HIMSS 2013: The Small Practice POV

Lea Chatham April 26th, 2013

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This past March, more than 35,000 healthcare providers, health systems’ staff, and technology experts attended HIMSS 2013, the annual conference of the Healthcare Information and Management Systems Society (HIMSS). An industry leader for more than 50 years, HIMSS is a cause-based, nonprofit organization designed to provide global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare.

Industry leaders from government, commercial payers, and more than 1,000 technology innovators engaged in debates, case studies, demonstrations, and dialogues aimed at solving some of  the most complex healthcare delivery problems facing our healthcare systems today. While this year’s HIMSS conference was extremely valuable, we, the Kareo team, noticed that the small medical practice was fairly underrepresented in the crowds.

Get the small practice POV on HIMSS 2013

Since small medical practices constitute such a large portion of the nation’s healthcare delivery network, we made it our mission to provide our small practice customers and friends with Kareo perspectives on the six  hottest topics of HIMSS 2013:

  1. Diminishing EHR satisfaction and usability
  2. Improving EHR usability
  3. Patient engagement
  4. Big data as a disruptive technology
  5. Innovation
  6. Beyond the device

In HIMSS 2013: The Small Practice Point of View, you’ll find the latest thoughts and statistics on each of these topics, plus Kareo’s practical perspectives for your small practice. Download this great resource today!

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Is Your Practice Ready for Meaningful Use Stage 2?

Lea Chatham April 25th, 2013

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The Ins and Outs of Meaningful Use Stage 2

The final rules regarding meaningful use in Stage Two of the government’s EHR Incentive Program are out. To date, billions of dollars of incentive funds have been paid to eligible physicians and providers across the United States. The rules to gain your incentive are changing-whether you are a first-timer, or a seasoned participant ready to launch into Stage Two. The important question: Is your practice ready?

Experienced medical practice expert Elizabeth Woodcock guides you through the requirements for Stage Two-and recent announcements that will affect Stage One.

  • Discover what objectives and measurements the government will require in Stage Two-and what it will take for your providers to successfully qualify.
  • Recognize the implications of the changes, and how to gear up for those changes today.
  • Understand the repercussions of not participating based on penalties that will be applied in 2015.

Gain knowledge about Stage Two in this dynamic and informative webinar-and learn the answer to questions that you might not have even thought to ask. Join us in this session to gear up for Stage Two of Meaningful Use. This event is brought to you by Physicians Practice and sponsored by Kareo.

Note: This Meaningful Use information is subject to change. For the latest updates, visit www.kareo.com/meaningful-use.

Register now to learn how to improve your patient collections—and your bottom line.

About the Speaker:

Expert Elizabeth_Woodcock will explain best practices for appealing denied claims

Elizabeth Woodcock, MBA, FACMPE, CPC is a professional speaker, trainer and author specializing in medical practice management. She has focused on medical practice operations and revenue cycle management for more than 20 years.

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Your Questions about Patient Payments with Credit Cards Answered

Lea Chatham April 23rd, 2013

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In her February webinar, 3 Innovative Ways to Improve Collections, practice management expert Rochelle Glassman discussed some strategies for getting your patient payments and collections under control. She suggested making it easier for patients to pay by offering online billpay, reminding patients about their balance due when they schedule an appointment and at registration, collecting copays, deductibles and self pay balances at the office, and getting authorization to charge credit cards for balances due or for patient payment plans. The webinar attendees had a lot of questions, which we answered. But we continue to get questions about credit authorizations. So here are some answers to help you make the most of this tactic.

Q: Can we get a copy of the generic credit card authorization form?
A:  Yes. You can download a generic credit authorization form here.

Q: How long does the credit card agreement remain in effect? Does there need to be an expiration date?
A: A payment agreement stays in effect until the balance is paid in full. When an agreement is made, it spells out the length of the agreement and the patient signs that agreement with the understanding of the length of the agreement. Recurring payments can be set up using a payment processing service. If you already accept credit cards, your merchant services department may already have a service in place which you can add to your current plan. Many banks such as Chase and Wells Fargo offer this option to their merchants for a monthly fee. This service is also available through other vendors such as Paypal, Chargify and Authorize.net. You can also use a credit card authorization form and charge the card manually each time.     

