EMR Reviews

Sage Intergy EHR V5.5 is CCHIT 2008 certified and is designed to complement the clinical approach of your practice. With the local presence of Bradford-Scott Data Corporation to ensure you get the proper hand holding needed and the national backing of Sage Software to continue to keep this product on the leading edge of technology; this is a duo that is untouched.

The latest Intergy EHR release focuses on maximizing clinical connectivity in order to optimize your patient’s experience and enhance your bottom line. Intergy EHR does this by touching every aspect of your practice, from enhancing patient care to maximizing billing procedures.

• Guideline-driven care for preventive measures and treatments protocols
• Advanced clinical flow-sheets provide a view of a patient’s progress and treatment effectiveness
• ePrescribing enhances accuracy and provides interaction alerts
• Orders & Tasks allow you to easily create and track orders such as mammograms, blood tests, etc.
• Drug Utilization Review (DUR) On Demand and ePrescribing provide you instant access to drug interaction information
• Clinical record summary for Interoperability improves efficiency by sharing information
• Automated patient visit templates improve documentation & analyze coding
• Patient Privacy options ensure the security of sensitive patient data
• Specialty specific product features provide tools designed for your practice

The ARRA Program (also known as the Stimulus package) has split the implementation of EMR and meaningful use into three phases.  The first proposed "Meaningful Use" Rule has a component for a lab interface. 

The objective is to be able to send requisitions and receive lab reports back electronically through an interface from system to system. 

The advantages to a lab interface are easy to see in our Intergy EHR system.

          Time, Efficiency and Better Patient Care -

• Lab results are posted to client accounts automatically when reports are retrieved. 
• A task is automatically sent to the physician that results are available to be reviewed.  Flowsheets can also be viewed to look at results over time and can be graphed.
• The physician may review and forward tasks to staff members for whatever is needed in followup.
• The patient receives better care as a result of this process.

Have questions about purchasing and implementing an electronic medical record system?  Contact Bradford-Scott Data Corporation and let us show you a better way to practice medicine.


 

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.

Have you put your plans for an electronic medical record system (EMR) in "time out" until the Meaningful Use law goes into effect?

If so, the wait is almost over, as the law is currently in the comment period.  Once Phase I criteria has been signed into law, the push will be on as everyone will want to get their share of  the stimulus money. 

Here are a few things to consider:



TIME:  Implementing an EMR is not an overnight process.  First things first -   commit your time!  Converting paper processes into electronic ones requires that you determine what steps you currently do and then setup the most effective way to reconstruct those electronically.  With a proposed list of 25 criteria for Phase I, you can easily see that time will be a factor.

CHANGE:  Everyone from the receptionist to the physician will be affected.  Don't make the mistake of thinking that an EMR system will only affect the physician. Take the time to get the staff invested, so they respond positively to changes in the office.  Try short meetings or lunches to review where everything stands - it's a great way to soothe anxiety.

SUPPORT:  When you select your EMR software, it's also important to pick the correct vendor.  Bradford-Scott Data Corporation provides excellent service and support to our clients.  Sage Intergy EHR V5.5 is CCHIT 2008 certified and has existing templates for multiple specialties and is easily customizable.  We use a blend of onsite, webinars, classroom and computer based training to take you live on our Intergy EHR system.  Our trainers will work with you to make the transition from paper to an electronic world.

Talk to one of our medical consultants today and see why Bradford-Scott Data Corporation customers are successful with EMR.

