Survey Shows Patients Not Bothered by EHRs

Lea Chatham February 25th, 2016

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Software Advice, a company that reviews tech solutions to improve patient experience, recently produced a video where they interviewed thought leaders about EHR workflow. This video shows how practices can use their EHR to enhance the patient experience. Tweet this Kareo story

“Software Advice has helped thousands of medical practices with a first-time or replacement EHR purchase, so we know just how important it is for the transition to new health IT to be as smooth as possible,” says Gaby Loria, researcher at Software Advice. “Providers tell us they want solutions that will optimize their workflow and enhance the patient-physician relationship. In this video, we set out to show that EHRs can do just that.”

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New OCR Guidelines Remind Practices to Follow HIPAA

Lea Chatham February 23rd, 2016

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By Lisa A. Eramo

As patient engagement continues to take center stage, it’s more important than ever for patients to gain access to their own health information. Not only does HIPAA require this, but it’s simply good for patient care. When patients access their information, they’re able to monitor chronic conditions, adhere to treatment plans, track progress, coordinate care, and identify errors.

Unfortunately, some physician practices tend to over-interpret HIPAA, says Angela Rose, MHA, RHIA, CHPS, FAHIMA, director of HIM practice excellence at the American Health Information Management Association (AHIMA). They use the federal law as a barrier to providing access because they tend to err on the side of caution in certain situations, she adds.

“Far too often, individuals face obstacles to access their health information, even from entities required to comply with the HIPAA Privacy Rule,” Jocelyn Samuels, director of the Office for Civil Rights, wrote in a recent blog entry. “This must change,” she added.

A thorough understanding of HIPAA is paramount, says Rose. In addition, practices need to know how HIPAA requirements stack up against the HITECH Act that is more stringent and exact in some cases. The good news is that new OCR guidelines published last month provide much-needed clarification. Tweet this Kareo story

What HIPAA does—and doesn’t—include
In summary, patients are permitted access to the following information in the designated record set:

  • Medical records
  • Billing and payment records
  • Insurance information
  • Clinical lab test results
  • Medical images
  • Wellness and disease management program files
  • Clinical case notes
  • Other information used to make decisions about individuals

Patients are not permitted access to the following information:

  • Quality assessment or improvement records
  • Patient safety activity records
  • Business planning, development, and management records (e.g., a practice’s quality records referencing an individual’s protected health information [PHI] that are used to improve customer service)
  • Psychotherapy notes that a mental health provider maintains separately from the rest of the patient’s medical record
  • Information compiled in reasonable anticipation of, of for use in, a civil, criminal, or administrative action or proceeding

HITECH specifically states that patients must have access to recent lab test results, a current medication list, a medication history, and a problem list maintained in Certified EHR Technology. This is something to consider if your practice is participating in the Meaningful Use (MU) EHR Incentive Program.

Timeliness of access
Practices must provide access to the requested PHI no later than 30 calendar days from receiving the individual’s request, as per HIPAA requirements.

However, according to HITECH MU Stage 2, eligible professionals must make information available within four business days of its availability. Stage 3 requires eligible professionals to make information available to patients within 48 hours of its availability.

Requests for electronic copies
Rose says many practices are still surprised to learn that per HIPAA, individuals have a right to request an electronic copy of their PHI when that PHI is maintained electronically by the covered entity.

According to the OCR guidelines, “If a covered entity has the capability to readily produce the requested format, it is not permissible for the covered entity to deny the individual access to that format because the entity would prefer that the individual receive a different format, or utilize other customary record access processes of the entity.”

4 tips to maintain compliance
Rose says to consider these tips to ensure that your practice meets HIPAA and HITECH requirements:

  1. Review the OCR guidelines carefully. In addition to the information reference above, the guidelines also provide information about methods for requesting access, verifying the identity of the individual requesting access, charging fees for copies of information, grounds for denying access, and more.
  2. Contact your local AHIMA state component association for more information about HIPAA and what your practice needs to do to comply.
  3. Develop an internal policy regarding how to handle different types of patient requests. This policy should address request formats, timeliness for response, and response formats. Educate patients about this policy and about HIPAA, in general, so they know what to expect.
  4. Implement a patient portal. Work with your EHR vendor to integrate portal technology that will allow you to respond to patient requests for PHI more quickly and even in an electronic format.

