Jeremy Weaver

Hello,

My name is Jeremy Weaver.  I am the Medical Programming Manager with Bradford-Scott.  I was hired in 1997 as the EDI programmer after graduating from Ball State University (Go Cards!).  In 2004 I took over as the Manager of the Medical Programming Department.

Working as the EDI Programmer for 7 years gave me a lot of experience making our Medical Software package work with different state requirements in Indiana, Ohio, Kentucky, Illinois and Michigan.   I know how frustrating it used to be keeping up with all of the payer specific changes to the electronic claim formats and in turn updating our electronic billing software to meet those needs.   With the HIPAA legislation things were supposed to get easier, right?  Well maybe things have become a little easier.  Due to HIPAA we have been able to establish a great working relationship with Emdeon Business Services to help maintain our Physician Billing Software. 

On a personal level, I am married and have three young kids that keep me from sleeping as much as I need to. 

If there is anything I can do to help, drop me a line.

• 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.

On Tuesday July 13, 2010 the Secretary of Health and Human Services announced the final rule to support the 'meaningful use' of Electronic Health Records.

Basically, this finalized the process to receive stimulus money under the Medicare Incentive program or Medicaid Incentive program for purchasing a qualified EHR system and being able to prove that you are using it in a meaningful way.  There were two companion rules announced as well
 

1. The first regulation issued by CMS defines the minimum requirements that providers must meet through their use of a certified EHR system.  (Defining what they mean when they say 'Meaningful Use')
2. The second regulation issued by the ONC identifies the standards and certification criteria that EHR systems must meet to be considered 'certified'.

Eligible professionals may received up to $44,000 under the Medicare Incentive or $63,750 under the Medicaid Incentive.

This final rule does include some modifications to the proposed rule that was issued on Jan 13, 2010.  One difference is that in the proposed rule eligible providers would have to meet 25 requirements to prove meaningful use of their EHR/EMR system.  In the final rule it amends that and divides the requirements into a 'core' group of requirements that must be met, plus additional 'menu' procedures that a provider can choose from.

Over the next several weeks, Bradford-Scott will be reviewing these rules/regulations in detail and working with our parent company, Sage Healthcare, to better understand these requirements and how to best help our clients successfully navigate the next several months.
 

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

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!)
 

• Objective:  Generate and transmit permissible prescriptions electronically.
• Measurement:  At least 75% of all permissible prescriptions written by the eligible professional are transmitted electronically using a certified EHR technology.

One concern in implementing an Electronic Health Records system is the length of time it takes to get it up and running.   You don't have too look hard on the Internet to find examples where it took 6-12 months to get the implementation off of the ground.

Here are some tips when trying to determine the time frame towards a successful EMR/EHR implementation:

1. Talk to your EMR/EHR vendor about realistic expectations towards a 'Live Date'.  Then stick to those dates.  Canceling training sessions can throw off your live date.
2. Be prepared for the training sessions to get the most out of your training time.
3. Make sure your Physicians are committed to learning the product and that they can schedule time to be trained on the product.  Let's face it.  An EMR/EHR product is only as good as the Dr that is using it.  They need to commit to learning it.
4. If you are implementing both an EMR/EHR and an Integrated Practice Management System at the same time plan the best use of your time.  Have your Front Office and Billing Staff learning the PM, while your clinical staff begins setting up their EHR templates.  This way both parties can get up and live on the product without waiting on the other side.
5. Make sure your Physicians are committed to learning the product ... wait, did I say that already?  Well it is worth saying it again. The Physicians are busy but without them committing to learning the product your implementation could take months longer than necessary.
6. With a push to get your EMR/EHR system up and running in 2011 to prove your 'meaningful use', expect your software vendor to have a  line of physicians wanting to implement.  Get in line sooner than later! Don't delay or you could risk not being ready in time.
7. (and maybe the most important) Contact Bradford-Scott!  We can help you design a proper implementation schedule and get your staff up and running on Intergy EHR by Sage.

The Sage Summit 2009 is taking place in a few weeks in Atlanta.  All Sage customers can attend for a fee.  The Summit will have workshops to learn about software tips, new product development including new technologies and provide technical solutions.

