How can ACS help?
- Help streamline your data collection with an eye toward reducing denials and qualifying for PQRI and other incentives.
- Add Procedure Code modifiers as needed for maximum reimbursement.
- Ensure diagnoses are linked to procedures properly to show medical necessity.
- Submit and follow-up paper and electronic claims.
- Follow up with insurances and patients for payment.
An Electronic Medical Records software system will save you time and money, help qualify you for incentive payments and decrease your exposure to malpractice
Save Time\How much time does your office spend pulling charts? Verifying eligibility? Searching for codes?
What if all these tasks were near instantaneous?
The chart you need may be at one of your other offices, on the physicians' desk, mis-filed or even filed correctly. Pulling the chart still takes time.
With an EMR, the chart is neatly displayed quickly right there on your computer screen. The pages are not dog-eared, coffee-stained, unreadable or misplaced.
Patient charts reside at a single source that can be retrieved and notated by practitioners in multiple locations.
Instantly share a portion of the chart electronically with a couple clicks of the mouse rather than hunting it down, unbinding, copying and mailing it out and waiting a couple days.
Charting is uniform; easily track research programs, PQRI or other data.
Decrease the amount of time documenting your efforts; improve E&M coding and have the documentation to prove your efforts. Code databases integrated - ICD-9, CPT, HCPCS, NDC, Drug Interaction, NPI and many others should be integrated into your EMR.
Immediate access to your patients' medications, allergies, lab results, diagnoses, procedures, past visit notes.
Instantly see who has arrived, where in your office they are located and who has seen them.
- Suzy arrived at 10:00am and is in the waiting room filling out a new patient questionnaire.
- Charlie is in exam room "A", has was seen by your nurse at 10:12am and is ready for you.
- You finished with Tom at 10:07am and he is at the checkout counter receiving patient care literature, arranging for his next appointment and his prescription is being ordered.
What will you and your staff do with your extra hours?
- Increase the efficiency of your workflow, greatly reducing the need for paper, storage, wasted time and postage.
- Reduce or eliminate transcription costs; a good EMR creates reports for you, both by capturing your efforts as stored data and by allowing dictation into the computer via a microphone headset and voice recognition software.
- Eliminate space required to store charts, both in your office and at a records storage facility.
- Reduce the number of employees needed and/or free them up to do other tasks.
- Decrease your exposure to malpractice -- everything is documented and coding is automatically calculated to match the level of service and amount of time you've spent with a patient. A good EMR also allows you to override it's findings so that you may change the coding if you deem it necessary.
Streamline Your PracticeReduce Errors
Charges are captured as you go, at the point of care. A good EMR assigns ICD-9 diagnoses and CPT/HCPCS services as you indicate the reasoning for your efforts and what services you have performed.
Automate Your Orders
Write out a script, verify compatibility with existing medications and instantly trasmit electronically to your patient's preferred pharmacy. No need for you to fax or phone in precsriptions or translate scribble.
Transmit orders to a lab or radiology unit; your patient shows up and the techs already know what you want done. If the facility also utilizes an EMR, results and images are transmitted electronically back to you and neatly tucked into the patient's chart.
Alerts, prompts, reminders to improve compliance with recalls, appointments, drug interactions, many more.
An electronic paper trail which justifies the level of service performed.
Instant, secure communication between you, your patient, pharmacies, hospitals and other caregivers.
Your patient can log in and see his/her progress, ask questions, access literature and patient education -- all noted in the system s o that you can prove every step of your patient care processes.
Government IncentivesYou need a "certified" EHR that will meet the American Recovery and Reinvestment Act (ARRA) of 2009 requirements.
This software certification allows practices incentive payments ranging from $40,000 to $65,000 per physician over the lifetime of the incentive program (depending on which incentive program you are pursuing) if your EMR system is fully implemented by 2011 and you're able to take advantage of the maximum incentives from 2011 to the end of 2014.
To qualify for the Medicare ARRA incentive payments, physicians must fit Medicare's definition of a provider, furnish Medicare Part B services, meet the "meaningful use of Electronic Medical Records" standard and use a qualified EMR. ($40,000 - $48,400 if you qualify for the HPSA bonus)
To qualify for the Medicaid ARRA incentive payments, your patient base must include more than 30% who are covered by Medicaid. ($65,000)
Starting in 2015, practices that are not "meaningful users" of EHRs will be subject to the following penalties:
How do you choose an EMR?Make sure you choose an EMR that is CCHIT certified. The Certification Commission for Health Information Technology inspects products against comprehensive functionality, interoperability, and privacy and security criteria using the Commission’s published methods. Products must be fully compliant. They must also meet or exceed applicable proposed Federal standards for certified EHR technology to support the 2011-2012 incentives under the American Recovery and Reinvestment Act of 2009 (ARRA). As part of the inspection, key aspects of successful use are verified at live sites, and product usability is rated. The CCHIT website is available at http://www.cchit.org/
Make sure the EMR can be customized for your specialty.