If you are looking for more information on the requirements of Meaningful Use and what is changing with modified Stage 2 and Stage 3, visit the Kareo Meaningful Use Resource Center.

About the Author

LisaEramofreelanceLisa A. Eramo is a freelance writer/editor specializing in health information management, medical coding, and healthcare regulatory topics. She also works as a healthcare content specialist for Agency Ten22. She began her healthcare career as a referral specialist for a well-known cancer center. Lisa went on to work for several years at a healthcare publishing company. She regularly contributes to healthcare publications, websites, and blogs, including the AHIMA Journal and AHIMA Advantage. Her focus areas are medical coding, and ICD-10 in particular, clinical documentation improvement, and healthcare quality/efficiency.

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Video: Tips to Choose the Right EHR the Second Time

Lea Chatham February 18th, 2016

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If you are looking to change EHRs, be sure to use the best methods for choosing your EHR the second time around. Use the tips provided by Dr. Tom Giannulli in this short video to help make the right EHR choice this time. Tweet this Kareo story


Need more help? Download our guide to help you select an EHR that fits your practice.

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Webinar: Discover How Billing Advantage Grew to Over 100 Practices

Lea Chatham February 17th, 2016

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Discover How Billing Advantage Grew to Over 100 Practices with Kareo
Tuesday, February 23
11:00 AM PT, 2:00 PM ET

Learn how Rick Kaufman has grown his medical billing company to serve over 100 practices across the US Tweet this Kareo story


What makes a medical billing company successful? The answer is a lot of different things. If you’re looking for suggestions on how to grow and strengthen your billing company, there is no better resource than someone who has been there and done that. This webinar is a conversation with successful billing company owner Rick Kaufman about how he has grown his company, Billing Advantage.

Hear directly from Rick how he:

  1. Grew to serve over 100 practices and 200 providers
  2. Uses technology to improve staff performance and customer satisfaction
  3. Added services like credentialing to increase revenue
  4. Implemented standards to ensure a consistent customer experience

Register now to hear Rick’s secrets to success.

Register Now

About the Speaker

Rick Kaufman is the owner of Billing Advantage, which serves over 100 practices nationwide.

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Six Things to Know about Medicaid and Telemedicine

Lea Chatham February 16th, 2016

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By Teresa Iafolla  

After looking at billing for telemedicine with commercial payers and Medicare, it’s time to review Medicaid. How does telemedicine reimbursement work when Medicaid is involved? It’s an important question, especially considering many remote and rural patients in need of better healthcare access are also Medicaid patients.

The answer is, telemedicine reimbursement through Medicaid works a little bit differently for every state. While most states follow the same sorts of guidelines and restrictions, each program varies in terms of which telemedicine services are covered.

So, how do you find out the guidelines for your state? Here are six tips to help answer your Medicaid telemedicine reimbursement questions. Tweet this Kareo story

