One of the most famous examples of the law of unintended consequences is Kudzu. Introduced to the United States in 1876, the plant was originally intended as erosion control. Currently spreading at a rate of 150,000 acres per year, the plant will overtake everything in its path when left unchecked. What are the unintended consequences created by your EMR implementation? EMR systems were intended to function as a clinical application that would replace the traditional paper chart with an electronic record that was more readily accessible, searchable, and shareable. As users began to input data into the EMR, administrators noticed all of the information necessary for billing could be captured from the EMR. When physicians use EMR templates to build charge information in their EMR, charge data can be passed directly to the PM system for billing. This could save a practice time on charge entry and eliminate the paper superbill! This is where the problem began.

Providers are fighting to be reimbursed for every dollar. Getting reimbursed properly requires back office staffs to diligently pay attention to changes in payor rules.

"Mind the gap" is a warning for passengers to take caution while crossing the gap between the train door and the railway platform. Introduced in 1969 on the London Underground, this warning also serves physician practices well as they pursue the important goal of implementing an electronic medical record (EMR). 

As you prepare for the ICD-10 changeover on October 1, 2013, what will you do with your paper superbill?

The new 5010 claim standard is driving new requirements in drug reporting, specifically for drug quantity and the unit of measure.

Rhonda Buckholz, vice president of ICD-10 training and education for the American Academy of Professional Coders (AAPC), addressed the American Academy of Otolaryngology (AAO) last week during the Annual Meeting and Expo in San Francisco. Ms. Buckholz explained that the forthcoming change from ICD-9 to ICD-10 will have a substantial impact on the entire practice.

Miscommunication between software vendors and physician practices is not only common; it has become an expectation among experienced healthcare administrators and consultants. In such cases, the vendor has over promised and under delivered. Although rarely intentional, it costs the practice valuable time and resources. One of White Plume Technologies’ fundamental operating principles is to under promise and over deliver.

What does White Plume Technologies contribute to the healthcare technology field? Find out in this question and answer session!

Meaningful Use Traps EMR and EHR Vendors There is a vast difference between what electronic medical record (EMR) or electronic health record (EHR) vendors are delivering and developing today and what physicians and their practice leaders want. The natural market-driven improvements that occur when software begins to achieve widespread adoption have been hijacked by an outside force. HITECH has not only injected the federal government into the EMR market by bringing a checkbook and gun to the game, but has also come between the healthy process of customers giving vital feedback to software vendors that allows vendors to improve the flexibility, usability, and economic benefits of their products.

EMR Gap Electronic medical record (EMR) systems have not reached the utopian level everyone expects; therefore an EMR gap exists. For the time being, the billing portion is lacking. All practices have different billing workflow, carrier contracts, and processes for handling exceptions. With EMRs, entire billing processes are not taken into consideration.

Can the hospital charge capture process evolve into something more professional than scribbled notes written on tongue depressors and lunch receipts? A more convenient and efficient option should be available. Physicians generally see roughly 25-75 patients a week in the hospital. The potential for lost charges is astronomical. Of those physicians, a generous 75% are still using paper based formats – or the backs of coffee sleeves – to document their charges, putting a heavy weight of responsibility on their shoulders for getting that information over to the billing staff. With the amount of innovation going on in the world, why does healthcare always seem to lag behind? It shouldn’t.  AccelaMOBILE is White Plume Technologies’ cloud-based application for capturing charges in the hospital. Users have the freedom to use their iPad, iPhone, Android, tablet computer, laptop, or desktop computer wherever and whenever they would like to capture a charge. AccelaMOBILE gives physicians the freedom to cut the cord and minimize lost charges. Often times, practices lose full reimbursement of services rendered because the encounter information never makes it back to the billing office. AccelaMOBILE removes that risk and ensures all charges are delivered electronically–and immediately–to billing staff. The best part: AccelaMOBILE is 100% free. No contract,...

To be reimbursed for the services practices provide, proper medical coding is required for insurance claims to be accepted. Medicare, Medicaid, and all private carriers each have separate rules about what they require in certain circumstances. HIPPA has been working to fix this problem, but many White Plume clients articulate this has not happened yet. Offices have to remember in this particular scenario, at this particular location, with this particular payer, this is required to be reimbursed appropriately. Billers and medical coders store that information on sticky notes, in notebooks, or in their heads. White Plume accelerates the process of storage, retrieval, and execution of the information to make sure it is disseminated to the right person at the right time, thereby also accelerating the entire revenue cycle. From a medical coding perspective, reimbursement rules continue to change and evolve over time. A rule gets changes, a claim gets denied, and a new protocol is necessary for the practice to be reimbursed in subsequent similar encounters. White Plume Technologies provides an accelerated tool to help identify those changes and prevent future mistakes. White Plume’s accelerated intelligence product, AccelaSMART, retains coding regulations from all of the different geographies around the country, insurance carriers, or even provider specific requirements, to comprehensively review all charge...

Reimbursement defined For physicians, reimbursement is about getting paid for what they have already done. After providing services, prescriptions, or advice, they are entitled to payment. For this to occur, medical coders, billers and practice managers must intervene. They try to document the correct CPT codes, with the correct modifiers, in the correct magic formula so insurance company will pay the practice correctly the first time. Otherwise several things may lead to denials such as missed modifiers, insurance-specific codes, new rules, and lost charges.

October 1, 2013 is the cut over day for practices to convert from the almost 30 year use of ICD-9 to ICD-10. While this conversion will obviously affect medical coders and billing staff, most of the marketplace is overlooking the impact this will have on the physician.

White Plume occupies a very unique niche in the Healthcare Technology field. AccelaSCAN, AccelaCAPTURE, AccelaMOBILE, AccelaPASS, and AccelaSMART accelerate the charge capture and coding review process. Many times practices use White Plume to fill the EMR Gap between their current electronic medical record (EMR) or electronic health record (EHR) and the ideal EMRs/EHRs of the future.

Medical Coding Today Accurate medical coding is essential to getting paid, regardless of the method used by the physician for capturing the charge data (e.g., paper encounter forms, electronic medical record). Strictly entering the correct codes for a procedure or diagnosis is never enough. After a physician finishes documenting a patient encounter, the claim is sent to the billing office for a final review. When an encounter is in the hands of billers and coders, the complex rules of medical necessity, correct coding and carrier-specific insurance rules come into play. If a claim is denied, it is most often due to data-entry errors, gender-specific/age-specific errors, registration errors, missing modifiers, or a lack of medical necessity. Reprocessing denied claims accrues additional costs and takes away from the practice’s bottom line.

Charge Passing From EHR to PMS The notion of EHR systems passing charge records directly to practice management systems seems logically appealing. Many of the work steps of the EHR in recording an encounter are identical to the PM work steps involved in billing the encounter. As the EHR system performs its time-of-encounter operations, it may locate and select the desired single appointment record—or at least the patient record—out of a collection of appointments (e.g., for this date and time, for this provider, for this patient at hand). The selection must describe or be associated with its location or place of service, and its provider. It must allow the user to record the procedures and diagnoses of the encounter by using common industry code sets (i.e., CPT and ICD codes). All these things are present during the encounter cycle for an EHR system. These data are essentially the elements of a billing record—the patient, the provider, the date, the location, the procedures, and the modifiers. So to many, the intuitive next step is to connect (i.e., interface) the output of one with the input of the other.  Encounter charge records out of EHR become encounter charge records into a PM system. Problems Between EHR and PMS Direct connection from...