As the use of various technology systems continues to increase within medical practices, interoperability between those systems becomes critical. An article called, “Interoperability a Key to Effective Communication” on the AAPC website states, “Disparate computer systems must communicate structured data in a way that both systems understand.” Consequences of having disparate systems could mean a…
Physician practices are concerned with finding EMR software that meets the needs and requirements of their particular organization. CTS Guides, a research company located in Rockville, MD offers a free Medical Software Selection Kit to help healthcare practices compare and review software options, define needs, prepare questions to ask vendors during demos, and gain more control over the software selection process. The kit provides software reviews, comparative product ratings including over 800 features, and a template to plan and rate vendor demos. To find out more about CTS and access the kit, click here.
Of course, no EMR or PM system is perfect. Ideally, each practice would employ an EMR and PM system vendor that would create a version to completely fit their situation. Without a perfect option, you should choose the best option for your circumstances. The following articles will help prepare you for the technology selection process ahead:
- Want a plethora of Medical Group Management Association’s (MGMA) EMR/EHR recourses? Visit a list here.
- How should you selecting the right EMR vendor for your circumstances? HIMSS’ article explains.
- What should you consider before changing PM systems? Read about this here.
- Want to know one vital component most EMR vendors offer but most practices fail to use, leading to denied claims? Read this article.
As anyone in the coding world knows, modifiers are a critical component for accurate billing and maximum reimbursement. The notorious complexity of modifier rules creates considerable lag when it comes to the forms review and editing process. The questions below highlight key factors that must be taken into account when applying modifiers to procedures. What…
I speak with clinics representing as many as 30 specialties, ranging from small practices of a few providers to practices consisting of hundreds of providers, nearly all of which have one thing in common: They are adopting new practice management systems.
No Such Thing as Perfect PM System
One thing is certain, no two clinics are alike. Not in workflow, billing needs, or in what they see as priorities for their organizations. In an ideal world, each system would be implemented in a fully customized fashion to meet the needs of a practice. Unfortunately, we don’t live in such a world. There is no “out of the box” perfect practice management system for a clinic. There is, however, a best solution for each individual clinic.
Ask: Why are you Changing?
Too often I speak with clinics that are in the process of changing PM systems that are unable to answer the question, “Why exactly are you changing systems?” The few who answer often reply with a vague: “the physicians wanted to,” “we feel like there is a better solution out there,” or “the clinic next door just signed paperwork with a new system.”
If you are thinking of changing, consider the following steps to start the decision process:
- List specifically what you are looking for in a new system.
- Read it out loud. If it makes sense, evaluate. There is certainly an advantage to knowing your options.
- Take a questionnaire that walks you through the new vendor/PM selection process
- Ask your current vendor for a list of features and functionality they have customized for your clinic over the years. Make sure any alternative systems can accommodate established clinic workflow and procedures.
- Consider: Are you maximizing your current system? You may find that some or all of your desired functionality already exists in the system you have already paid for!
Years are spent perfecting current workflows, processes, and procedures around existing technology in order to create the perfect practice management system. If an EHR is driving your purchase, is it worth the disruption to implement a new practice management system as well? Or, would you consider taking the “best of breed” approach?
Choosing a New PM System
If you decide to choose a new PM System:
- Be sure the new vendor can accommodate your clinic’s requirements.
- Ask for several references of the new system.
- Ask clear and specific questions about the new system and vendor.
Unfortunately, clinics often experience tremendous disappointment after implementing a new system—usually a result of not completing enough new vendor research. While it is easy to believe purchasing a new system will solve all current frustrations, clinics often find that they are simply replacing their known problems with a new set of frustrations.
I challenge clinics to do their homework. Take a step back and look at the bigger picture. Take a moment before valuable time and resources are invested in a new system and answer the question, “Why are you looking to replace your current system?” Are you using your current system for everything it has to offer?
— Shelley Scarbrough, Client Account Representative, White Plume Technologies
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? Think back to charge entry employees. Usually, when keying charges into the PM system, the process is more complicated than simple data entry. Those employees are required to actually fill gaps in the claim that were missed by the physician or are required by every insurance carriers. When the charge entry process is automated by EMR, charge data flows directly from the physician into the PM system without the benefits of a claim review.
Are you brave enough to have charge data go directly from physicians onto a claim? Most physicians do not want to be medical coders or have to remember thousands of coding rules that apply in different scenarios with different payers. Most billing and A/R staffs would rather not receive denials resulting from charges going directly from physicians onto a claim. The solution most billing managers employ is to designate the same charge entry employees used prior EMR templating to review the charges from the EMR and make corrections prior to submitting the claims. This erodes the savings from automating the charge entry process!
Be careful not to let the kudzu overtake your carefully manicured billing process. Overgrown already? Seek a medical coding and claim scrubbing solution today.
When u look at the typical project plan for an EMR implementation, the clinical components are typically the focal point: template selection and customization, physician training, clinical workflow, etc. Automating the charge capture and coding elements are usually placed at the bottom of the work list and may never get fully implemented.
When many EMRs were originally designed, charge capture and coding was not a major design objective. As an ancillary feature and benefit of EMRs—untested in the real world—that EMRs could replace the superbill began to appear in sales presentations.
“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).
White Plume’s code scrubbing capabilities came to the rescue of one orthopedic practice.
It is a very difficult and trying time in healthcare today for both the business and the clinical leadership of a practice to try to navigate themselves from where they are today to where they want to be in the future. It’s really kind of a perilous type of proposition.