practice Analysis Report
RCM Analysis Report
AR Summary Report

“PERSISTENT REVENUE INFLOW IS THE SINGLE PARAMOUNT WANT OF THE MEDICAL BILLING PROCESS”

Stretch your achievement from good to excellent with these proven medical billing strategies. It will be the hot topic in 2014 as most practices are going out-of-kilter due to stringent policies and other industrial factors.

Tiger Team Checks the EHR Feasibility with Accounting of Disclosures Proposals

November 21, 2013 by Ango Mark Leave a Comment

The Policy – Technology Equilibrium

In a recent convention of Privacy and Security Tiger Team, it was advised to the HIT Policy Committee that pilot projects must be instated to scrutinize the pragmatism of technical ability of electronic health record (EHR) systems – to revise requirements for accounting of disclosures of protected health information (PHI) and to create the access reports for patients’ utility.

The Outlook of Pilot Testing

The Tiger Team is set to buttress the federal regulators of Healthcare IT Policy in an endeavor to assess the technical feasibility of EHR with requirements of accounting of disclosures. Furthermore, it aids scrutiny of prospective stages of HITECH Act’s EHR certification program.

To accomplish the HITECH incentives, eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs) must perform “meaningful use” of certified EHRs. In that, patient engagement is a further mandatory requirement for the eligible entities. The pilot project envisages all these requirements’ harmony with the technological aspects.

A Lesson Learnt from the Mistakes

In May 2011, the Office for Civil Rights (OCR), proclaimed the proposed rulemaking for overhauling the accounting of disclosures requirements under HIPAA. This proposal was said to be wrongly pitched and it engendered copious grievances from many healthcare providers with a unified aim to protest the controversial new “access report” provision.

The new “Access Report” must encompass the following data:

Date and time of access.
Name of the person or practice evaluating the PHI.
A note on the information.
A description of the user action (Is information created, modified or deleted?).
EHR disclosures for treatment, operations and payment.

Many of the suggestions posted on the walls of HHS on the access report proposal underscored that it would prove to be technically impracticable, intricate and expensive to execute.

The Roadmap to New Regulations

The Pilots deem that they have formulated the final recommendations which will be presented to the HIT Policy Committee on 4^th December 2013.
Then, these suggestions would be analyzed by the Office of the National Coordinator for Health IT and the Department of Health and Human Services’ Office for ‘Civil Rights’.
These two entities of the Department of Health and Human Services (HHS) would devise any new ultimate regulations.

Access Report – What to include and what not?

The tiger team throws a clear recommendation that patients must enjoy “high-level transparency” with respect to their data use and disclosures. Besides, it seems that it will narrow down the disclosure restrictions so that only the third parties outside the healthcare enterprise may be concerned.

In this milieu, Egerman emphasizes the philosophy “less is more” – as per which only the filtered, pertinent details must be passed on the patients so as to avert confusions and safety hazards of EHR users.

“Baker suggests that for the safety of healthcare workers, names of individuals accessing patients’ healthcare records could be sieved from the “access reports” issued to the patients, but accessible to the healthcare entity when inspecting allegations or suspicion of inappropriate access.”

Finally, Tiger team accentuates that the EHR system must be tuned in line with the final regulations of this pilot project.

Medical Billing Tips for Optimal EHR Usage

October 21, 2013 by Ango Mark Leave a Comment

Doctors Fed-up by EHRs with Inefficient Billing Workflows :

Healthcare practitioners have implemented EHRs/EMRs to comply with federal stipulations. However, many of them are unable to make optimal utilization of these EHRs/EMRs. Hospitals and clinics fail to receive complete payments for their services rendered – due to sloppy billing processes. Such improper billing workflows pose many revenue collection problems for doctors. Overworked doctors find it difficult to cope up with the requirements of healthcare business. They do not have the time to ensure optimal revenue collection and adhere to changing federal/state regulations and stipulations of insurance companies. Rather, they would prefer focusing on patient care.

What is the Expert Opinion ?

EHRs/EMRs with inefficient billing workflows continue to cause dissatisfaction among physicians. Holly Knapp, President of Loveland-based Medical Billing Advocacy of the Rockies (MBAR), LLC, and member Medical Billing Advocates of America (MBAA) claims:

A. Patients do not know whether their bills are correct.
B. Clinics and hospitals are not sure whether the insurance company has correctly reimbursed medical claims.
C. Only 20% of prepared claims are correct.

Need for Professional Billing Experts :

Any EHR without the right billing option is like bread without butter and will not meet the revenue collection requirements of clinics and hospitals.This requires a team of experienced and knowledgeable professionals, who are well-versed with the intricacies of existing and changing codes and resulting billing processes across the US.

Increase the Efficiency Of Your Medical Practice :

There is an imperative need to enhance the functionality of the EHR by :

1. Ensuring streamlined, accurate and thorough clinical documentation. This documentation covers all workflow stages in a hospital or clinic, right from the time the patient reports at the reception and passes different stages of diagnosis, treatment, and discharge, and finally collection of patient’s dues.
2. Correct selection of codes and related modifiers based on clinical documents.
3. Ascertain medical necessity of diagnosis and treatment from the point of view of insurance agencies.
4. Check whether the patient is eligible and covered by the insurance for claiming reimbursements.
5. Prepare the insurance reimbursement claims correctly based on the combinations of codes and modifiers.
6. Prepare the claims in time and send to insurance payers.
7. Check the progress of claims sent to insurance.
8. Analyze rejected claims and resubmit corrected claims.
9. Make tight follow up for every claim.
10.Collect patient’s payment dues through aggressive follow-up.

You are free to contact MedicalBillingStar for any problems related to EHR/EMR or medical billing.

Here’s the presentation view on “12 tips to rebuild your EHR strategy”.

Join The webinar

Lisa Maciejewski-WestCMC, CMOM, CMIS, MCS-P