When it comes to potential for improvement, healthcare is frequently reactive as opposed to proactive. Instead of putting in place infrastructure to prevent it, it is frequently a race to remedy what went wrong.
EMR/EHR is a major financial outlay for providers for something that is not specifically a medical product, which is related to the aforementioned.
Since many doctor's offices are mainly concerned with collecting incentive money, EMR/EHR is frequently something that can be more easily viewed as administrative rather than helping patients.
EMR/EHR firms are attempting to differentiate their product from the competition from every point possible. While claiming that their EMR "software" also handles billing, several EHR/EMR suppliers include billing software with their products.
They also promote the idea that the billing and the EMR are "connected" to one another. They claim that customers can save money by handling their own billing and collections (Revenue Cycle Management), but everyone who is knowledgeable with RCM knows that this is simply untrue.
Personally, I think of the EMR as existing entirely independently of billing. Even while a provider may have billing software, doing the billing in-house is not always the best course of action. Actually, the majority of healthcare providers who outsource their medical billing already have billing software.
The problem for the majority of healthcare providers who choose to outsource is that they are aware of the need to maximize their reimbursement at all times, but they do not have experienced staff who can proficiently and consistently handle the billing, claims tracking, phone calls, denials and appeals process, staying up to date with the ongoing changes to healthcare mandates, clearinghouse and electronic submissions, credentialing, and they are aware that the experience they get from outsourcing.
Many providers are aware that outsourcing results in cost savings. A knowledgeable person in that position can be difficult to find, train, and retain in an office.
In the end, your billing software is only as good as the person using it, regardless of how good it is. The billing process determines a provider's income. No matter how amazing their software is or whether it is connected to their EMR/EHR, if they don't, they will lose money.
Your EMR/EHR and practice management solution's ten main characteristics can speed up the transition and help you save money.
1. Implementation:
This must be emphasized. Know your requirements and preferences before selecting an EMR/PM solution. By streamlining daily operations, enhancing the patient-physician relationship, and enhancing patient quality, an EMR/EHR should help medical practices provide better patient care.
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2. Management commitment:
Given this, a smooth transition requires the support of personnel and providers. This would entail assembling a small, tightly knit project team made up of "systems thinkers"—individuals with a clear understanding of how the existing organization operates but also the ability to envision how it might function in the future.
3. Dependable software that emphasizes practice requirements:
Specify which billing information that is unique to your practice or specialization the practice would want to collect.
Do encounters and super-bills get converted to claims by the EMR? With the practice management software does it "interface"? If not, the practice will undoubtedly take longer and cost more money. This feature (important for ophthalmology and optometry practices) should be applied with the proper fee application, taxes, and discounts for claims.
4. Real-time:
Electronic eligibility and claim filing should come standard in any EMR or EHR. Does the software have the ability to instantly verify a patient's eligibility? Do they offer direct claim verification through the clearinghouse?
5. Solid financial and accounting reporting:
Any billing elements of an EMR/EHR must have effective report management.
6. Electronic payment tracking:
The payment procedure should be fully documented. The ability to record and disclose each activity taken to submit a claim for payment should be among the features.
7. Real-time claims rejection analysis:
Clearly displayed error codes are a must. Users of this feature will be able to: quickly settle problematic claims; examine the causes of claim rejection; and provide the practice with the chance to monitor red flags as they appear and carry out various audits.
8. Billing codes:
This automated functionality allows for the direct pulling (interfacing) of E/M codes and procedures from the EMR/EHR documentation.
Services are promptly documented by retrieving patient data as it is submitted during patient history, physician notes, pathology and radiology inputs, procedures, and prescriptions. The embedded Meaningful Use dashboard aids providers in monitoring their progress toward certification
9. Multi-User, Secure, and User-Friendly:
Users should be able to employ strong embedded claims editing solutions, claim status technology that continuously monitors claims status for increased reimbursement, automatic claims submissions, to mention a few.
10. Monitoring, backups, and data recovery:
Prevention is always the best policy, so a system for system monitoring and backups should be solidly in place.
Streamline your medical practice with advancedmd software where you can access the EHR and PMS dashboard very efficiently.