Q: What do I say to a patient who refuses to give credit card info for fear of fraud?
A: You can assure them that the practice is maintaining security standards and give them a copy of the practice’s credit card security policy.

Q: Are there any legal requirements with regard to keeping credit information on file?
A:  Yes, the merchant must be PCI DSS (The Payment Card Industry Data Security Standard) compliant. When compliant, you can legally store credit card information, with the exception of the CVV code. You can never, store the CVV code. Your merchant services provider should meet these standards. Details on the requirements can be found at PCI Security Standards Council at www.pcisecuritystandards.org.

Q: If you charge a credit card payment using Kareo, does it post to the patient account automatically?
A:  Yes, on the New Payment screen, indicate the method as “credit card” and hit the Process Credit Card Payment button. You will need to be signed up for Kareo’s Patient Payment Services and have a card swipe connected to your computer. Contact the support team for more info or review the online how to article – http://www.kareo.com/help/practice-management/howto/enter-payments-from-credit-card

Q: In Kareo, how can patients make online payments?
A:  If you sign up for our patient payment services you will be able to direct your patients to an online account where they can make credit card payments online. Also, if you send patient statements through Kareo to your customers those statements it will provide your patients with a link that takes them directly to this online payment portal.

About the Author: Rochelle Glassman

Rochelle Glassman

Rochelle Glassman is a passionate advocate for physicians and medical practices who has devoted her career to helping doctors get paid. She is the President & CEO of United Physician Services, and is a nationally recognized healthcare consultant known for her candor, tenacity, and vision.

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Complimentary Webinar: What You Need to Know about Meaningful Use Now!

Lea Chatham April 17th, 2013

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Wednesday, April 24, 2013
1:00 PM EDT/10:00 AM PDT
Speakers: Barbara Drury, FHIMSS

There is a new landscape for electronic health records (EHR) in the post-ARRA/HITECH era for medical practices. Looking ahead, meaningful use (MU) is having a huge impact on the healthcare business, industry, and physician offices. If you are just getting started with MU or haven’t implemented an EHR yet, you need to join us at this event. This presentation will review how we got where we are, what you need to know to navigate this new landscape, and what is coming down the road from HHS and CMS around electronic health records. You’ll learn:

  • About the history of Meaningful Use
  • The basic requirements of Meaningful Use
  • The maximum incentives and the penalties
  • And where things are headed!

Register today!  You don’t want to miss this.

Who Should Attend Private practice owners, physicians, practice managers, office managers and others concerned about selecting, purchasing, and implementing an EHR and attesting for meaningful use.

Note: This Meaningful Use information is subject to change. For the latest updates, visit www.kareo.com/meaningful-use.

Register now to learn about the benefits of medical practice marketing

About Your Speaker:

Join Barbara Drury to find out what you need to know about meaningful use now

Barbara Drury, BA, FHIMSS, is President of Pricare Inc., an independent health information technology consulting firm founded in 1982. She frequently lectures and writes about the impact of office-based computer systems and electronic medical record systems for entities such as medical societies, healthcare organizations, and others. Ms. Drury is an appointee to the ONC’s Technical Expert Panel on Unintended Consequences of HIT Adoption. She has achieved Fellow Status with the Healthcare Information and Management Systems Society (HIMSS) and currently serves on the HIMSS Public Policy Committee. Ms. Drury is also a frequent speaker at the HIMSS Annual Conference and is the recipient of the December 2004 and the April 2009 Spirit of HIMSS award.

Register now to learn about the benefits of medical practice marketing

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Take Control of Your Patient Flow (Part 2)

Lea Chatham April 16th, 2013

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by Rico Lopez, Senior Market Advisor at Kareo

Rico Lopez

In my last post, Take Control of Your Patient Flow (Part 1), I reviewed the impact of poor patient flow and the signs that is a problem in your practice. So, now you are probably wondering what to do next. There are several possible root causes for problems with patient flow that in turn affect your bottom line.  In this, and subsequent, posts, I will look at some of the bigger problems and offer solutions.