  1. Keep your type of telemedicine in mind. While there are many different types of telemedicine (i.e. store-and-forward, remote patient monitoring, etc.), live video seems to be the standard when it comes to Medicaid. Currently, all state Medicaid programs, except for Rhode Island, offer some sort of reimbursement for live video telemedicine services. An additional nine state Medicaid programs cover store-and-forward telemedicine and 16 provide some reimbursement for remote patient monitoring.
  2. If you’re not a physician, make sure to check you’re eligible to bill for telemedicine. Some state Medicaid programs limit which healthcare providers can bill for telemedicine services. Currently, 15 states allow any type of healthcare provider to get paid for telemedicine. Other states range from only offering coverage to physicians to a long list of specialists, like podiatrists or oral surgeons.
  3. Brush up on the terminology. One of the hardest parts of figuring out how Medicaid handles telemedicine in your state can be just figuring out the terminology! Most provider manuals will have a section that explains what each term means. But otherwise, here’s a quick guide to some common terms:
    - Spoke site: this usually refers to the location where the patient is at the time of service. A spoke site is typically a small rural health clinic, or a health facility in a more remote location.
    - Originating site: originating site and spoke site are often used interchangeably to refer to the patient’s location at the time of service.
    - Hub site: The hub site refers to the central “hub” of the telemedicine program, or where the healthcare provider is at the time of service.
    - Distant site: Distant site is similar to the hub site and means where the healthcare provider is at the time of service.
  4. Check what locations qualify as billable telemedicine sites in your state. Remember that location terminology we just covered? Some state Medicaid programs will specify the types of healthcare facilities or other locations that qualify as a distant and originating site for telemedicine services. For instance, 25 state Medicaid programs specifically recognize the patient’s home as an eligible originating site for telemedicine. That means if you live in one of those 25 states, patients can see you without leaving their homes!
  5. Know your billing codes. Knowing the telemedicine billing codes that your Medicaid program uses helps you in two ways. It ensures those claims get processed correctly, and it can tell you which specific healthcare services can be delivered via telemedicine. In most cases, if a state Medicaid program covers telemedicine, they’ll usually reimburse for the standard evaluative & management codes at the very least (99201 – 99215). To note that the service was done via telemedicine, you’ll also need to add on the GT modifier to the appropriate E&M code. Many Medicaid programs will additionally reimburse for other services, like behavioral health consultations. Check your state policy page, or ask your Medicaid representative for your list of billing codes.
  6. Always consult your Medicaid provider resources and representative with questions. As you’re researching the Medicaid rules for telemedicine reimbursement in your state, the best place to start is with your Medicaid provider manual or your Medicaid program website. If you need any additional help, you may also want to check out these websites:
    - eVisit State Telemedicine Policy Center
    National Telehealth Policy Resource Center
    American Telemedicine Association State Policy Center

Note that your Medicaid manual may not be completely up-to-date, so you should always verify the guidelines with your Medicaid representative.

Got these basic tips to Medicaid reimbursement under your belt? You’re one step closer to getting your telemedicine program up-and-running and providing care to those hard-to-reach patients.

About the Author 

Teresa Iafolla is Director of Content Marketing at eVisit, a physician-first telemedicine solution connecting providers to their patients via secure, video chat. Teresa manages and writes for the eVisit Blog, a resource for physicians and practice managers trying to improve their practices and boost revenue. To contact Teresa with questions or comments, email

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Medical Billing & MU Updates in February Getting Paid Newsletter

Lea Chatham February 10th, 2016

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The February Kareo Getting Paid Newsletter provides some updates on medical billing and Meaningful Use for 2016. Get advice on managing fee schedules, applying for a MU hardship exemption, the latest survey on patient use of online physician reviews, and more. The newsletter also offers a chance to discover upcoming events, news, and resources from Kareo. Plus, learn about how to register for upcoming webinarsRead all this and more now! Tweet this Kareo story


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The Medicare Fee Schedule and Your Specialty: What’s the Scoop?

Lea Chatham February 8th, 2016

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Have you taken the time to review and update your fee schedules? It’s an important part of starting the year off right. Your practice management system should update the Medicare Physician Fee Schedule (MPFS) for you, but you still need to make adjustments to your practice fee schedule and ensure you make any other needed updates for commercial payers. Often staff are so busy closing out the old year and getting ready for the new one that things like this get overlooked. You may not even know how the changes to the MPFS are impacting your bottom line.

On Thursday, February 11, you’ll have a chance to get a great overview from expert Elizabeth Woodcock on what changes occurred on January 1 and how your Medicare reimbursement has changed based on your specialtyTweet this Kareo story

Here are a few highlights from her presentation:


To attend this free webinar, register now.

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Meaningful Use Hardship Exception Extended, But Not by Much

Lea Chatham February 8th, 2016

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Barbara Drury, BA, FHIMSS

If you won’t be able to successfully attest for Meaningful Use (MU) under the Medicare or Medicaid program for 2015, you may be looking at a payment adjustment in 2017. The only way to potentially avoid the MU penalty is by filing for a hardship exception. Tweet this Kareo story


The hardship exception process can be used if you tried to demonstrate meaningful use but had difficulties due to external circumstances. Essentially, you tell the Centers for Medicare and Medicaid (CMS) about the circumstances through an application form called the “2017 Payment Adjustment Hardship Exception Application,” which can be found on the CMS website. The deadline to submit the application was extended in recently legislation from February 29 to March 15, 2016.