1. Include a DUNS Number. A DUNS Number must be included in order for an application to be reviewed.  DUNS numbers can be obtained by accessing www.dunandbradstreet.com or by calling 1-866-705-5711. Include the DUNS number next to the OMB Approval Number, which is located in the upper right corner of the application face page.
2. Keep the audience in mind. Reviewers will use only the information contained in the application to assess the application. Therefore, the applicant should be sure the application and responses to the program requirements and expectations are complete and clearly written. Do not assume that reviewers are familiar with the applicant organization. Keep the review criteria in mind when writing the application. 
3. Start preparing the application early. If applying electronically through Grants.gov please ensure that adequate time is allotted to register and download applicable software and forms. Grants.gov offered a "Webcast" (registration required) entitled "Get Started with Grants.gov" that provides start-up requirements and tips.
4. Follow the instructions and application guidance carefully. The instructions call for a particular organization of the materials, and reviewers are accustomed to finding information in specific places. Present information according to the prescribed format.
5. Be brief, concise, and clear. Make each point understandable. Provide accurate and honest information, including candid accounts of problems and realistic plans to address them. If any required information or data is omitted, explain why. Make sure the information provided in each table, chart, attachment, etc., is consistent with the proposal narrative and information in other tables. 
6. Be organized and logical. Many applications fail because the reviewers cannot follow the thought process of the applicant or because parts of the application do not fit together. 
7. Be careful in the use of appendices. Do not use the appendices for information that is required in the body of the application. Be sure to cross-reference all tables and attachments located in the appendices to the appropriate text in the application. 
8. Carefully proofread the application. Misspellings and grammatical errors will impede reviewers in understanding the application. Be sure pages are numbered (including appendices) and that page limits are followed. Limit the use of abbreviations and acronyms, and define each one at its first use and periodically throughout application.

If not, you might want to give this a read...

There is a ton of content talking about EMR Systems, meaningful use, stimulus dollars, and the governments American Recovery and Reinvestment Act of 2009.   There is a tidal wave of anticipation and preparation going on in many physician offices around the country.  Rules have now been proposed and thousands of doctors are making the investment in an EMR Software now to ensure they are prepared to collect their share of the pie. 

If your office hasn't made the investment yet, it's not too late, but time may be running out.  There are several reasons why investing in an EMR System now is more important than ever.

1)  Your office may need to demonstrate meaningful use for all required measures depending on specialty.   Did you know there are 25 of them?   Healthcare IT outlines the details in this article and shows that there is much to do.  Did you know you have if you miss one of them you may not qualify for any of the money?   Timing will be key.  Physicians will want to have a comprehensive grasp of their product before they begin the reporting period.   Once you are on the clock so to speak, you want to make sure you're ready.

2) Software vendor's schedules are filling up.   Is the office down the street implementing an EMR?   Maybe the group next door as well?  There is a pretty good chance that many of your colleagues have entered into the game or soon will.   This means vendors will be swamped and schedules will fill up fast.   Don't wait until the line gets too long.  Take advantage today.

3) What if the money runs out?  We've seen it before..."Cash for Clunkers".  I'm guessing that there is a bucket of cash for this project and when it's gone, it's going to be hard to get paid.  I'd much rather be on the front end of the line then the back.   Only time will tell if there is enough money or not, but I'd rather not find out the hard way.

4) Did you know there are proposed penalties for not successfully implementing an EMR by the mandated deadlines?   As I mentioned before, each office will want ample time to implement and adjust business practices to meet the requirements. 

5) It takes time to find the right product and vendor.  You'll want to spend enough time looking at EMR Systems and completed a thourogh EMR Review.   Finding a local vendor with a nationally backed product is key.

Many practices have completed their EMR Reviews and are well on their way to meeting or exceeding the milestones necessary to qualify for stimulus money.   There is still time to get on board and tack advantage of this rare opportunity.   However, there is an expiration date, and that my friends will be here before we know it.  

Give Bradford-Scott a call at 317-713-2065 or check us out on the web at www.bradfordscott.com for all the information you need regarding the ARRA guidelines.

As always, feel free to comment.

Go Colts!

Jason

Sage Intergy EHR V5.5 is CCHIT 2008 certified and is designed to complement the clinical approach of your practice. With the local presence of Bradford-Scott Data Corporation to ensure you get the proper hand holding needed and the national backing of Sage Software to continue to keep this product on the leading edge of technology; this is a duo that is untouched.

The latest Intergy EHR release focuses on maximizing clinical connectivity in order to optimize your patient’s experience and enhance your bottom line. Intergy EHR does this by touching every aspect of your practice, from enhancing patient care to maximizing billing procedures.