To have any hope for resolution of any condition, you have to make a commitment to change. There will be struggles and even the dreaded trial and error, but in the end, you can make it better. In this treatment plan, we will discuss designing your Appointment Scheduling Template based on your projected patient flow.

Was your schedule set up to maximize your provider times or was it established using the traditional business hours that start at 8 AM and end at 5 PM? Don’t feel bad if you said the latter – surprisingly, most practices still build their appointment schedules in the same manner today as it was done 10-15 years ago.

Schedules that are tailored to the traditional business hours do not account for the “true” available time of your provider(s) and your staff. If your provider arrives at the office at 8:00 AM and your first appointment is at 8:00 AM – how quickly will your staff prep the patient to see the provider?

Coincidentally, if your front desk staff also arrives at work at the same time, are they ready to jump in to work and get the patient’s chart ready for the nursing staff? They typically have to log in to their workstations and prepare their work area before they can even call up the first patient.

A lot of practices will also plug in new patients or physicals (appointment types that typically require a longer visit time) in what they think are logical places in the schedule without fully understanding the downstream effect to their staff and to their providers. Worse yet, they will overbook slots to ensure that the provider always has a patient ready to be seen – again without fully understanding the downstream effect.

Some practices, by experience, have adjusted their schedule to account for staff coming in earlier to ensure that patients are ready to be seen when the provider is ready. The question now is whether you accounted for the full patient flow from beginning to the end of the day. Before you can fine tune your Appointment Schedule Template you must first create a projected patient flow.

So how do you create your projected patient flow? 15+ years ago, we used colored notecards, color markers and pushpins on a large bulletin board. Later on we moved to colored post-it notes and then finally to Microsoft Excel, which allows you to easily adjust slots, labels, colors and maintain versions in separate worksheets by copying the previous sheet and then applying adjustments.

Patient Flow Worksheet

What do I need to create this worksheet?

The provider start and end times represent the time when the provider is ready to see the first patient and when the last patient of the day should be complete. This needs to be very specific since everything else will revolve around it. This is why the Provider Time column has a label “Start Here.”

The projected patient “stops” or staff interactions occur at Patient Check-in, Registration, Nursing, Provider Exam, Visit Wrap-up and Patient Check-out. In your practice, you may have more or less.  This may sound very simple but be sure to account for all areas since it will impact the overall timing.

You’ll need to create a list of all Appointment Reason Types (New Patient, Physical Exam, Follow-up, Consult, Nurse Visit, etc.) and the average length of time to perform this type of visit. Also, estimate the number of patients by appointment types for a typical day.

Once you have all of the above, then it is time to assemble. Start with the Provider Time column. Based on the number of exam rooms in your practice, determine the timing between patients to keep your provider going from one room to the next.

Now go backwards to the previous stops and determine the average interaction time required and keep going back until you arrive at the Check-in time.

Note that the “Check-in” time is the time you want the patient to initiate the visit. For the majority of the appointment types, this is the same as the patient’s appointment time, but many practices want their new patients to arrive 30 minutes before their appointment time to complete paperwork or fill out forms. Be sure to factor this in to your scheduling template.

Do not rely on your staff to tell the patient to come in a few minutes early to “fill out forms” before they are seen. Your staff may not always remember to tell the patient or the patient may not remember by the time the appointment comes up.

If the patient does not show up early as instructed, you are now waiting for the patient to complete your forms and the practice will fall behind. These types of delays will cause gaps in your provider slots and push all appointments back. We will talk more about other unanticipated delays later, but for this one, why not just factor this in to the patient’s appointment time and allow you to maintain control of your schedule?

