Select an EHR certified by the Office of the National Coordinator for Health IT (ONC). A certified EHR is necessary to qualify for federal and local incentive payments.
Our income increased in large part due to significant fee structure enhancements available from third party payors for practices using a qualified EMR. The increases clearly have paid for the ongoing operating cost of the system.
November 28, 2009 - 8:58am — David Gorelick, M.D.
When we set up our system we took the top 100 codes used by each specialist/physician for the previous year. We set those up in favorite folders with common names so they would be easy to find. We maintain billing staff internally to process claims - although everything is streamlined with EHR's, the insurers still bounce things back and someone needs to process those that fall out. If I can't quickly figure out what code to use, I put a "billing note" in and ask the billing staff (one of which is a certified coder) to figure it out for me. If it is something that will be used commonly, we add it to the favorites folders in a place where others can find it.
I certainly don't know how everyone will set up their office support and EHR, but we haven't found this to be an issue. It did take a bit of prep work, similar to most other sections of the EHR prior to implementation, but the time spent to organize/customize the CPT section for our group was well worthwhile. If others looking to implement have systems that offer customization, spend the time at the start to organize everything as best you can to save everyone time during live use.
November 27, 2009 - 6:31pm — Yul Ejnes, M.D.
A mixed advantage/disadvantage is that the EHR requires the entry of ICD-9 diagnoses in order to enter test and procedure orders as well as charges. This ensures the greatest detail and specificity of coding, making the claims cleaner, thereby decreasing the number of bounced claims and improving cash flow. However, it comes at the cost of turning the clinician into a coder. Commonly used codes are not the problem, but when the patient with a painful right thumb or a lump on their thigh comes in, you appreciate why coders train to be coders. Googling the narrative + "ICD-9" often turns up usable diagnoses much faster than eClinicalWorks does.
November 24, 2009 - 10:58pm — David Gorelick, M.D.
Time is money. Any tool that improves efficiency will save time and provide return on investment - and then some. If you are willing to invest the time and effort to learn everything about your office workflow, along with everything about the EHR, you can make it work. You need to analyze the workflow of each component of your office and each component of the EHR. Find a way to match the technology to your workflow, but don't try to preserve workflow that is inefficient. Many will need to adjust their workflow to utilize the technology in a more efficient manner.
Don't just dive in. You need to step back, look at every aspect of the office workflow, do a detailed analysis and plan your implementation, training, and use of the EHR. Refresher training is key. Months after using the system, learning a new trick to save 10 seconds can be a pleasant eye opener to someone that thought they were doing it the most efficient way.
No matter how you look at it, computerizing each component job of a medical office will improve efficiency, save time, allow physicians and staff to do more for the patients, see more patients, document more effectively, produce quality reports, participate in P4P projects, get home earlier - a win-win situation all around.
September 14, 2009 - 6:59am — Lisa Shea, M.D.
The EMR is able to capture all the data points necessary for the appropriate E & M service. We had been grossly underbilling physician services before. We also saved tremendously on transcription costs.
Answers
Our income increased in large part due to significant fee structure enhancements available from third party payors for practices using a qualified EMR. The increases clearly have paid for the ongoing operating cost of the system.
Using an EHR? Yes - athena health
When we set up our system we took the top 100 codes used by each specialist/physician for the previous year. We set those up in favorite folders with common names so they would be easy to find. We maintain billing staff internally to process claims - although everything is streamlined with EHR's, the insurers still bounce things back and someone needs to process those that fall out. If I can't quickly figure out what code to use, I put a "billing note" in and ask the billing staff (one of which is a certified coder) to figure it out for me. If it is something that will be used commonly, we add it to the favorites folders in a place where others can find it.
I certainly don't know how everyone will set up their office support and EHR, but we haven't found this to be an issue. It did take a bit of prep work, similar to most other sections of the EHR prior to implementation, but the time spent to organize/customize the CPT section for our group was well worthwhile. If others looking to implement have systems that offer customization, spend the time at the start to organize everything as best you can to save everyone time during live use.
Using an EHR? Yes - eClinicalWorks
Disclosure: Owner/practicing partner of Aquidneck Medical Associates, Inc. Contracted as the Case Management Physician Advisor at Newport Hospital (a Lifespan affiliate) and as an advisor for BCBS of RI to help facilitate HIT integration in community practices
A mixed advantage/disadvantage is that the EHR requires the entry of ICD-9 diagnoses in order to enter test and procedure orders as well as charges. This ensures the greatest detail and specificity of coding, making the claims cleaner, thereby decreasing the number of bounced claims and improving cash flow. However, it comes at the cost of turning the clinician into a coder. Commonly used codes are not the problem, but when the patient with a painful right thumb or a lump on their thigh comes in, you appreciate why coders train to be coders. Googling the narrative + "ICD-9" often turns up usable diagnoses much faster than eClinicalWorks does.
Using an EHR? Yes - eClinicalWorks
Disclosure: Shareholder of Coastal Medical, Inc.
Time is money. Any tool that improves efficiency will save time and provide return on investment - and then some. If you are willing to invest the time and effort to learn everything about your office workflow, along with everything about the EHR, you can make it work. You need to analyze the workflow of each component of your office and each component of the EHR. Find a way to match the technology to your workflow, but don't try to preserve workflow that is inefficient. Many will need to adjust their workflow to utilize the technology in a more efficient manner.
Don't just dive in. You need to step back, look at every aspect of the office workflow, do a detailed analysis and plan your implementation, training, and use of the EHR. Refresher training is key. Months after using the system, learning a new trick to save 10 seconds can be a pleasant eye opener to someone that thought they were doing it the most efficient way.
No matter how you look at it, computerizing each component job of a medical office will improve efficiency, save time, allow physicians and staff to do more for the patients, see more patients, document more effectively, produce quality reports, participate in P4P projects, get home earlier - a win-win situation all around.
Using an EHR? Yes - eClinicalWorks
Disclosure: Owner/practicing partner of Aquidneck Medical Associates, Inc. Contracted as the Case Management Physician Advisor at Newport Hospital (a Lifespan affiliate) and as an advisor for BCBS of RI to help facilitate HIT integration in community practices
The EMR is able to capture all the data points necessary for the appropriate E & M service. We had been grossly underbilling physician services before. We also saved tremendously on transcription costs.
Using an EHR? Yes - NetSmart's Avatar
Disclosure: No ownership or financial interest in any related business or association