Reap Benefits of EMR But Don’t Let it Dictate What to Document & Which Code to Use

Thu, Jun 26, 2014

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The E/M code suggestions offered by your EMR can be helpful; but that does not mean you can use that to justify all high-level codes.

Using electronic medical records (EMRs) in your practice comes with umpteen benefits – Be it saving time, creating legible documentation or sharing history with fellow providers. However, relying too heavily on EMRs could come with its own pitfalls.

Heed these three tips to know where your EMR system could be leading you astray:

Exam Documentation Does Not Carry Over

You may be relying on your EMR too much if it constantly shows E/M documentation that’s robust in one section and not so in another (such as exam). To cite an example, an auditor down-coded many of a practice’s E/M claims due to empty ‘physical exam’ sections in the documentation. The practice explained that the EMR vendor had told them that patients being seen for established problems already have documentation on file and that the EMR will carry it over from one visit to the next. But the truth is carrying information over for follow-ups is permissible for some degree of past medical, family, and social history and not for an exam.

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Five Reasons Why You Should Go Technical with Your Patient Records

Mon, Jun 23, 2014

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Moving to an EMR will ensure you boost quality of care and catch errors before they cost you money.

Converting from paper records to an electronic medical record system (EMR) is a huge effort and may leave you wondering whether making the change is really worth it. Check out these five reasons why experts urge you to take the ‘electronic’ way.

Boost for Quality of Care

Electronic systems often provide access to a database of national outcomes data from users of the same software – which is essential for measuring and improving your care.

One more advantage is that many of the systems will connect you to research the best practices for treating certain diagnoses. Therefore an EMR can really help drive evidence-based practice. Electronic systems can also help standardize your care. For instance, if your practice sees the same diagnoses quite often, you could bill shells for certain care plans so that you have some standardization of care to begin with.

Clients Anticipate EMRs

Whoever is buying your services wants to see a modern operation. Switching to an EMR is important because when a customer wants you as the vendor, you need to continue to meet the customer’s expectation. Moreover, a more modern feel in your clinic may help bring in patients who are shopping around for a physician/therapist or are alert to small details like being current.

Errors are Caught Before They Shows on Your Claims   (more…)

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Tighten Up Your EHR Privacy and Security with a Thorough Risk Analysis

Wed, Jun 11, 2014

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Reduce your HIPAA breach dangers and avoid steep penalties. 

With the increased enforcement and higher fines as well as the $10,000-minimum penalty for “Willful Neglect” of compliance, the compliance status of your electronic health record (EHR) system now matters more than ever. But you can reduce your Health Insurance Portability and Accountability Act (HIPAA) breach dangers and stay calm about your EHRs at the same time by performing a thorough risk analysis.

Why risk analysis

Risk analysis is the cornerstone of your compliance process. Risk analysis is mandatory under the HIPAA Security Rule’s Meaningful Use and the health Information Technology for Economic and Clinical Health Act.

Whom to involve

You and your staff can perform the risk analysis; however watch out that “the risk analysis can become quite technical.”  So it’s always best to have your IT staff involved, at least partially, if not throughout. You could check out your local regional extension center that provides tools and helps perform the risk analysis and resulting mitigation.

How often to perform risk analysis

One of the big questions is how often you should perform a risk analysis. You should try to do it at least once a year. You should also perform another risk analysis anytime there is a major technological or physical change. This may include a new EHR, a new component to your EHR system or new computer network architecture. (more…)

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Get CPT code updates with online CPT codes 2013 look-up, only on Supercoder!

Wed, Aug 21, 2013

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Diminish 2013 Transition hurdles with CPT code updates at your fingertips

This year has ushered in a lot of new codes which has potentially impacted each and every practice. Only the right resource will help you overcome all your coding and billing woes and make sure you are collecting deserved pay. Now you can easily get all the desired CPT information at your fingertips, save time, improve efficiency and keep your practice compliant and profitable.

Supercoder now offers user-friendly and time-saving online tools like Specialty Physician Coder, Code Search and Fast Coder that one can use to access all the new codes to stay compliant and profitable this year. Most of the time, coders find it difficult to search for the right code which are relevant to their practice but this year, Supercoder subscribers can easily find all the CPT code updates with just a click. With a new feature called the “Historical Reference toolbar”, one can easily search for updated CPT codes along with the deleted ones for all specialties.