In my example, I scheduled the first new patient to arrive at 7:30 AM, even though my staff will not begin registering the patient in the system until 8 AM allowing the patient 25-30 minutes to complete the forms. You will need to adjust this “padding” based on your experience with your patients and the number of forms you require.

Additional Tips and Tricks

  • Do NOT book multiple patients with the same Appointment Reason Types on the same time slot. We will discuss overbooking in a future post and why this is not always the right solution.
  • Do NOT book extended Appointment Reason Types either on the same time slot or in back to back time slots (i.e. Back to back New Patient slots). Try to stagger these throughout the day and fill in the gaps with nursing appointments or other visit types that do not require face-to-face interaction with your provider.
  • It is ok to have a New Patient come in on your first time slot, but be sure to also schedule follow-up appointments at the same time and shortly thereafter. This will allow the patients to flow back to the provider to be seen while the New Patient is going through registration.
  • If you only have a couple of exam rooms, you may want to stagger your patients by 10 or 15 minute increments. If you have more than two then, you can space out by 5 or 10 minutes. The patient wait time in the exam room should never be more than 5 minutes and definitely less than 10 minutes. When sitting alone in a room, 5 minutes feels like an eternity. Remember, the exam rooms may still require cleaning/ restocking before you bring in the next patient, so be sure to account for this.
  • Make sure you build in time throughout the day for your provider to do charting, coding and returning phone calls.
  • Establish your policy on walk-in or triage patients. If this is a normal occurrence in your practice, then go ahead and designate time slots to accommodate these patients. Balance it out with your average no-shows – so if you have an average of two no-shows a day, then you can fill in with a couple of walk-in or triage patients.
  • For some practices, it may be ideal to factor in lunch breaks to the template to account for the availability of staff. Note: Not everyone goes to lunch from 12 to 1 PM when the typical practice is closed for lunch break. At 12 PM, the provider and nurses may still be finishing up the last few patients of the morning so they may not be able to go to lunch until 12:15 or 12:30. However, the front desk may be able to go to lunch at 11:30 or 11:45 when all the morning patients have been checked in and will be back at the front desk to greet the first afternoon patients.

Fine-tuning your Appointment Schedule Template will take weeks and sometimes longer. Be patient and do not be too quick to make adjustments. I always say, “Don’t second guess your decisions unless outcomes tell you to do so.” If you have spent the time to analyze and map out your patient flow, then the expected changes will eventually come. Remember, you are dealing with a lot of old habits from your patients, your employees and your providers. It will require a total effort and buy in to succeed.

Watch for my next post when I’ll look at fine tuning your staff’s work schedule and how cross training will improve bottlenecks in your patient flow.

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Read Great EHR Tips in April Getting Paid Newsletter!

Lea Chatham April 11th, 2013

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The April edition of the Getting Paid Newsletter is out. This month’s issue is full of useful information on meaningful use, EHR features, and working smarter with your A/R. Barbara Drury, FHIMSS, discusses some realities of meaningful use in preparation for her upcoming free webinar, Everything You Need to Know about Meaningful Use Now. Ron Sterling, an EHR expert, provides the list of must have EHR features for small practices. And, Thom Schildmeyer, President of Aesyntix Health, Inc., offers his practical advice for managing A/R without working harder. In addition, there is information about our upcoming free webinar and a chance to win $150. So, if you haven’t already read it, check it out now!

Read Great EHR Tips in April Getting Paid Newsletter

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Your 2013-2014 Meaningful Use Timeline

Lea Chatham April 10th, 2013

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Meaningful use timeline for eligible professionals

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Top EHR Features Small Practices Need, Part 2

Lea Chatham April 8th, 2013

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By Ron Sterling

Small practices are at a significant disadvantage when choosing an electronic health record (EHR). The wide range of products and the dizzying array of EHR capabilities lead to skirmishes about features and technological wars with your practice caught in the middle. For example, the ability to print a list of patients any one of 100 different ways may be a minor benefit to your practice when what you really want is an online listing of important messages.

