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Are you worried about HIPAA audits? Tips to come out unscathed!

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Are you worried about HIPAA audits? Tips to come out unscathed!

Don’t let a HIPAA audit catch your practice off-guard!

HIPAA audits are painful and unwelcome. But failing an audit can be a disastrous and a huge blow to the reputation of medical practices. Despite guidelines being formulated every other day, there is, very little coordinated effort being taken by healthcare organizations to meet them. Failure to prepare is preparing to fail.

Put these ten tips into action to prevent your medical practice from penalized by auditors. It is a team effort so rope in employees and make a cohesive effort, to stay HIPAA compliant. There are lot of plates spinning and deadlines to meet. So it is important you chalk up a plan and tick things off a checklist to stay on track and move towards complete HIPAA compliance.

  • Run a thorough end to end risk analysis check across the entire organization. Check your documentation management and informational security policies.
  • Devise clear cut policies such as passwords for accessing information and that all images such as scans are securely encrypted.
  • Invest in workforce training. Conduct regular workshops for all your employees on operating procedures and security protocols.
  • Monitor closely if all the newly implemented procedures are working in the first place. Check and re-check the progress of each strategy created to meet HIPAA guidelines.
  • Keep clinical documentation updated and maintain a report of your security procedures and documentation. This will help when auditors ask for evidentiary documents.
  • Create a contingency plan. In a landscape that is constantly shifting things may not play out the way you plan. Having a plan B is important too.
  • Revised HIPAA guidelines place emphasis on business associates and subcontractors being HIPAA compliant. Discuss with your business associates about the security measures they have to follow and keep tabs on the physical and informational security they provide.
  •  Laptops and paper based records are the major reasons of data breaches. Almost 202 cases of data breaches due to stolen or lost laptops have been recorded according to a 2014 survey. Prohibit employees from bringing laptops or digital storage devices to office.
  • If you work with a business associate and need to share medical information insist that your partner has a secure VPN connection to transmit and receive medical data.

Simple ways to maximize the ROI of your EHR!

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EHR ROI

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.

Is your medical practice ready for Meaningful Use audits?

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Tips To Face MU Audits

Prepare your medical practice for CMS audits

A recent statistic reveals that one in twenty practices that have attested for MU will face an audit. And that most practices are most likely to face pre-payment audits. The increased governmental scrutiny can catch practices off-guard. Several hospitals maintain a ‘Book of evidence’ in case auditors come knocking by.

Attesting for Meaningful Use is not enough! Medical practices should ensure they can face audits head-on and have the requisite medical documentation.

Tips to become audit ready!

  • Always be ready! The best to insulate your practice from audits and fines is to be prepared. Always save the electronic documentation that supports your attestation. Save the documentation that has the values you entered in the Attestation Module for Clinical Quality Measures. Also, ensure that your payment calculations are carefully documented.
  • Your primary documentation includes the time period of the report, the denominators and numerators for the CQMs and evidence that it was created for that particular EP, hospital or medical center. Additional documentation includes a clear review of medical records. And documents to prove and support each measure attested for.
  • Most providers make the mistake of hating CMS auditors with a vengeance! It is important to comply with audit requests promptly. Providers should have pertinent document in hand after they receive the initial request letter from the contractor. Providing sketchy documents and one line statements will do more harm than good. Detailed, precise and evidence based documentation is required.
  • Medical care providers should stop being backseat drivers. Relying on admin staff or practice managers too much can be a risky proposition. Physicians should stay in the loop, verify documentation, analyze medical care records and medication lists. It is mandatory for every physician to make sure their patient records are accurate. As the slant is on evidence based care there is no better person than physicians to verify the veracity of documents.
  • Is your EHR certified? Receive documentation from the vendor stating that they are CHERT certified. The Office of the National Coordinator maintains a list of certified EHR products. Monitor upgrades and verify that your system meets evolving guidelines and measures. Get a copy of the licensing agreement with your vendor to submit to the auditors.
  • Conduct a thorough security risk assessment of your medical practice. Check if your practice is compliant with the existing security regulations. Not conducting an extensive security risk assessment periodically, can trip you up when the auditors reach your practice.

Is all these tips helpful for you? Tell us how your prepared for Meaningful Use Audits?

5 ways hospitals can reduce their physician shortage rate!

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physicians

Is your hospital facing a shortage of physicians?

The country has been hit by massive physician shortages. Bureaucratic pressures, financial constraints and the sheer pressure of offering medical care while trying to deal with complex electronic systems, have forced physicians to retire early. Recent studies suggest that the shortage will only become more acute over the years.

Retaining physicians and providing a healthy environment to work in has quickly become the biggest worry and challenge of hospital CEOs. Physicians quitting their jobs and leave can lead to dissatisfied and confused patients.

5 ways to improve physician retention…

The magic of a shared vision!

