Bradford Scott Medical

Bradford-Scott Data Corporation and GI Pathology are pleased to announce the opportunity for your Gastroenterology practice to participate in a lab donation program for EHR software, consistent with applicable law.

Donation Period: March 15, 2010 – June 15, 2010

Donation Geographic Area: National Offering

Donation: GI Pathology, PLLC, will donate to qualified providers, up to 85% of the cost of eligible expenses for licensing, implementation, training and ongoing maintenance for Electronic Health Records (EHR). Donations are subject to specific terms not communicated in this letter, pursuant to the August 8, 2006 Final Rule of the HHS Office of Inspector General, establishing safe harbors for the donation of certain EHR technology. The donation is not conditioned on the recipient doing any business with GI Pathology for your laboratory testing needs.

Qualifying Criteria: 

·        The Gastroenterology practice has not purchased, been given or otherwise implemented EHR software or signed a contract to purchase .

·        The practice has at least one full time employed Gastroenterologist.

If your practice would like to participate in this donation program, please fill out the return card and drop in the mail or contact Bradford-Scott representative today at (317) 713-2065 or visit our website www.bradfordscott.com for more information.

Bradford-Scott is located in the Indiana in the heart of the Midwest. We are known as one of the largest Medical Software Vendor in the area. Currently Bradford-Scott Data Corp is launching a campaign to bring EMR to you.  We would love to come to your office and give an EHR Demo to display our systems capabilities as your new EHR System.

Our EHR and Medical Billing software is a high tech integrated system that is easy to understand and use. We are able to help you customize the system to fit your Medical office. This will not only improve the efficiency in your office, but will also qualify you for the available EHR Stimulus package.

The government is forcing the industry to all move towards an EHR system. They are offering an EHR Stimulus credit to those practices that have implemented an EHR system by 2012-2015. After that they are still requiring the medical practice to move to EHR, but with no stimulus offered.

So do not be left in the cold, get your EHR demo scheduled today and let us show you our product and services available!

• Patient Flow Tracking
• Electronic RX or E-prescribe
• EHR progress note documenting
• Orders
• Recording Vitals
• Charge Submission
• EM Coding
• Tasking and Phone Messaging

• What happened to the information
• The nature of the information
• Steps that could mitigate the potential harm
• The number of individual identifiers present in the information

The guiding principle in selecting the right Electronic Health Record (EHR) for your practice is simple.  In order for an EHR to work, physicians and clinicians should be able to use the technology in a way that enhances their workflow rather than impedes it.

Sage Intergy EHR enables you to leverage clinical information by providing you with a customizable system that adapts to existing workflows rather than forcing you to change how you work. Plus, special enhancements for primary care, as well as both surgical and non-surgical specialties, mean Sage Intergy EHR easily adapts to the needs of any size or type of practice.

With over 50 years of combined experience in the healthcare market, Sage and its Channel Partner Bradford-Scott Data Corporation understand that the needs of a Gastroenterology practice can vary greatly from those required by an OB/GYN group. When it comes to choosing an electronic health records (EHR) system, it's important to consider how that technology will work for your practice, whatever the specialty.  Sage Intergy EHR was built to accommodate those unique needs, so you can be sure the system works, thinks and moves the way you do.

Sage Intergy EHR has built-in features for the following types of specialty practices:

• Cardiology
• Gastroenterology
• Nephrology
• Neurology
• Obstetrics/Gynecology
• Orthopedics
• Pediatrics
• Primary Care
• Radiology
• Urology

Contact a member of Bradford-Scott sales team to see how we can support your specialty practice.

• Patient Specific Medical Information
• Personal Medications
• Pharmacies
• Health Conditions
• Online Patient Services
• New Patient Registration
• Appointment Requests
• Prescription Refill Requests
• Pre Visit Forms

The decision to stop recognizing Current Procedural Terminology® (CPT) codes 99241–99245 and 99251–99255 in the Medicare program as of January 1, 2010, took many by surprise. In justifying its decision, CMS cited a 2006 Office of Inspector General report that 75 percent of consultations were billed incorrectly.

Offsetting the elimination of those payments, the codes CMS directs physicians to use instead received modest increases in the work relative value units (wRVUs). The small boost to units associated with these E/M codes, espouses CMS, means the decision to eliminate payment for consults is budget neutral for the Medicare program.

CMS’ exclusion of consultation codes for Medicare patients will certainly affect physician revenue, especially if private payers follow suit. Physicians must also devise new strategies for coding and documentation to continue getting reimbursed for seeing these Medicare patients, or else just decline to see them at all.

Here are answers to common questions physicians are asking about the new Medicare consultation policy:

How do I code consults for Medicare patients? 
Use the appropriate E/M code. For a patient in the hospital, code from the series CPT 99221-99223 for the initial encounter and 99231-99233 for subsequent encounter(s).

Can I ask the patient to sign an Advance Beneficiary Notice (ABN), and collect directly from the patient? 
CMS no longer recognizes the consultation codes as valid, as opposed to non-covered; therefore, you cannot use an ABN and bill the Medicare patient.

If physicians are directed to use the initial hospital visit code, how is an admission identified? 
To report an admission for Medicare, append AI (“a” – “eye”), the principal physician of record, to the initial hospital care code (99221-99223) or initial nursing facility care code (99304-99306). The new modifier is informational only; no additional remuneration is provided.