To select the right product, you need to focus in on specific capabilities that will help you manage patient services and care. In my first post, Top EHR Features Small Practice Need, I reviewed some of the key things to look for a vendor and type of EHR software. In addition, these specific EHR software features should be at the top of your list:

  1. Orders: Clinical orders are typically recorded in the paper chart to avoid liability issues. EHR orders are a critical feature to support your involvement in accountable care organizations (ACO), and patient centered medical home (PCMH) as well as meeting the evolving standards of care. Clinical orders should include the status and due date of the plan item for the patient. For example, a treatment order may be pending for a future time, have been completed, or even refused by the patient. To efficiently manage services, you should be able to view all patients with selected types of open orders (Ex. A1C) for selected due dates as well as review orders on the patient summary screen.
  2. Health Maintenance: Health maintenance items are care standards that apply to patients based on their age, sex, diagnosis and previous treatments. Immunizations for children, colonoscopies for patients over the age of 50 and annual checkups on hip replacements are examples of health maintenance items. The PCMH and ACO strategies include attention to health maintenance items as an important proactive strategy to avoid more serious problems. Health maintenance items should be automatically and clearly displayed when the patient qualifies for the care standard.
  3. Procedure Scheduling Management: Specialists need a tool to monitor the progress of patients through the surgery or procedure scheduling process. The EHR should provide the ability to schedule multiple resources or recurring visits as well as recording and managing patient-specific information about the procedure and services.
  4. Referral Management: Primary care practices need to track patients who are referred to other providers and the status of those care recommendations. The EHR should be able to assign a patient service to an outside party and track the status of the referral up to and including receipt of the referral clinical report.
  5. Messages: You will need to record messages to transfer patient issues to other staff or to remind the practice about an important patient issue. The message should document the cycle of events associated with the issue such as passing a question to the doctor to be followed up by the nurse. Additionally, the message should include an “alarm” feature so it does not show up on your to do list if it is an item with a future activation date.
  6. Diagnostic Interfaces: Many doctors rely on information from a variety of diagnostic devices to support clinical analysis and patient care. At some point, the diagnostic results, and/or images will have to make their way to your EHR. Ideally, the EHR should send your diagnostic order to the lab information system as well as receive the results into the EHR for review and inclusion in the patient record. Note that some orders and results are part of the Meaningful Use measures.
  7. Image Upload, Scanning & Annotation: Images include incoming diagnostic images, reports from other parties and even scanned portions of the patient’s paper chart. Your doctors need to be able to determine whether the image is waiting to be reviewed as well as where the image came from. As important, the ability to directly draw on the image and save the annotated view is helpful to highlight important observations. The doctor and staff should be able to attach a note to the image and include the image in patient or referring doctor correspondence.
  8. Patient Summary Screen: Patient summary screens display key information about a patient status or situation. Note that requirements can vary by specialty. For example, pediatricians are interested in immunizations while surgeons may want to see a list of prior surgeries. All doctors want to see a list of medications, current conditions and outstanding care items. The patient summary screen should offer options to present views that will be relevant to your doctors without cluttering up the presentation.
  9. View Options: When looking for patient information you want to have different view options that are built into the EHR. For example, you may want to see the patient chart in chronological, or reverse chronological order as well as grouped by type of information (Ex. Lab tests, radiology tests.)
  10. Patient Portal Integration: Patient portals support interactions with the doctor and provide immediate patient access to important care information. Patient portals support PCMH and ACO strategies as well as certain Stage 2 Meaningful Use Measures. Secured messages between doctors and patients are supported through patient portals. The EHR should be able to send patient information such as the clinical summary, reminders and results to the patient portal. Additionally, patient information entered in the patient portal should be accepted into the EHR to allow you to fully document your interactions with patients in the EHR.
  11. Authorization and Disclosure Tracking: The recent changes to handling and disclosure of patient information through the HIPAA Omnibus rules as well as the more complicated rules for impermissible use and disclosure of protected health information (PHI) increase the importance of keeping appropriate records for disclosures and uses of PHI. The more information one can record on the status of the disclosures for a patient, the less chance of a problem. The EHR should record patient limitations on distribution of PHI as well as document when information is distributed.

