Hospital Information Systems

The Centers for Medicare & Medicaid Services has detailed the terms for FFP (Federal Financial Participation) of up to 90% matched funds. 

Three requirements must be met in order to be eligible for FFP matched funds:

1. Administration of Medicaid incentive payments to Medicaid EPs and eligible hospitals;

2. Oversight of the Medicaid EHR Incentive Program, including routine tracking of meaningful use attestations and reporting mechanisms;

3. Pursuit of initiatives that encourage the adoption of certified EHR technology for the promotion of health care quality and the electronic exchange of health information.

The full text of the letter sent to Medicaid Administrators for your state is located on the CMS website.

Bradford Scott Medical has a great suite of products that will help your practice meet these requirements; Intergy by Sage Practice Management & EHR Software. Contact us today for more information or to set up a demonstration.

 

1. Less trips to the doctor's office - When we can email our doctors instead of having to set appointments for every little thing, like a prescription refill, we will be saving time and money!  Less time taken off of work, less money spent in gas, and less time spent waiting in the lobby will always be positives in my book.
2. Access to your medical records on vacation - With EHR technology being rapidly embraced, it's just a matter of time before doctors and hospitals will be able to share our medical records.  If I'm off getting married in Vegas, and I need to seek medical attention, my doctor from the Hoosier state can send my info with a touch of a button.  I don't know about you, but I don't like having to re-take tests and blood work if I don't have to!
3. No more leaving messages and calling back for lab results - How many times have you called for your results, only to be told to call back later?  Wouldn't it be nice if we could just log on and see the results for ourselves?  Very nice!
4. No more hauling X-rays and medical files - If we are referred to a specialist, that physician will need our past records, tests, and/or X-rays.  But what id they could just retrieve them like a digital picture?  No more sorting through papers, waiting for faxes, or hauling them yourself.
5. Prescriptions - When prescriptions are transmitted electronically, the system automatically checks for interactions and correct dosage.  Do you go to more then one doctor for more than one reason?  Now you don't have to worry if the pharmacist will catch it.  Electronic prescriptions have saved millions already, and the doctor gets a kick-back right now from Medicare, what's not to love?

Look around your office and notice all the stacks of paper everywhere. With an integrated EMR system all the stacks of paper can be eliminated through document imaging.  Most EMR vendors will discuss converting your paper chart into an electronic chart. However they do not focus on all the other paper documents in the office. Each Medical office receives, radiology reports, discharge letters, referral letters, lab results, and many other items daily in a paper format.

Bradford-Scott Data Corp has an EMR product that can convert all your paper into electronic files no matter how they get to your office. There are many items that come into the office through fax. With a faxing solution these items can be directly imported into the system and sent to the doctor for review and stored in the patient chart. 

Another way to cut out the paper is to receive your Radiology reports,  Ultrasounds, hospital reports, and an other paper documentation on an cd and then import them into the system using the imaging feature in your EMR system.

Your Medical Office can even go a step further and scan in all their EOB's into an electronic file cabinet. So can staff information, patient education, and doctors registration. Security settings within the EMR system can be set to only all certain people to see certain types of documents.

The opportunities to eliminate paper in your office are endless. You will not only make it easier to find the medical records you are looking for, but also help environment by cutting back on the use of paper. Electronic Medical Records Systems make it easy to organize your office.  

• Well, first of all the HITECH Act states that payments for Medicare providers may begin no sooner than January 2011 for Eligible Providers (Hospitals = no sooner than October 2010).  The Final Rule that was just published helps define the payment time line further ...
• Fall 2010 - The ONC expects the certified EHR systems will be ready for purchase.
• Jan 2011 - Registration of Eligible Providers (and Hospitals) with CMS for the EHR incentive program will begin
• April 2011 - Attestations for the Medicare program may begin for Eligible Providers (and Hospitals)
• May 2011 - Medicare EHR incentive payments will begin in mid May.

Key changes in the final CMS rule include:

For more information regarding the new rules and the requirements , click on this link to the CMS EHR Incentive site.

Now that you are ready for electronic medical records, start your search with Bradford-Scott Data Corporation.  We can help you as you start your journey toward electronic health records.  Contact us on our website or at 317 713-2065 to speak to one of our medical sales consultants!
 

• 3 deaths
• 14 permanent disabilities
• 31 temporary disabilities
• 39 hospital admissions
• 34 emergency room visits
• 267 physician office visits

These days most physicians are being lured to electronic health records (EHR) with Federal Stimulus money.  What they should really be lured by are the true beneficial reasons for adopting EHR.
 