How will I get paid when a referring physician requests my opinion? 
CMS directs physicians to use the appropriate E/M code and will reimburse the physician even when services are requested within a practice within given parameters: “Medicare may pay for an inpatient hospital visit or an office or other outpatient visit if one physician or qualified NPP in a group practice requests an evaluation and management service from another physician in the same group practice when the consulting physician or qualified NPP has expertise in a specific medical area beyond the requesting professional’s knowledge.” Remember, this policy relates to Medicare, so you can continue using the consultation codes for non-Medicare patients.

Should physicians stop using consult codes altogether? 
It may be the easiest path from a process perspective but most payers, other than Medicare, continue to pay for consults. Because the payment differential is significant – consults pay up to 30 percent more than a visit code at the corresponding level – experts don’t advise dropping them altogether.

How do I handle Medicare as a secondary payer (MSP)? 
This may be the most confusing situation of all because CMS essentially authorizes you to change codes when it is the secondary payer. CMS instructs: “Bill the primary payer using a consultation code that is appropriate for the service, and then report the amount actually paid by the primary payer, along with an E/M code that is appropriate for the service [our emphasis], to Medicare for determination of whether a payment is due.” Develop processes for “crosswalking” codes on MSP claims, catching MSP claims before they are submitted to Medicare, and re-working any denied claims that miss your crosswalk process.

Does this policy change apply to Medicare Advantage plans? 
Medicare Advantage plans aren’t required to embrace the new payment policy, but some have. It’s important to check with the plans with which you participate.

Is it no longer necessary to send reports to referring physicians? 
Although it’s no longer necessary to follow CMS’ documentation rules specifically related to consults, CMS states: “…physicians should continue to follow appropriate medical documentation standards and communicate the results of an evaluation to the requesting physician.” Furthermore, one of the proposed “meaningful use” criteria for the HITECH Act’s electronic health record bonus program is: “Provide summary care record for each transition of care and referral”.

How can I get more information?
Review the MLN Matters 6740: Revisions to Consultation Services Payment Policy.

In jettisoning consultation codes for Medicare, CMS cited audits showing high levels of inappropriate consultation coding, physician confusion about its rules, and its own disagreements with the consultation coding guidance in the AMA’s CPT® Manual. The new day for consultation coding is here. Let’s see how it works.

Written by Elizabeth W. Woodcock, MBA, FACMPE, CPC of Woodcock & Associates.

• Albany Obstetrics and Gynecology experienced 20% fewer missed appointments
• Patient information became increasingly more up to date
• Verifying coverage for patients reduced denied claims by as much as 70%
• The days in accounts receivable has been reduced to less than 30
• Phone nurses quickly accessed/updated information - relieving front desk congestion
• With EHR, paper charts aren't needed, saving over 3 hours per day in chart pulls
• Physicians are able to view patient information from outside the office

"It's invaluable that the physicians can look at patient records when they are on call, especially being able to see lab results,"

• Survey of your site:  The representative should spend time face-to-face with you and your staff before the demo to ensure they have a clear understanding of your business objectives
• Integrity:  Does the glove fit the hand?  A company with Integrity will make sure they have a product that meets your needs instead of just selling you something.
• Customized EMR demo:  The demo should relate to the site survey and the objectives you defined
• Testimonials:  Any good company should be able to provide testimonials directly from their users
• References:  This is a user you can reach out an touch.  These references will help you gain a better understanding of the advantages of the product and vendor.   It's your opportunity to ask questions and receive honest credible feedback.
• Focus beyond the sale: The representative should be a part of the process before, during, and after the sale. 

• Medicaid - When it comes to Medicaid, it is up to each state to determine how they will pay out the ARRA EHR stimulus money.  Sure, some will most likely try to keep it as to close to the Medicare model as possible, but we'd be silly to thing that some states wouldn't go in a completely different direction. 
• Medicare - The earliest that we'll see Medicare ARRA EHR stimulus money is in the spring of 2011.  Remember, you have to prove "meaningful use" of your "certified EHR" for a minimum of 90 days to receive the incentives.

• Providers must have and use a qualified eRx system and report on his or her adoption and use of electronic prescriptions
• Providers must meet the criteria for successful electronic prescriber specified by CMS for a particular reporting period
• At least 10% of a successful eRx provider's Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure.

• It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today.  This helps over 31 million Americans afford health care who do not get it today – and makes coverage more affordable for many more. 
• It sets up a new competitive health insurance market giving tens of millions of Americans the exact same insurance choices that members of Congress will have.  
• It brings greater accountability to health care by laying out commonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.  
• It will end discrimination against Americans with pre-existing conditions.
• It puts our budget and economy on a more stable path by reducing the deficit by $100 billion over the next ten years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.

In February 2009, Congress passed landmark legislation to encouage the adoption of electronic health records (EHRs).  Later President Obama signed it into law.  Part of the multi-billion dollar package, known as the American Recovery and Reinvestment Act, the Health Information Technology for Economic and Clinical Health allocates $19 billion to encourage the health care industry to adopt information technology using an EHR System.

On the other hand, if providers choose not to participate, they will receive lowered Medicare reimbursement rates.

Medicare Physician EHR Incentives

If you would like more information about the EHR Stimulus package, contact Bradford Scott Data Corporation at www.bradfordscott.com.