Advanced Revenue Cycle Analytics: An Overview


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.

EMR vendors are correct when they advertise coding as a feature. However, vendors and clients have a different idea of what the coding component or on-board editing function will actually do. EMR vendors usually offer standard CCI edits and an E&M generator, without much flexibility. They are not configured to handle exceptions, allow users to write their own edits, or account for carrier specifications. Clients want those options. They expect EMR billing to account for everything their veteran billers know, but all of the workarounds, exceptions, variations, and preferences are not considered in current EMR billing workflow.

Delivering coding feedback to the physician in EMR templates slows them considerably. Physicians should not be burdened with the coding process; their job is to see patients. Feedback should be given to those who have the knowledge and responsibility to correct charges at the appropriate time: medical coders and billing staffbefore the charge is posted to the Practice Management (PM) system to reduce claim denials.

Bridging the Gap

With White Plume solutions, you can bridge the gap between where your EMR is today and the EMR of the future. Use AccelaSMART for scrubbing charges to promote clean claim submission, which helps increase reimbursement. This customizable engine can be built to handle modifiers, physician quirks, and insurance differences, while being updated quarterly for LCD, NCD, and industry-standard edits.

Physicians should not be bothered with coding feedback. AccelaSMART delivers these edits to the billing staff to take appropriate action. Billing staff can then make appropriate changes and then post them to a Practice Management (PM) system. 

Why endure EMR templates and still require multiple employees to verify, edit, correct and resubmit claims that could be passed throughAccelaSMART and submitted cleanly the first time?