• Guideline-driven care for preventive measures and treatments protocols
• Advanced clinical flow-sheets provide a view of a patient’s progress and treatment effectiveness
• ePrescribing enhances accuracy and provides interaction alerts
• Orders & Tasks allow you to easily create and track orders such as mammograms, blood tests, etc.
• Drug Utilization Review (DUR) On Demand and ePrescribing provide you instant access to drug interaction information
• Clinical record summary for Interoperability improves efficiency by sharing information
• Automated patient visit templates improve documentation & analyze coding
• Patient Privacy options ensure the security of sensitive patient data
• Specialty specific product features provide tools designed for your practice

• Electronic prescriptions
• Intergy EHR by Sage version 5.5 is a CCHIT certified product consistently finishing atop EMR reviews
• Medical claims software with over 25 years of development
• Interfaces with hospital information systems
• Customizable for Pediatrics EMR, OB GYN EMR, Orthopedics EMR, Cardiology EMR, and many other specialties
• The best service and support in the Midwest

Sage Intergy EHR V5.5 is CCHIT 2008 certified and is designed to complement the clinical approach of your practice. With the local presence of Bradford-Scott Data Corporation to ensure you get the proper hand holding needed and the national backing of Sage Software to continue to keep this product on the leading edge of technology; this is a duo that is untouched.

The latest Intergy EHR release focuses on maximizing clinical connectivity in order to optimize your patient’s experience and enhance your bottom line. Intergy EHR does this by touching every aspect of your practice, from enhancing patient care to maximizing billing procedures.

• Guideline-driven care for preventive measures and treatments protocols
• Advanced clinical flow-sheets provide a view of a patient’s progress and treatment effectiveness
• ePrescribing enhances accuracy and provides interaction alerts
• Orders & Tasks allow you to easily create and track orders such as mammograms, blood tests, etc.
• Drug Utilization Review (DUR) On Demand and ePrescribing provide you instant access to drug interaction information
• Clinical record summary for Interoperability improves efficiency by sharing information
• Automated patient visit templates improve documentation & analyze coding
• Patient Privacy options ensure the security of sensitive patient data
• Specialty specific product features provide tools designed for your practice

• Provide a digital equivalent of the legal, paper-based medical record
• Facilitate a provider's documentation of patient encounters
• Organize and format information captured electronically in a computerized patient record or electronic chart
• Include a clinical data repository

• Ingergy EHR by Sage v5.5 is a CCHIT certified EMR product.  Why CCHIT?  It's the standard against which all EMR systems are measured.

• "delivers exceptional levels of performance, usability and productivity to physicians."
• "users are making excellent use of it to achieve higher quality of care and better outcomes."

Sage Intergy EHR V5.5 is CCHIT 2008 certified and designed to complement the clinical approach of your practice. With the local presence of Bradford-Scott Data Corporation to ensure you get the proper hand holding needed and the national backing of Sage Software to continue to keep this product on the leading edge of technology; this is a duo that is untouched.

The latest Intergy EHR release focuses on maximizing clinical connectivity in order to optimize your patient’s experience and enhance your bottom line. Intergy EHR does this by touching every aspect of your practice, from enhancing patient care to maximizing billing procedures.

• Guideline-driven care for preventive measures and treatments protocols
• Advanced clinical flow-sheets provide a view of a patient’s progress and treatment effectiveness
• ePrescribing enhances accuracy and provides interaction alerts
• Orders & Tasks allow you to easily create and track orders such as mammograms, blood tests, etc.
• Drug Utilization Review (DUR) On Demand and ePrescribing provide you instant access to drug interaction information
• Clinical record summary for Interoperability improves efficiency by sharing information
• Automated patient visit templates improve documentation & analyze coding
• Patient Privacy options ensure the security of sensitive patient data
• Specialty specific product features provide tools designed for your practice

What is CCHIT?  According to their website, the acronym stands for Certification Commission for Healthcare Information Technology.   

So what does that mean?  The goal of the commission is to promote the adoption of robust EHR products by using a credible certification process.  It is widely considered the standard for a good EHR product.   
 

Bradford-Scott is pleased to offer Intergy EHR by Sage.  Intergy EHR V5.5 has been CCHIT certified for 2008.   The following areas have been certified by  the commission.  To find more information about the Intergy EHR product visit the website.

• Functionality — setting features and functions to meet a basic set of requirements. (For additional details, see the CCHIT Functionality Criteria for 2007.)
• Interoperability — enabling standards-based data exchange with other sources of healthcare information. (For additional details, see the CCHIT Interoperability Criteria for 2007.)
• Security — ensuring data privacy and robustness to prevent data loss. (For additional details, see the CCHIT Security Criteria for 2007.)