Medical Billing System

The OmniMD Medical Billing system allows the practice to manage all patient billing and accounting seamlessly and efficiently. It is fully integrated with the EMR, appointment system and charge capture. Taking advantage of the information flow, it allows quick and easy billing while ensuring a high degree of accuracy and traceability.

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.

EMR, Transcription, Special EMR, EHR, Electronic Health Record

Medical Transcription in the Era of Electronic Medical Records.

EMR has revolutionized the healthcare industry in recent times. Many experts felt that EMR & Voice Recognition would totally replace Medical Transcription - however; the industry soon realized that transcription has certain advantages over point & click charting and many physicians preferred to dictate notes rather than document the data at the point of care themselves.

The most critical part of any Electronic Medical Record (EMR) is the method of data entry. EMR is about aggregation of patient encounter data at the point of care in order to provide a complete, accurate, and timely view of patient information. An electronic medical record is not just a typed record of the patient encounter, but an extremely useful decision support tool. The data can be entered into the EMR via any of the two general mechanisms: direct entry by the physician using point and click templates or transcription of dictated notes. Point and click template indicates that each data element, which is to be inserted, requires selection, navigation, point and click process for capturing patient information.

Transcriptions have been around for years for documenting patient encounters. A medical provider dictates the medical note into a phone or a recording device. The transcriptionist receives the dictation and transcribes it. It may be reviewed by the supervisor for checking errors. The final computerized file is then either emailed directly to the healthcare provider or the file is transferred to a web site and is later downloaded by the provider.

Each method has its pros and cons.
Point and Click Templates

Most EMR systems allow providers to generate clinical documentation, by selecting variable terms from pre-structured point-and-click templates. Users simply point and click to select appropriate choices from lists of choices to record a patient encounter. The end result would be a document that closely resembles a transcribed procedure note.

Advantages

• Completely customizable templates. The doctor can specify the layout of the template, which helps him to adjust the template as per his practice & procedure.
• Provide consistent, complete and accurate data. The chances of medical errors are reduced since the data is documented in customised forms.
• Provide consistent, complete and accurate data. The chances of medical errors are reduced since the data is documented in customised forms.
• Store / organize data for subsequent retrieval.
• Each click adds data elements to the database. Point-and-click systems create data that can be used to generate clinically useful reports, such as health maintenance reminders, disease management etc.
• One of the major advantages of template based charting is the time needed to make the document available as a medical record. Since notes are created within the EMR, they are available immediately upon completion.

Disadvantages

• It takes more time, and definitely more concentration for a physician to navigate through large data set and create progress notes using point and click templates.
• Templates must be customized as per the physician's requirement. Customization can be inflexible and costly.
• Well accepted by only tech-savvy doctors.
• The approach of direct data entry by the physician has generally failed because busy providers reject it altogether.
• Output from these templates is too canned and identical. It loses individuality for each patient.
• It is difficult for a provider to capture complete patient encounter on computer in front of a patient.

Medical Transcription

Transcription has long been the standard for documenting patient encounters. It is more convenient for a provider as compared to handwritten notes or electronic data entry. There are many advantages of transcription in comparison to point and click charting. There are a few disadvantages as well.

Advantages

• Corresponds intuitively to the physician's usual method of working. Dictation remains the most intuitive and least time-consuming means of data entry.
• Physicians can dictate anytime, anywhere using PDA, Dictaphone or telephone at their convenience.
• Providers need not change the way they practice just to accommodate an EMR. EMR can interact with transcription service so that transcriptions can be attached directly into the patient's electronic medical record, if such a facility is provided by the EMR vendor.
• Provides expressive power to describe patient's condition and other health related events.

Disadvantages

• Details of the exam can easily be forgotten and omitted while dictating, if dictation is not captured immediately at the point of care
• It cannot be queried for generating reports unless transcribed in pre-formatted templates
• Transcribed reports are not immediately accessible. Physicians would normally have to wait for 12 to 24 hours for charts to be delivered, unless few vendors supporting 2-4 hours short turn around time.
• Transcription provides for more efficient use of doctor's time.
• Although average transcribed report costs $2 to $4, it can reduce the doctor's time spent on data entry. Considering the value of doctor's time, transcription is not a costly proposition.
EMR should give the freedom to the physician to decide to use either Point & Click or Medical Transcription. For a physician, the EMR that fits into his practice workflow would be invaluable. A competent EMR must have a template driven charting feature and the ability to interact with a transcription service at the same time. Both are indispensable features of Electronic Medical Record Software, as doctors are not unanimous on point and click charting or transcription. Such an EMR will be both efficient and cost effective.
The trends in transcription itself are changing with Medical Transcription service providers aiming to adopt new technologies. These technologies will evolve to increase efficiency & accuracy, decrease turnaround time and support data capture. While many of these technologies like such as digital dictation and electronic signature exist today, several technologies are still on the horizon.