ASP or in-house?
The ASP model is a remote computer system that hosts your EMR somewhere other than your office
You can access your EMR via the internet using a web browser, from anywhere.
The EMR server is managed by a professional IT company -- no worries about how to back up your data or how to get the system going again after a crash as these and all other hardware / software maintanence issues are handled for you.
You "buy in" for a portion of the total cost of the EMR package; you and other physicians are using the same system so many of the initial hardware and software costs are shared. Your speed of access is directly tied to your internet connection speed. Images may take a few seconds to download to your PC. You'll also require redundant failover internet connections so that if your internet "goes down" you can still access your data.
You're totally relying on the ASP host company. How quickly can they recover from a disaster? Will they go bankrupt next month?
The in-house model is a Client-Server environment where the EMR server exists at your office.
- You have total control over your own data.
- Access from inside your office is not dependent on the internet.
- Better functionality with on-site resources such as scanners, imagers, printers, etc.
- You still have access from outside your office.
- You pay up front for all the software and hardware required to run your EMR system.
- You are responsible for all your IT demands, including data backup, workstation and network troubleshooting, program updates, etc.
Can your current Practice Management (billing) software integrate with an EMR?
Some EMR products can integrate with another company's billing software (assuming that the billing software is able to export data in a standard format, most likely HL7. Be sure to ask if you want to continue using your current billing platform.
Many EMR products have an integrated Practice Management system available. Interoperability is of no question here. The EMR and PM are designed to work together.
Quality of Service
Expect to have some bumps in the road while you migrate to an EMR system. Be sure to check on the service level and responsiveness of the EMR software company. If you have to wait days, weeks or months for an answer or patch, you might be better served using a different EMR package.
Don't just listen to what the EMR provider has to say; be certain to contact current (and past if possible) users of the EMR package you intend to purchase. What stories do they have to tell? Are they still happy? Would they use this EMR again knowing what they know now?
While there are several very good and many horrible EMR software packages, we recommend eClinicalWorks with exceptions for some specialties such as Oncology and Anesthesia.
GlossaryEMR - Electronic Medical Records are created and maintained within a charting/billing software residing at a physician's office or clinic, a hospital or pharmacy, etc. and is maintained by the individual Care Delivery Organization.
EHR - Electronic Health Records is a name given to the ideal that some or all portions of a person's Electronic Medical Records, (culled from all physicians, hospitals, dentists, pharmacists, etc that the person has seen) be stored electronically and is accessible to all who require access or have legitimate business in viewing the record. The individual patient as well as his/her healthcare providers have access to the EHR. The healthcare provider may export chartnotes, diagnoses, etc. to the EHR or view remarks and findings exported from other providers. The patient also has access to the EHR and may view and/or append data as well.
PQRI - Physician Quality Reporting Initiative is a physician quality reporting system designed to improve the care of patients through evidence-based measures that are based upon clinical guidelines and includes an incentive payment for eligible professionals who satisfactorily report data for on quality measures furnished to Medicare beneficiaries. The incentive payment for 2010 is 2%
PECOS - The Internet-based Provider Enrollment, Chain and Ownership System is a way for providers to enroll and maintain their Medicare enrollment information online. Internet-based PECOS is available to physicians, non-physician practitioners, and provider and supplier organizations in all States and the District of Columbia. PECOS has a number of advantages over paper-based enrollment, and gives you quicker access to your enrollment information. Note that soon you must validate your PECOS record in order remain a valid ordering/referring entity.
Taxonomy Codes (HPTC) are a HIPAA standard code set and is a code representing your specialty. Taxonomy codes are national specialty codes established as an ASC X12 HIPPA standard used by providers to indicate their specialty at the claim level. Not all carriers require you to submit your taxonomy code.
NPI - The National Provider Identifier is a standardized provider identifier implemented with HIPAA and all health care providers are required to obtain and use an NPI as of May 23, 2007. The NPI replaces all existing provider identifiers used today (sort of - some carriers, especially Medicaid carriers, still require some form of legacy identifier in addition to or instead of the NPI) to identify health care providers as health care providers in HIPAA standard transactions. If you deal with Medicare patients in any way, you must have an NPI.
eRx - Electronic Prescribing System is a means of electronically communicating a prescription to a pharmacy. To qualify for incentive payments, your system must meet certain standards. Incentive payments for 2010 is 2% of the group practice's total estimated Medicare Part B Physician Fee Schedule allowed charges.
ARRA - American Recovery and Reinvestment Act of 2009; Within the ARRA stimulus package, funds are intended to enhance the use of Electronic Medical Records (EMR) by service providers and hospitals. You can receive a portion of the ARRA stimulus funding through the "meaningful use" of EMR. Practices NOT using a qualified EMR by 2015 will see a penalty in the form of Medicare reimbursement reductions.