1.  Better Access:  Never look for a chart again, information at your finger tips, access the chart remotely, etc...

2.  Better Documentation:  Legible documents, updating patient meds and problems at each visit, patients able to update medical history from home and have information downloaded into your EHR, import discrete data from labs, hospitals, etc...

3.  Better Care Management:  Ability to track patient health maintenance with alerts to remind clinical staff of overdue labs, x rays, etc...

4. Better Prescribing:  Less time spent speaking with pharmacists, electronically send scripts to pharmacy, refill scripts in seconds, catch important drug interactions and ability to pull a group of patients for a recalled drug.

5.  Greater Efficiency:  Electronic tasking, batch form letters, eliminate time copy charts, reduce transcription, eliminate chart costs, etc...

6. Higher Income:  Qualify for pay for performance (PFP) bonuses, capture all your charges at time of service, re assign your transcriptionist and filing clerk to help with collections, confidently code at higher levels, etc...

These are 6 good reasons why physicians should be adopting EHR!  To learn more about how an EHR can increase your revenues, reduce your costs and become more efficient, contact Bradford Scott Data Corporation today!

• Correspondence for the patient to get Orders completed at a hospital or radiology facility.
• Correspondence that will thank a patient for coming in and give them a copy of the doctors suggested plan.
• There is also correspondence that refers a patient to another doctor.
• Specialty correspondence that pulls in a summary of the patients diagnosis and plan to send back to their referring doctor or medical practice.

• Family medical history
• Existing conditions
• Allergies
• Medications
• Surgeries
• Hospital stays
• Labs tests and results
• Dental and vision records
• Religious information
• Immunization records
• Emergency contacts
• Living wills

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.

Meaningful What? Stimulus What? Who's on first?  Can somebody explain this in 500 word or less?

Let me break down Meaningful Use as simply as I can.

• $19 billion have been allocated by the federal government to encourage the health care industry to adopt information technology (more specifically an Electronic Health Records System).
• To be eligible to get some of the $19 billion you must do 3 things

1. Be an eligible professional or hospital
2. Implement a certified EHR product between 2011 and 2014
3. Use it in a Meaningful Way

Okay, are you still with me?  Then let's go one level deeper. Let's make some assumptions:

• You are an eligible professional (doctors of medicine, etc.)
• You have or will have a certified EHR system.  (All vendors in the medical software industry will have to get their software certified (including CCHIT) or go out of business.  We are going to assume your system is or will be certified)

There are two types of incentive programs (The Medicare way or the Medicaid way).  You can pick either but you can't choose both at the same time!
 

• Medicare:  Physicians that treat Medicare patients can receive up to $44,000 payable over 5 years.

• Medicaid:  Physicians that treat Medicaid patients are eligible for up to $63,750 payable over 6 years

Are there strings attached?  Of course.  And the biggest string is called 'Meaningful Use'.  The Government isn't going to just give you some cash for buying or even implementing an EHR system.  You have to prove to them that you can use it in a meaningful way that improves patient health care.  And they plan to accomplish this string by outlining 25 objectives and ways to measure those objectives.  Most of the measurements are percentage based.  (For Example:   At least 50% of all clinical lab tests whose results are in a positive/negative or numerical format need to be recorded in the EHR as structured data.)

For a complete list of these objectives, I recommend that you check out CMS or contact Bradford-Scott.  One important note:  The Meaningful Use definition is still under a proposed state and can be commented on until March.

That's it.  That's the nutshell.  Oh, and there is one more catch.  Starting in 2015, those physicians who choose to not participate will receive a 1% reduction in their Medicare allowed charges.  This reduction will increase by 1% each year up to a maximum of 5%.

So the moral of the story is that if you have plans on implementing an EHR/EMR system don't wait.  If you begin using it in a meaningful way in 2011 you are going to get more incentive payments than implementing in 2014.  And if you don't implement by 2015 you  are going to lose Medicare reimbursements.

Do you need help on what to do next?  Whether you are cardiology, orthopedics, or family practice, contact Bradford-Scott and ask about our Sage Intergy EHR system and how it can help you prove your meaningful use and improve patient care.

(and I kept it under 500 words!)
 

• Phone support for medical billing system and electronic medical records software
• Phone support for hardware, including servers, printers, backups, etc.
• Training classes for new and existing medical claims software and EMR customers
• On-site implementation of Intergy by Sage and Intergy EHR by Sage
• EDI Enrollment for new and existing customers
• R&D for our medical office billing software and EHR software
• Interface work with hospital information systems, labs, and EMR systems
• Countless other things...including blogging!

