Integrating Medical Billing with EMR

Doctors work in a competitive and changing environment. Consumers are more demanding, regulations are more stringent, costs are rising and government reimbursement is constrained. On the other hand, increased use of IT tools has revolutionized the profession by enabling efficiency in the practice workflow. There remains the problem, however, of gaps between the medical practice, its back-end systems and the physicians.

The primary concerns for a medical practice are:

• Documentation

• Revenue

• Increasing Overhead

A medical billing service is a doctor's key to getting paid. Although the medical profession is adopting various systems to streamline workflow, most doctors are still finding it difficult to get paid fairly and quickly.

In addition, insurance companies regularly change their medical review policies with respect to claim payments. Rejected claims due to non-compliance or submission errors result in a decrease in reimbursement and, hence, revenue.

It is essential that the practice be well organized and control its practice management processes efficiently to ensure profitability. It is important for the practice to recognize and address the various bottlenecks present in its workflow and information management. The need is to streamline workflow and documentation, improving communication and reducing wasted time and resources associated with patient visits.

Integrating Medical Billing with EMR

With the increasing acceptance of EMR by physicians, it is essential that they adopt a system that automates the entire billing process – starting from point-of-care through reimbursement by the payer. Information technology has provided the tools required to efficiently manage a practice.

To date, there is a tendency to have multiple systems carry out the different operations of a practice – EMR for clinical documentation, practice management for billing and financial administration, document management for patient reports, appointment scheduler for appointments and so on. Therefore, integration of such islands of data is essential to get the maximum benefit of technology. This will ultimately increase the efficiency of the billing process, leading to an increase in cash flow by creating an end-to-end solution that ties together the entire physician office from scheduling to treatment and finally, to billing.

Advantages of Integration

· Easy to Use and Easy to Manage

Once a patient record is entered in the EMR, the information is automatically shared with the billing system. Redundant entries are automatically eliminated because access to all patients' demographic and insurance information is quickly distributed from one central point to other modules. Procedure codes, diagnosis codes and other information added just once during treatment are made available for billing. Super bills with procedure and diagnostic codes are transferred to the billing system and can be used to generate and send claims.

· Improve Cash Flow and Collections

Physicians can quickly and easily select the proper procedures and diagnoses and create electronic super bills right at the point-of-care. While capturing the charge, the software checks the accuracy of the CPT and ICD codes to ensure wrong charges are not sent to the insurance company. Some systems come with an E&M wizard for capturing appropriate level of coding. This creates complete ‘super bills' with the right coding. As a result of direct integration, with all the required fields filled out correctly, the practice is able to get claims out in just a few minutes, instead of the usual day or two.

· Practice and Patient Reporting

Integration of the billing system with EMR helps in generating customized reports. Easy access to all supporting documents/reports required for claim processing helps in managing the entire process in a far more effective way - compared to a stand-alone billing system. Also in case of audits, complete patient charts and documentation is available for verification.

· Online Insurance Eligibility Check

Some EMR providers also offer the facility of instant online check for insurance eligibility to verify a patient's medical benefits. This information provides assurance that the insurance record on file is current before services are delivered. The feature streamlines the patient registration process - claims are sent to the right insurance carrier, thereby decreasing the number of rejected claims, fewer days in AR (accounts receivable) and ultimately resulting in increased revenue.

All these advantages lead to an increase in revenue generation in much less time compared to any other conventional method used for medical billing. Integrating billing with EMR reduces the large amount of associated paperwork, the problem of collecting from non-paying patients and the overall collection costs. Streamlining practice workflow in this way will enhance productivity, efficiency and quality of care.

Integrating Medical Billing with EMR

Author: Divan Da've

Doctors work in a competitive and changing environment. Consumers are more demanding, regulations are more stringent, costs are rising and government reimbursement is constrained. On the other hand, increased use of IT tools has revolutionized the profession by enabling efficiency in the practice workflow. There remains the problem, however, of gaps between the medical practice, its back-end systems and the physicians.

The primary concerns for a medical practice are:

• Documentation

• Revenue

• Increasing Overhead

A medical billing service is a doctor's key to getting paid.  Although the medical profession is adopting various systems to streamline workflow, most doctors are still finding it difficult to get paid fairly and quickly.

In addition, insurance companies regularly change their medical review policies with respect to claim payments. Rejected claims due to non-compliance or submission errors result in a decrease in reimbursement and, hence, revenue.

It is essential that the practice be well organized and control its practice management processes efficiently to ensure profitability. It is important for the practice to recognize and address the various bottlenecks present in its workflow and information management. The need is to streamline workflow and documentation, improving communication and reducing wasted time and resources associated with patient visits.

Integrating Medical Billing with EMR

With the increasing acceptance of EMR by physicians, it is essential that they adopt a system that automates the entire billing process – starting from point-of-care through reimbursement by the payer. Information technology has provided the tools required to efficiently manage a practice.

To date, there is a tendency to have multiple systems carry out the different operations of a practice – EMR for clinical documentation, practice management for billing and financial administration, document management for patient reports, appointment scheduler for appointments and so on. Therefore, integration of such islands of data is essential to get the maximum benefit of technology. This will ultimately increase the efficiency of the billing process, leading to an increase in cash flow by creating an end-to-end solution that ties together the entire physician office from scheduling to treatment and finally, to billing.