There is nothing that works like teamwork! Explain about your hospital’s goals, aspirations and vision for the future. Let new recruits know beforehand the patient population they are most likely to handle and the volume of work per day. Being transparent can invoke trust and make physicians feel a part of a team and not well-oiled machinery.

Provide administrative support…

The deluge of admin work every single day can catch most physicians, off-guard. Delegate staff to junior staff, hire scribes or outsource tasks such as billing and transcription. This can, not just unburden physicians but also cut down on administrative expenses.

Perks matter!

To make physicians stay longer offer perks that most competitors don’t. Profit-sharing options, paid holidays, fitness and entertainment space, allowances, lesser working hours and a positive work atmosphere and culture, can stop physicians from looking for other employment opportunities.

Is there space for professional development?

Every healthcare professional likes to grow, to fledge. An environment that stifles their growth and wears them out means they are going to quit sooner rather than later. Include professional development activities such as conducting regular workshops, seminars, group discussions etc… This will not only ensures your employees are actively involved, but also, more aware of current healthcare regulations. A working environment that is conducive to growth can make physicians stay back longer at your hospitals. It is not just perks and incentives, but the fact that they can navigate tricky learning curves with your organization that will help them stay put!

Offer EMR training!

The major reason for befuddled and disgruntled physicians is complex EMR systems. Hire EMR consultants and experts to train new physicians. Manuals and discussion forums can only be of so much help. Hiring someone to offer remote or on-site EMR guidance to new recruits will prevent them from feeling lost and increase productivity at the practice.

Obamacare is facing flak once again for making millions of Americans uninsured

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affordable care act

Is Obamacare playing out the way it should?

The controversy, rumblings and conspiracy theories surrounding Obamacare refuses to die down. Just when you thought, that everything that could be ever lauded or criticized about, Obamacare was over. John A Boehner’s current controversial statement of Obamacare resulting in net loss of patients with insurance coverage has raised eyebrows and voices of dissent.

Millions and millions of Americans are losing their coverage due to Obamacare, seniors in particular are facing the brunt of a healthcare law that is snatching away benefits, they’d enjoyed for years.

What do those thousand plus pages mean to the healthcare industry?

According to a recent statistic as many as 4.7 million Americans have had their healthcare plans cancelled. Stopgap measures, such as the one year exemption for those who’ve had their coverage plans cancelled, to have healthcare coverage, have proved to be equally unsuccessful and unpopular.

Damage control measures can ironically be counterproductive as eleventh hour changes can cause more mayhem and instability. It further proves that the thousand plus page law may not be the magic fix to bring down costs, as it was hoped to be.

Like your plan? Lose it…

The president’s promise to citizens that if they like their healthcare law they can keep it has turned out to be a false and hasty promise. Apart from the millions of individuals who’ve lost coverage, nearly 80 million people with employer healthcare plans stand to lose their benefits as well. Employers are gob-smacked by the high prices of Obamacare.

Jumping at shadows?

The enrollment phase has just reached the half way mark and it may be a tad too early to jump at conclusions. The number of people who’ve lost coverage is slightly jacked up and the paranoia surrounding the new law will have to abate. It is being widely hoped that Obamacare will elbow out archaic healthcare plans and usher in more affordable and well planned coverage plans.

Several healthcare experts feel that the counterbalancing efforts taken by the Government have been largely ignored by the rabble rousers. The ACA can end the fear of medical bankruptcy for millions of Americans and reduce costs in the long run. It can improve healthcare and make good quality medical treatment affordable for all. People across the USA are praying hard that these don’t turn out to be failed promises as well!

Do you think Obamacare has failed in its promises? Share your views in the comments section below.

Five Common Gaffes of Healthcare Providers in an EHR selection

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EHR Support

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.

Time for medical practices to go active on social media!

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It is time for medical practices to go active on social media!

A thousand “Likes” for socially active hospitals!

Are you a physician who thinks social media is not for serious people? That it is only meant for frivolous gossip and friendly banter? You have a second thought coming! Healthcare professionals are taking to social media in a big way.

It helps people across the healthcare continuum, connect with their peers, stay updated about current changes in the industry and most importantly, engage with patients.

Dealing with frustrated patients…

Hospitals that are active on social media are ahead of the curve and more patient friendly. For years patients who were unhappy with their physicians, waited till the next visit to the doctor’s office to vent out their frustrations. Now it is just a matter of logging into their FB and rant…

A hospital that is on Facebook gives its patients an opportunity to share their concerns with providers in a healthier way.  

They’ve postponed MU again?

Medical care professionals who have social media accounts are more likely to be in the know. One of the very important uses of being on social media is that they help in keeping healthcare professionals updated, in an ever evolving industry. It builds awareness about key issues and helps in disseminating vital information.

We are family!

There is a growing need for physicians to galvanize and speak up against draconian regulations and reimbursement cuts. To reassert their need for EHRs that is built around their workflow requirements and practice needs. To remain silent is to comply. And that is why it is more important than ever for medical professionals to be on social media.