Some of the external circumstances are self-explanatory (i.e., insufficient Internet, natural disaster, practice closure, bankruptcy, and complete lack of face-to-face interaction). One, not multiples of these may be selected as the primary reason that prevented you from demonstrating meaningful use. Two other hardships are also allowed:

  1. Lack of Control over EHR Availability: Typically this would apply to an EP who is an employee or contractor and provides 50% or more of his/her encounters in a practice where the EP has no control over the presence or use of a certified EHR.
  2. EHR Certification/Vendor Issues: Circumstances that may fall into this category include:
    1. Delays experienced by the vendor trying to get certified to the 2014 Edition
    2. Delays in vendor’s availability of installation and training resources due to a backlog of customers
    3. Decertification of the currently installed EHR
    4. Vendor decision to no longer pursue certification.

More than one eligible professional (EP) may be included on the application as long as the same hardship applies to all EPs listed. This application can be submitted electronically or by fax to a third party contractor on CMS’s behalf.

In addition to submitting the application to CMS, you must keep all records that would support the specific hardship being claimed: emails regarding sales, training, installation, available dates, sales invoices, training invoices, press releases regarding availability of EHR, certification, meeting minutes, etc. For 2017, these documents are not required to be submitted with the application but you must make them available upon request.

For more details on the application process or to start your application, visit the CMS website or the CMS Frequently Asked Questions.

If you are looking for help with Meaningful Use, check out the Kareo Meaningful Use Resource Center.

About the Author

Join Barbara Drury to find out what you need to know about meaningful use nowBarbara 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 served as 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 has served on the HIMSS Public Policy Committee and the Davies Ambulatory Award 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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Survey Shows Patient Use of Online Physician Reviews Growing

Lea Chatham February 8th, 2016

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A new study from Software Advice shows that reviews of physicians are having a greater impact on patient decision making. It turns out that the majority of patients are using online physician reviews in some way. Tweet this Kareo story

Nearly 85% of patients surveyed said they consult a reviews website to view or post comments and ratings of healthcare staff. And when using review sites, 77% of patients said they use them prior to choosing a physician, making it a crucial first step in selecting a new doctor.

“Our data shows online reviews are a very significant part of the selection process when it comes to healthcare providers,” says Market Researcher Gaby Loria. “Reviews-based rankings are often the first impression people get of a practice and can make or break a doctor’s online reputation. Seeing as more than three-quarters of patients surveyed use online reviews as their first step in finding a new doctor, individual physicians and large practitioner groups alike can’t afford to ignore the influence of these sites. ”

The impact of positive reviews is so strong that many patients would consider going out of network if the physician’s ratings were better than those of an in-network provider. “Good reviews have the power to loosen purse strings, as 47% of people in our survey say they wouldn’t mind going out-of-network to be treated by a well-reviewed health care provider,” says Loria. “It pays for practices to keep their web presence front of mind.”

Reviews are also playing a role in patient retention and satisfaction. According to the survey, 23% of the respondents said they use reviews primarily after selecting a provider or to evaluate a current provider. Half of of patients said they leave very positive or somewhat positive feedback while only 6% said they leave somewhat negative or very negative reviews.

The low number of negative reviews should be encouraging news for physicians, many of whom are hesitant to ask patients to leave reviews for fear of a bad one. Even more encouraging is that patients also said they would be likely to disregard a review that seemed exaggerated or where the author’s expectations seemed unreasonable.

The survey really indicates that there is definitely benefit in asking patients for feedback after a visit. Doing this is more likely to generate positive reviews than negative ones, and potential patients will probably view negative reviews with a critical eye.

The survey also asked patients what information is most important to them in a review. Quality of care was at the top of the list followed by physician ratings and patient experience. Within the category of quality of care, accurate diagnosis was the top concern. For the practice at large, staff friendliness topped the list.

This survey strongly points to physician reviews and ratings playing an increasing role in recruiting and retaining patients. With today’s affordable practice marketing automation solutions practices can’t afford not to focus on increasing patient reviews and improving their online reputation.

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Believe or Not: Patient Portals Can Improve Efficiency

Lea Chatham February 4th, 2016

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Patient portals really can save time for patients, providers, and practice staff. Discover how in this short video from Dr. Molly Maloof. Tweet this Kareo story

Are you interested in learning more about the benefits of engaging patients in your practice? Download 10 Ways to Engage Patients now.

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