Advantages of Integration

·  Easy to Use and Easy to Manage

Once a patient record is entered in the EMR, the information is automatically shared with the billing system. Redundant entries are automatically eliminated because access to all patients' demographic and insurance information is quickly distributed from one central point to other modules. Procedure codes, diagnosis codes and other information added just once during treatment are made available for billing. Super bills with procedure and diagnostic codes are transferred to the billing system and can be used to generate and send claims.

·  Improve Cash Flow and Collections

Physicians can quickly and easily select the proper procedures and diagnoses and create electronic super bills right at the point-of-care. While capturing the charge, the software checks the accuracy of the CPT and ICD codes to ensure wrong charges are not sent to the insurance company. Some systems come with an E&M wizard for capturing appropriate level of coding. This creates complete ‘super bills' with the right coding. As a result of direct integration, with all the required fields filled out correctly, the practice is able to get claims out in just a few minutes, instead of the usual day or two.

·  Practice and Patient Reporting

Integration of the billing system with EMR helps in generating customized reports. Easy access to all supporting documents/reports required for claim processing helps in managing the entire process in a far more effective way - compared to a stand-alone billing system. Also in case of audits, complete patient charts and documentation is available for verification. 

·  Online Insurance Eligibility Check

Some EMR providers also offer the facility of instant online check for insurance eligibility to verify a patient's medical benefits. This information provides assurance that the insurance record on file is current before services are delivered. The feature streamlines the patient registration process - claims are sent to the right insurance carrier, thereby decreasing the number of rejected claims, fewer days in AR (accounts receivable) and ultimately resulting in increased revenue.

All these advantages lead to an increase in revenue generation in much less time compared to any other conventional method used for medical billing. Integrating billing with EMR reduces the large amount of associated paperwork, the problem of collecting from non-paying patients and the overall collection costs.  Streamlining practice workflow in this way will enhance productivity, efficiency and quality of care.

NJHIMA 2008 Annual Meeting

Omni MD ™ showcases its Electronic Medical Records (EMR), Medical Transcription, Practice Management, Patient Portal and Document Management Solutions at New Jersey Health Information Association (NJHIMA) 2008 Annual Meeting. Omni MD ™ ( www.omnimd.com ), a leading developer of CCHIT Certified and HIPAA compliant healthcare practice solutions, presented its new version of its Electronic Medical Records (EMR), Medical Transcription, Practice Management, Patient Portal and Document Management Solutions at New Jersey Health Information Association (NJHIMA) 2008 Annual Meeting held on June 19and 20, 2008 at the Bally's Atlantic City in Atlantic City, NJ. Electronic Medical Records, Practice Management, Medical Transcription, Document Management and Conversion, Patient Reminder and Patient Portal was highlighted at the event. New Jersey Health Information Association (NJHIMA) 2008 Annual Meeting ( http://njhima.org/AnnualMeetingHome.htm ) is New Jersey's largest meeting of Hospitals and Practices. With over 55 exhibitors showcasing their products or services, the event was an ideal platform for Hospitals and Physicians to network with peers, experts and vendors while exploring the benefits of the most innovative health information technologies. Divan Da've, CEO, Omni MD ™ says "The aim at NJHIMA 2008 Annual Meeting was to showcase Omni MD ™ Integrated EMR and Practice Management, and highlight its strong customization and point and click features. We also used this opportunity to present an overview of our integrated services such as medical transcriptions, patient portal, patient reminder and document management to private practices and hospitals." The CCHIT certified Omni MD ™ Electronic Medical Records Software (EMR) addresses the vast information needs of practices and hospitals. The EMR system also includes specific ICD codes and CPT Codes that are used to capture accurate charges and quickly generate electronic superbill at the point of care. Omni MD ™ solution is HIPAA complaint and it can be fully integrated with billing, practice management and other HL7 compliant software. To meet specific practice needs, Omni MD ™ offers customizable point­ and ­click templates and it can also accommodate specialty forms and templates that are currently being used by the physicians. Attendees were able to experience the product first hand and learn more about how EMR can improve their practice workflow and patient care by migrating from paper ­based health records to EHR systems. Omni MD ™ offers specialty EMR software for Cardiology, Dermatology, Endocrinology, Gastroenterology, Family Practice, Internal Medicine, Neurology, OB/GYN, Ophthalmology, Orthopedics, Urology, Pain Management, Pediatrics, Psychiatry and Pulmonology. Omni MD ™ 's Electronic Medical Records (EMR) suite comprises of Appointment Scheduler, Patient Reminder, Online Eligibility Check, Charge Capture, Prescription Writer, Specialty EMR, Point and click, Referral Management, Document Management, Lab Interface, Patient Education, Medical Transcription, Integrated Medical Billing Services and Practice Web Site. Omni MD ™ EMR Suite is a fully integrated solution for a physician who is looking to automate practice workflow without worrying about operating on different systems and platforms or implementing technology in patches.