Small practices need easy-to-use and comprehensive solutions to clinical operation and patient service challenges. Focusing on the key features needed to improve workflow and support staff and doctors will provide the right tool and a practical solution to the needs of the small practice.

About the Author

Ron Sterling, EHR consultant, discusses the EHR features small pratices need Ron Sterling publishes the popular EHR Blog Avoid-EHR-Disasters.blogspot.com, and authored the HIMSS Book of the Year Award Winning Keys to EMR/EHR Success. He is an independent EHR consultant. Find out more at www.sterling-solutions.com.

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Work Smarter, Not Harder

Lea Chatham April 8th, 2013

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By Thom Schildmeyer, President, Aesyntix Health, Inc.

Over the last three months, we have had a significant increase in providers asking about cash flow. Specifically, they want to know whether or not they should open up their practice to more payers and/or seek alternative revenues sources. The complaint is the same: “I am working hard, but my income continues to go down.”

Oftentimes, the “knee-jerk” reaction is to aggressively try to attract and treat more patients, thinking higher volume alone will result in more money. Yet, there are considerable expenses associated with this strategy that can reduce profitability, from marketing and advertising to the actual cost of service.

In fact, many providers who travel down this path find themselves working harder and longer hours, only to increase levels of stress with marginal benefit to their bottom line. I recommend something different.

Focus on Your Outstanding A/R
Fortunately, there’s a much easier way to increase your revenue without expending additional resources. And it’s right there in front of you: your outstanding accounts receivable (A/R).

For example, take a practice that on average posts $50,000 in clinical charges each month. It’s not uncommon for this practice to have an outstanding A/R balance of 1.5 times that amount, or roughly $75,000, carried over each month. An average contractual adjustment rate of 25 percent* results in approximately $56,250 that the practice has earned and is legally owed, but has not yet collected. (* this rate varies based on a number of factors)

Can they afford to walk away from this money, leaving well-deserved revenue on the table? For most practices, including this one, the answer is no. But where do they start? The first step is to assess whether their billing staff has the capacity and expertise to focus on A/R collections. If so, simply redirecting them with a sense of urgency to improve performance can yield significant results. This practice does have the resources and did look to redirect.

Work Your Unpaid Claims
When assessing your outstanding A/R, look first at your unpaid insurance claims. Collecting on a higher number of claims sooner than later will result in immediate revenue for your practice. Below are a few best practices I suggested to this practice to help facilitate smoother claims submission and, most important, faster payment:

  • Identify patterns with insurance carriers: When working to resolve unpaid claims, it’s important to find a pattern relative to each insurance carrier. If you are able to discover a common factor, you can modify your billing style to avoid future denials.
  • Review claims before resubmitting: Make the most of the information you have before spending time to gather more, by addressing the following items:
    – Ensure that proper contractual adjustments are made to each line item.
    – Verify that CPT and ICD-9 codes are for covered services.
    – Check modifiers; remember global periods, unrelated procedures on the same date of service, and separately identifiable evaluation/management services.
    – Review insurance authorization and physician referral requirements to determine if an authorization is (or needs to be) in place.
    – Determine if the bill should be moved to a secondary insurance or the patient.
  • Create a strategy for easy “wins”: If all information appears correct and claims still require follow-up, prioritize your unpaid claim list to pursue the “low-hanging fruit” first. Considering the age of the claim and outstanding dollar amount to prioritize your list is a common way to increase your collections success rate.

A less applied, but perhaps even more valuable technique is to look closely at your payer mix, identifying those that are easiest to work with and have faster turnaround times. Are you required to complete an online form, mail a letter, or make a phone call? If “Carrier A” processes claims in 10 days and “Carrier B” processes in 28 days, where should you start?

Combining these principles with your existing A/R process can help resolve more claims in a shorter amount of time. Furthermore, receiving the outstanding funds quicker can make the average amount per claim less relevant to your overall strategy. And ultimately, this is one step towards working smarter, not harder, to increase your bottom line.

