EHR/EMR Should Create More Efficient Billing
An EHR/EMR in conjunction with the right Practice Management (PM) software can make your billing more efficient. Of course for the most effective use of the billing component, you will need to do your pre-work and make sure the PM is set up with the appropriate allowable reimbursement in the system.
To get the most from the EMR and the clinical decision making rule your EMR needs to be set up to allow for those functions to work with your physician. Many EMRs offer benefits of saving time, improving completeness in records, and even prompting physicians for documentation. EMRs can also cover coding markers within the note helping with the level of the visit. You run into problems if you have people that try to shortcut the system. When, people shortcut the system they inadvertently delete coding markers that help with creating the proper visit level. This is very risky behavior and could lead to an audit.
Some of those risky behaviors are using a copy/paste function or an auto creation without customizing the data as it pertains to an individual patient. Another behavior is using a “one size fits all” template without options as a default. Your templates should be able to be tailored to pull in information as it pertains to the patient not just the symptom or the disease.
Once your EMR is set up, it should feed into your billing system. The right PM system set up correctly will work in conjunction with insurance company’s standards, as well as, health care guidelines. For your practice, it should help serve you by ensuring to weed out possible rejections from insurance companies before the billing is ever submitted; placing possible denials on hold to correct the issue before the claim is submitted.
Imagine the time that has been saved now versus the old system of submitting a claim… the claim was rejected. At which point you start over with finding the proper documentation and mail a second time. Of course we all know this can happen a third time where your claim is returned, then the claim is corrected and sent off in the mail once again. This brutal cycle can continue on and on.
With the billing system and the EMR working together, you gain valuable irreplaceable time for your staff and have the ability to receive your reimbursement even faster than before. At the crux of it all, real improvements in documentation and coding should be happening in your practice currently. You should be reaping the rewards of a successfully installed EHR/EMR and Practice Managenemt system.
If EMRs are not properly used, it can lead to inaccurate, outdated, or misleading information. All users of your EMR should receive complete training and education on how to use them correctly.
If PM systems are not properly set up and utilized, it can lead to extended wait times for reimbursement, and possible denials. Or it could be worse and lead to audits. If you do not have your system set up to maximize the benefits you should call your vendor or look to hire an outside consultant with experience to help you get set up.