It builds a sense of community and can empower users. It can encourage networking with peers and working as a collective force.

Being close to patients!

It is impossible for a medical practitioner who sees around 30 patients a day, to follow up on every one of them and offer personalized care. Being on social networking platforms means, patients are just a click away. It helps to connect with patients and drive up patient engagement.

You can educate patients on using patient portals and offer health advice, without the pressure, of another patient waiting in the reception.

Handle competition deftly!

At the end of the day medicine is business. Social media is the best way for medical practices to promote themselves. When there is heavy competition amongst peers, it is the most socially engaged medical practice that wins!

ICD10 costs are a whole lot higher than expected! Will physicians be ready by October?

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ICD-10 Implementation

Eyes to the skies! ICD-10 costs are skyrocketing!

The titters have died down! Forget those jokes about walking into a lamppost and macaw bites. ICD-10 is going to bite medical practices much harder. With the deadline for implementing ICD-10 looming closer. It is time for medical practices to do more than just wait for the next pushback announcement.

As every day, news trickles about the cost of implementation and the impending deadline, physicians are shaking in their boots. But there is little hope for another deadline shift.

The shocking increase in costs over the last four years!

The approximate cost for implementing ICD-10 in 2008 was $83290. Four years down the lane the costs have escalated to $226,105.

Medium sized practices are going to feel the pinch as well; from costs estimated to be 285,195 in 2008 it has now skyrocketed to 824,735. And the costs are going to be as much as 8 million dollars for large sized medical practices.

The costs come as a sticker shock for medical practices that are still reeling under the pressure of accommodating the enormity and breadth of ICD-10. Medical coders who were using a coding system for several years are now faced with the challenge of working with codes that are absolutely foreign to them.

Though people on the other side of the wagon argue that greater specificity can help researchers and increase reimbursements, long term pay offs mean short term losses.

It is not going to be an easy transition…

Well almost everybody knew it! Right from the day ICD-10 was announced there have been voices of dissent. But as the deadline draws near it is clear that physicians have been caught off guard. It is going to change the workflow of medical practices and medical practitioners are justifiably, freaked out.

Still don’t have an ICD-10 coder?

Practices cannot afford to bill without a trained coder. Hiring novices means struggling under a deluge of rejected medical claims. An increasing number of medical practices are thinking of hiring virtual coders. Or, fall back on the time tested solution of outsourcing.

It is the hour of reckoning and practices should either ramp up their implementation process or stay behind. Complaining about the costs is not going to help physicians. Trying, to find ways to protect their revenue stream, and, investing in the new coding system, will.

5 Common Patient Collection Flaws to Avoid

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Stay Away from Patient Payment Collection Gaffes

Is Your Collection Rate Unhealthy?

Many clinical and non-clinical departments of the medical practices overlook the payment collection from the scratch and most of the times you may combat for the collectibles at the eleventh hour. If it is so, you have some useful stuff here, to hone your collection strategies.

Small mistakes cost you more…

Collecting your hard earned money shouldn’t an end term activity. The collections of physicians, pathology or radiology labs, pharmacies, if unattended on-the-dot, your Accounts Receivable (ARs) would become unmanageable leading to piled-up bad-debts. Thus, point of service (POS) payment is very crucial for a robust healthcare business.

Notably, most physicians want to stay away from the financial dealings and deem that time involved in the finance management could be utilized for patient care and updating the clinical knowledge. But finally, you may land up in big troubles like unmet payroll, unrewarded hard work, dwindled profits or increased bad-debts.

Take care of your funds with these collection tips:

#1 – Ignorance of co-pays

Physicians need to be more attentive and understand that co-pay collection from the patient must be a demand instead of being a patient’s choice. As per the insurance payer contract, the doctor must collect the co-pay from the patient in each visit.

 #2 – Bill Generation for Co-pays

Another common co-pay collection mistake is that you may bill the patient’s co-pay which once more goes against the payer contract policy. Missing the POS collection calls for unnecessary addition of the administrative cost in bill generation, follow-up and collection.

 #3 – Information Deficiency

It is the highly frequent yet imperative issue due to the negligence of the front-end staffs. Important patient’s information like date of birth, insurance carrier and policy details, scanned copy of insurance cards, exact billing address, contact number and many demographic data, if left out at the patient check-in, eligibility issues may arise and hamper your reimbursements.

 #4 – Lack of Payment Pattern Discussion

Mailing the bills directly to the patient and upon patient’s rejection seeking the help of the collection agency may help you, of sure. But, conversing with the patient up on encounter, to make payment arrangement is a much better option to collect your dues.

 #5 – Missing Further Step

When your collection methods are not working out, you need to proceed further either through collection agency or legal proceedings. Of note, this is the point at which doctor-patient relationship may get broken. If the aforesaid 4 steps are followed impeccably, you won’t find any lapse in the serene patient care.

Why are physicians disillusioned with their EHRs?

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Why are physicians disillusioned with their EHRs?

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.