About the Author

Thom Schildmeyer shares tips to solve real world medical billing problems

Thom Schildmeyer is President of Aesyntix Health, Inc, a leading provider of billing and purchasing solutions for dermatologists and cosmetic surgeons. He has more than 20 years experience consulting with practices in the areas of financial analysis, practice valuation, human resources, training and development, sales management, marketing, and patient relations.

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Meaningful Use … Your Practice, an EHR, and the EHR Incentive Program

Lea Chatham April 8th, 2013

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By Barbara Drury, FHIMSS

Did you know that The American Recovery and Reinvestment Act (ARRA) has nothing to do with the health of you, your patients, or your practice? Really!

ARRA was a job stimulus bill designed to stimulate the US economy. I remember the first time a physician colleague said that to me, and I had to agree. ARRA was a multi-pronged approach to get the economy going. However, Congress used the HITECH section of ARRA to outline how the acquisition of electronic tools and the meaningful use of these tools would create and enable data collection. During the time between President Bush’s 2004 State of the Union Address where he called for elimination of paper medical records within a decade and President Obama’s signing of ARRA in 2009, the natural adoption rate of EMRs was about 5% a year. In multiple studies by the CDC (“National Ambulatory Medical Care Survey, 2001-2012), the definition of a “full-featured EMR” versus a “basic system” showed mixed indicators of functions offered and/or used as well as differences in the rate of regional adoption.

ARRA has certainly changed everybody’s world since 2009: government, EHR vendors, and practices like yours. You now need to pay closer attention to patients’ compliance while monitoring and reporting on quality measures. However, despite this need for enhanced care management and tracking, for many practices, today’s EHR incentive program is still not enough to drive adoption. In part this is because for many the costs outweigh the benefits—for now.

For example, an OB/Gyn practice that does not have enough Medicare or Medicaid to qualify for the EHR Incentive may not see a reason to adopt an EHR. In addition, incentive payments are not given for mid-level providers except in a few situations. For many practices that have expanded their approach to team care to include PAs, this means incurring the cost of a provider license in the EHR for the mid-level without receiving an incentive for that provider. Unfortunately, whatever your reasons for not attesting to meaningful use, you will be eligible for the 1% 2015 Medicare penalty unless Congress quickly intervenes—and Congress is focused on other issues.

Even if you choose not to be a “meaningful user” as ARRA has defined it, , I do think that every practice needs to understand how they are affected by the Meaningful Use Program. I also believe that there are many other short and long-term benefits (practice data for contracting discussions, shift from quantity to quality payment programs, etc.) to implementing and using an EHR. Knowing all the ins and outs helps you to make informed decisions.

If you are interested in learning more, join me on Wednesday, April 24 for Everything You Need to Know about Meaningful Use Now. I’ll review the details of meaningful use and discuss some of what we’ve discovered about the EHR Incentive Program in the real world. Register Now.

Note: This Meaningful Use information is subject to change. For the latest updates, visit www.kareo.com/meaningful-use.

About the Author:

Join Barbara Drury to find out what you need to know about meaningful use now

Barbara Drury, BA, FHIMSS, is President of Pricare Inc., an independent health information technology consulting firm founded in 1982. She frequently lectures and writes about the impact of office-based computer systems and electronic medical record systems for entities such as medical societies, healthcare organizations, and others. Ms. Drury is an appointee to the ONC’s Technical Expert Panel on Unintended Consequences of HIT Adoption. She has achieved Fellow Status with the Healthcare Information and Management Systems Society (HIMSS) and currently serves on the HIMSS Public Policy Committee. Ms. Drury is also a frequent speaker at the HIMSS Annual Conference and is the recipient of the December 2004 and the April 2009 Spirit of HIMSS award.

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Welcome to Getting Paid, a weblog by Kareo offering ideas, news and opinions about medical billing and practice management with the goal of making medical billing easier and yes, getting you paid. Visit the Product Blog for more information on our products.

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