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Industry Group Announces Top 5 HIT Companies for 2010

Wed, Jun 9, 2010

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The fevered search for HIT vendors continues for many health care organizations. It’s always nice to hear about vendors who are singled out for their excellence in the specific area of HIT — many companies claim to know the area, but do your research before believing what you’re told in a marketing meeting.

Five firms have made it to the top list of health care IT companies with the most potential in 2010, according to a HIT industry group. Read on to find out who they are.

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Doctors Need More Convincing To Support Home Care Device

Wed, Jun 9, 2010

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Doubt over financial viability could be the only thing holding them back.

Home monitoring devices could be the next big thing in health care, but the technology won’t catch on unless doctors get a more lucrative financial incentive for using the technology.

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Poll Finds Dramatic Impact of Telehealth on Health Care

Wed, Jun 9, 2010

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Respondents fear unresolved reimbursement issues could be a barrier.

The use of telehealth technology will have a positive impact on the health care industry over the next 10 years, a poll by Intel suggests.

Eighty-nine percent of the health care decision makers polled put their bets on the technology, but also expressed some reservations, including the reluctance of patients and caregivers to try it, and the issue of reimbursement.

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OCR May Expand Accounting of Disclosures under HIPAA

Thu, Jun 3, 2010

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HITECH Act requires use of EHRs as tools to inform about disclosures under Privacy Rule.

Health care organizations and providers thought they dodged a bullet long ago when they convinced HHS to exclude disclosures of patient data used in the process of treatment and payments from the HIPAA privacy rules. But now, thanks to the HITECH Act, HHS is back, wondering what would be so terrible about requiring an accounting of such disclosures now.

Through a request for information issued in early May titled HIPAA Privacy Rule Accounting of Disclosures Under the Health Information Technology for Economic and Clinical Health Act (75 Fed Reg 23214 May 3, 2010), the HHS Office for Civil Rights says it expects to learn more about the interests of individuals, and the administrative burden on covered entities as well as business associates, concerning accounting for such disclosures.

Under current standards of the HIPAA Privacy Rule, an individual has the right to receive a listing – known as an accounting of disclosures — that explains when a HIPAA covered entity discloses the individual’s information to others. The current rule, however, does not require a covered entity to list disclosures to carry out treatment, payment, and health care operations.

The HITECH Act of 2009 upgrades the current rule by providing an individual a right to receive information about disclosures made through a covered entity’s use of electronic health records for purposes of carrying out treatment, payment, and health care operations. To do this, the covered entity must have the capacity to track, store and compile a vast amount of information regarding EHRs.

Specifically, the OCR’s RFI seeks comments from health consumers and health care providers/organizations concerning:

  • What are the benefits to the individual of an accounting of disclosures made for treatment, payment, and health care operations purposes?
  • If you are a covered entity, how do you make clear to individuals their right to receive an accounting of disclosures? How many requests for an accounting have you received from individuals?
  • What is the feasibility of an EHR module that is exclusively dedicated to accounting for disclosures (both disclosures that must be tracked for the purpose of accounting under the current HIPAA Privacy Rule and disclosures to carry out treatment, payment, and health care operations)? Would such a module work with covered entities that maintain decentralized EHR systems?

After reviewing comments from the RFI, HHS is expected to issue a Notice of Public Rulemaking on the new accounting for disclosures regulations with a 60-day comment period, according to the law firm McDermott Will & Emery. Final rules will follow thereafter.

There is money to be given out to medical practices for using EMRs. AUDIO: Medical Coding 101: The Need-to-Know for CEOs.

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Twenty Ways Your Facility Could Be Violating HIPAA

Thu, Jun 3, 2010

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Use this checklist on your next walkthrough to make sure you’re not overlooking crucial security breaches.

It’s always a good idea to complete regular walkthroughs in your health care organization in order to quickly and easily monitor your staff’s HIPAA compliance.

Read on to find a helpful tool for HIT pros in the form of a checklist.

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Florida Turns to Voice Recognition to Bust Fraudsters

Thu, Jun 3, 2010

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Pilot program in South Florida enters testing stage.

Voice or speech recognition has been a useful technology for fields including special education, call centers, and national defense. The health care sector could be the next bandwagon passenger, as regulators in Florida are beginning to use voice recognition to combat fraud.

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