The “red flags” rule is now scheduled to take effect on June 1, 2010, after another delay announced earlier by the Federal Trade Commission as it considers new legislation that would exempt small businesses, including medical practices, from compliance. The rule mandates the creation of identity theft prevention programs, and will apply to any organization that can be considered a creditor with “covered” accounts (i.e.-commercial accounts that involve multiple transactions). Most providers, many physician medical billing companies and some health plans are expected to comply.

The American Medical Association, American Academy of Family Physicians and other industry groups have weighed in against the rule, on the basis that physicians do not meet the definition of creditors. A completely sensible argument. But medical practices need to proactively engage in some agreed set of identity theft prevention practices.  Incidences of medical identity theft are increasing. Smaller medical practices (which account for nearly 80% of all U.S. practices) may be more vulnerable, as thieves could perceive them to be lower risk targets based on the assumption that they lack the sophisticated security procedures of hospitals or larger health care organizations.

Despite the widespread outcry from industry groups, the actual impact on a practice for complying with the red flag rule may be minimal. The new rule would simply buttress state privacy laws that already require health care organizations to respond to breaches of certain patient information. In addition, there is a great deal of overlap between the proposed FTC regulations and HIPAA, which applies to medical practices or other entities that are conducting electronic transactions. But you should still be vary aware of these red flags. You must be able to protect your patient medical records.

Here are some Red Flag identifiers:

• Suspicious documents. Has a new patient given you identification documents that look altered or forged? Is the photograph or physical description on the ID inconsistent with what the patient looks like? Did the patient give you other documentation inconsistent with what he or she has told you — for example, an inconsistent date of birth or a chronic medical condition not mentioned elsewhere? Under the Red Flags Rule, you may need to ask for additional information from that patient.
• Suspicious personally identifying information. If a patient gives you information that does not match what you have learned from other sources, it may be a red flag of identity theft. For example, if the patient gives you a home address, birth date, or Social Security number that does not match information on file or from the insurer then fraud could be afoot.
• Suspicious activities. Is mail returned repeatedly as undeliverable, even though the patient still shows up for appointments? Does a patient complain about receiving a bill for a service that he or she didn't  get? Is there an inconsistency between a physical examination or medical history reported by the patient and the treatment records? These questionable activities may be red flags of identity theft.
• Notices from victims of identity theft, law enforcement authorities, insurers, or others suggesting possible identity theft. Have you received word about identity theft from another source? Cooperation is key. Heed warnings from others that identity theft may be ongoing.
  
  
  If you’re covered by the Rule, your red flag program must:

1. Identify the kinds of red flags that are relevant to your practice
2. Explain your process for detecting them
3. Describe how you’ll respond to red flags to prevent and mitigate identity theft
4. Spell out how you’ll keep your program current.

At Bradford Scott Data Corporation our EMR systems and our medical practice billing software has several built in features that can help you protect your patients from identity theft. Please contact our sales team at : www.bradfordscott.com/medical.php

Medical practices concerned about compliance can learn more at:
http://www.ama-assn.org/ama/no-index/physician-resources/red-flags-rule.shtml
 

With public attention on the ARRA stimulus funds in recent months, physicians have been feeling the pressure to adopt electronic health records. The vision is that in the next couple of years, the technology will be advanced enough to exchange health data freely between systems. Yet there is some skepticism from many in the health care industry that the lack of infrastructure and data sharing standards means that the day of sharing patient records between providers, labs and hospitals is a lot further off than the current administration is hoping.

 If practices know that payers and government agencies are invested in coordinating these efforts, it will reassure physicians that they won’t be left alone to arrange dozens of interfaces with a myriad of other systems. In fact, the inability of some smaller practices to afford EHRs at all has been another issue that has troubled advocates of health care technology. The Medical Group Management Association (MGMA) voiced concern back in July that those practices without the purchasing power of larger medical groups would in effect be penalized for their inability to show meaningful use. This stumbling block to widespread EHR adoption may soon be removed if a  new proposed legislation to make smaller practices eligible for business loans to buy electronic health records is passed.

Let Bradford Scott Data Corporation tell you all about our EMR and practice management systems that even the small practices can afford.

There is still a long way to go, but perhaps these and other measures will give physicians  confidence that the current path of health care enhances the chance that they will spend more time treating patients and less time tracking down information.

You can contact bradfordscott.com/index.php for all your health care software solutions.