Who gets benefit from ICD-10 delay? CureMD 13:26

The Protecting Access to Medicare Act 2014 has been signed into law by Obama that effectively patches the sustainable growth rate (SGR) formula into action and delays ICD-10 to Oct 1, 2015.

Reactions within the healthcare industry to the news of ICD-10 delay are similar to those of the teachers in school delaying the final exam. Students who are unprepared feel delighted and look forward to the spare time received to prepare and study for upcoming exams. But those students who have studied intensively, worked hard and paid for the tutors and spent a great amount of time, energy and effort for the upcoming exams are upset that their efforts have been wasted and they have to spend their time and resources again in order to be prepared for the exams in 2015.

So who is actually relieved?

• Ill –Prepared Vendor: Not all vendors are certain that their vendors are ready for the ICD-10 transition.
• Payers and CMS: Many providers have reported that payers are still not ready for testing. Like Medicare that won’t start the ICD-10 end to end testing until the end of July.
• AMA and Physician Practices: The AMA doesn’t want to move to ICD-10 entirely. They approximate that the cost of switching to ICD-10 will range from $225,000 to $8 million for practices which will force many out of business.
• Providers who need more testing, implementation, training or optimization: KLAS spoke with many different providers and they welcomed the delay as one of them says:  “we have breathed a sigh of relief on hearing the announcement. We will adjust our timeline for training and revise our plan accordingly.”

 

Outsourcing Medical Billing CureMD 08:35

For medical professionals most of the times the complex part of their job is not about patient care but medical billing. That is why most of the time medical practices have decided to outsource their medical billing. Some of the physicians and practices will be uncertain about making the switch but it has many benefits that can make the practice run effectively and efficiently.

For healthcare professional and physicians the decision to switch from in house billing to outsource medical billing requires a lot of research and better understanding of how medical billing affects a practice. Once this is understood, the practice can save a lot of money and stress by outsourcing the medical billing.

Reasons to go for an Outsource Medical Billing Company

• Reduction in billing errors- There will be huge reduction in billing errors once the practice outsource their medical billing to an outside billing company. The percent of claims that are rejected or denied will decrease, giving a maximum reimbursement on claims. The billing company will make sure that all the claims are submitted in a timely manner.

• Skilled professionals- Medical billing professionals are proficient in insurance rules and regulations as well as HIPAA guidelines. Outsourcing medical companies are expert in dealing with the insurance companies. They will be able handle the negotiations and stay in constant touch with them which ensures the accuracy of a claim.

• Ease up the providers- Many providers would prefer to focus on their patients rather than spending lots of time on the paperwork required for a claim. This becomes possible when outsourcing is done. Healthcare professionals often spend large part of their day filling out the details for medical claims and bills that they get very little time to spend with their patients.

• Improves scheduling- Excessive paperwork can affect the number of appointments that are scheduled by the healthcare provider. This will reduce the practices ability to become profitable and also contribute to the decrease in patient satisfaction.

• Saves time- Making the billing outsourced allow healthcare professionals to focus on the patient care rather than focusing on other technical details.

• Cost effective- The reason why outsourced medical billing is so famous among practices is that it is cheaper than a company doing its own billing. Those practices that outsource the billing are able to cut down on the unnecessary office hours that are required for the billing and the extra employees.

Outsourcing companies are better and affordable choice than in-house medical billing employees because they do not need benefits nor are they paid hourly salary. Instead these companies charge a flat rate per claim or collect some percent of the reimbursements on a claim. Outsourcing would lower the costs for medical billing allowing the practice to save money which can be further used as an investment for improved patient care.

Ways to make sure your practice selects the right EHR system CureMD 13:09

Getting your practice ready for the EHR implementation can be a difficult task. The truth is that the advice columns that you see usually contradict each other and the direction that you receive from your fellow physicians may not apply to your practice.

But there are these basic guidelines that every practice needs to know in order to purchase an EHR.

Measure your Practice’s Readiness

Is your practice ready to face the changes in workflow associated with switching from paper records to digital or from one EHR to another? To answer this you need to do analysis of both your clinical and financial circumstances.

You need to be financially ready. Having server-based EHRs would require high installation costs that can cripple your practice financially. Alternatively, having a cloud-based EHR can help ease down the financial burden by paying relatively inexpensive monthly fee with no startup costs. Next make sure if your staff is ready for the switch. If your staff is not computer literate than it can make the implementation slightly difficult, so look for a vendor that has a dedicated implementation team to provide you a smooth transition.