On the healthcare side there will be information about Intergy EHR and Intergy Practice Management (along with many other products).  After looking though the agenda this will be a great place to learn about getting the best out of your Medical Charting Software or your Electronic Medical Record system.

They also plan on having technical support sessions where you can schedule time to sit down with a Sage Support Technician and work on a wide range of topics including your specific issues from Pediatrics EMR to something related only to Orthopedics.

It looks to be a great and valuable time.  If you'd like more information click here or go out and Google 'Sage Summit'.

Bradford-Scott is a proud Changel Partner with Sage.  To find out more about BSDC follow this link to our website.
 

• Intergy By Sage is a comprehensive practice management system that provides advanced scheduling, billing, and management tools that will help your practice run more smoothly and efficiently.
• Sage Intergy EHR V5.5 is CCHIT 2008 certified Electronic Health Record software that is designed to complement the clinical approach of your practice.

• Reduce no-shows by pre-confirming appointments
• Increase office efficiency by reminding patients to bring necessary paperwork and records
• Improve collections by reminding patients of their balances and co-pays
• Eliminate staff involvement in delivering appointment reminders and lab test results

One concern in implementing an Electronic Health Records system is the length of time it takes to get it up and running.   You don't have too look hard on the Internet to find examples where it took 6-12 months to get the implementation off of the ground.

Here are some tips when trying to determine the time frame towards a successful EHR implementation:

1. Talk to your EMR vendor about realistic expectations towards a 'Live Date'.  Then stick to those dates.  Canceling training sessions can throw off your live date.
2. Be prepared for the training sessions to get the most out of your training time.
3. Make sure your Physicians are committed to learning the product and that they can schedule time to be trained on the product.  Let's face it.  An EMR/EHR product is only as good as the Dr that is using it.  They need to commit to learning it.
4. If you are implementing both an EHR and an Integrated Practice Management System at the same time plan the best use of your time.  Have your Front Office and Billing Staff learning the PM, while your clinical staff begins setting up their EHR templates.  This way both parties can get up and live on the product without waiting on the other side.
5. Make sure your Physicians are committed to learning the product ... wait, did I say that already?  Well it is worth saying it again. The Physicians are busy but without them committing to learning the product your implementation could take months longer than necessary.
6. (and maybe the most important) Contact Bradford-Scott!  We can help you design a proper implementation schedule and get your staff up and running on Intergy EHR by Sage.

• Patient Registration
• Document and Image Management
• Scheduling
• ePrescribe Prescription Writing

• Orders and Phone Tasking
• Automating Lab Orders
• Wireless Connectivity
• Drug Utilization Review

• What happens when the tapes aren't getting rotated?
• What happens when your tape isn't readable? 
• What happens when the person in charge of the System Backup is on vacation?
• What happens when a disaster strikes your office (such as a tornado or flood)?
• How often are you replacing your tapes?

And just when you thought it was gone .. HIPAA is back and better than ever! 

For those of us that lived through the Standard Transactions and Code Set updates to our medical office billing software back in 2003 that moved the industry's hodge-podge of EDI transactions to a standard format (ANSI 4010), we probably aren't to eager to relive it.

Well get ready ... because it is coming again.

In January CMS published 2 new final rules:

• The first is an update to the standard transactions formats with the transition to ANSI 5010.  This is long over due, and is scheduled for implementation by all covered entities by Jan 1, 2012. (Jan 1, 2013 for small health plans)
• The second rule is specific to the transition to ICD-10 codes.  Again, this has been talked about for a long time and now it seems like with the 5010 implementation this will be possible.  Implementation is scheduled for Oct 1, 2013 for all covered entities.

These rules are available at the Federal Register.

Bradford-Scott Data Corp has already started our preliminary research of the two new rules to determine what impact it will have on our physician billing software, what changes/updates we might have to make to our medical billing systems and more importantly how this will impact your cash flow.  In the coming months we will be working closely with our industry partners in both the practice management product development and clearinghouse areas to make sure these transitions will be as smooth as possible.

For more information about HIPAA and the new final rules, please visit the CMS website at

http://www.cms.hhs.gov/home/regsguidance.asp


For more information about Bradford-Scott's software solutions including:

• Practice Management Software
• Enterprise Medical Software
• EMR Electronic Medical Records

Please visit our website at http://www.bradfordscott.com/index.php