Make a Plan

Plan for Implementation begins by knowing how the new EHR will affect the operations in the short term. Initially the implementation will be slowed down while the staff gets accustomed to new systems do don’t expect your practice to be performing at a maximum efficiency right at the start so adjust your expectations accordingly.

You also need to address the concerns regarding the security issues that may occur as a result of implementation.  Review the new HIPAA rule regarding the financial penalties for non compliance, in order to make sure that your practice is in compliance once the implementation is complete.

Sift through the vendors

Once you are ready with a plan, start looking at potential vendors. To find out which solutions will work for your practice, give the vendors common office and patient scenarios so they can know how their software will handle these issues. It is also important to ask your vendor to be clear about costs. 

Don’t only rely on whatever sales person tells you. Speak to current users in your specialty and get some idea of how the software will work and what changes it will make to your practice.

Deciding to implement an EHR is one of the biggest decisions your practice is ever going to make. So make sure you don’t rush into buying a new EHR system, instead analyze your practice, plan and conduct a comprehensive research before making up your mind on a new EHR solution.

Improved Care Coordination CureMD 08:51

As we see that medical practices and technologies have advanced to give a sophisticated quality care it is necessary to have the teams of healthcare providers, primary physicians, nurses, technicians and other clinicians.

Each member of the team has its own specific interaction with the patient and depending on the team’s individual member’s area of expertise; every person would have a different view of the patient. Thus in effect the view of the patient by the healthcare can become fragmented into different pieces of facts and symptoms. Healthcare provider requires less broken views of patients.

Having an EHR across the continuum of care allows for:

• Better integration between providers
• Up to date medication lists
• Standardization of data, order sets and care plans
• Giving access to experts for rural health care providers by  sharing with them the  best practices
• Faster, convenient and simpler management of disease

How EHRs improve Coordination 

Electronic Health Record (EHR) systems help decrease the disintegration of care by providing a better coordination. EHR allows to organize and integrate the health information and makes its distribution easy among all the providers that are involved in the patient care. For example, alerts from EHR can be used to notify providers when a patient arrives in a hospital, allowing the hospital staff to follow up with the patient.

Using the EHRs providers can access to accurate and up to date information. This is important with those patients who are:

• Visiting several specialists
• Making a changeover between care settings
• Have received treatment in emergency settings

EHRs allow better availability of patient information that gives reduction in medical errors. Thus have a improve care coordination leads to a better of care and an enhanced patient outcome.

Solo practitioners are half as likely to adopt EHRs, but why? CureMD 07:24

The news may not be of a surprise to anyone who works in a smaller medical practice, Commonwealth Fund has revealed a new that shows that solo physicians are half as likely to adopt the EHR technology as compared to the larger group of primary care providers. Practices of twenty or more have an overall EHR adoption rate of 90%. While one in two solo practitioners have access to this technology.

Although small practices have been supported by regional extension centers (RECs) and encouraged by incentive payments, those practices that have distributed the financial burden between themselves are more successful in overcoming the barriers that are consistently faced by the solo practitioners.

The collected data from 2009 to 2012 confirms that despite the $18 billion in incentive payments from CMS the obstacles faced by small practices haven’t gone away. A significant financial expenditure is needed to build infrastructure and upgrade computers which is not possible for the solo practitioners. Despite the work of RECs that offers valuable guidance during the process of picking an EHR, meeting the challenges of Meaningful Use etc. physicians themselves need to take a great deal of monetary responsibility on their own shoulders for the success of these projects.

Physician who read the horror stories of hospitals getting bankrupted may not want to risk their business that they have created from nothing. Older providers who are nearing retirement see little reason to invest in this technology that is difficult to use for them.

Patient interaction is important to those physicians who work in the independent settings and this is no secret that patient-physician relationship changes when a laptop enters the room. A research study from Northwestern University verifies that physician get absorbed in their screens  to a high extent, frustrating their patients who rely on a personal connection to most actively participate in their care.

Those solo physicians who have accepted Medicare might start regretting their decisions that they have made once they start facing the financial penalties for not participating in the EHR Incentive Programs. Two percent of Medicare reimbursements don’t seem like a killer, but CMS also requires participation in a variety of different electronic quality programs that gets easier when a provider uses EHR. Those who drop out of this can find around 10% of their reimbursements stop pouring in through the door and this can be a big problem for solo doctors.

Independent physicians who are at the edge regarding the EHR adoption still have lots of resources to help them who are on the hurdle regarding the adoption of EHR still have plenty of resources available to them and they are not alone in this.