Medical Billing Forum

General Category => General Questions => Topic started by: Mariana on June 06, 2011, 08:41:00 AM

Title: Emr system
Post by: Mariana on June 06, 2011, 08:41:00 AM
I am getting ready to open my billing business but i have a question about the EMR system. i heard from another medical biller that with the new EMR system that the doctors will not be using more paper charts and everything is going more electronically. The EMR system will make the billing much more easier that they will not be needing to outsource anymore. Whats your opinion about that? I want to make sure if i am opening the business there will be a need to outsource. And how will the doctors office provide information to the billing business since everything will be done in their EMR system? I just got a little disapointted when she told me that because i want to make sure if i am opening a billing business there are still going to be a need to outsource. She told me she lost two accounts because they went to the EMR system. Any comments on that?
Title: Re: Emr system
Post by: pattil88 on June 06, 2011, 12:38:08 PM
Medical billing services have to stay on the cutting edge of what's going on in the overall industry, just like any other business. EMR's (and a ton of other services that practice management software vendors are floating around out there) have developed some powerful tools that will make practices think twice about outsourcing. However, I try to "adapt" our services to ensure that a practice is getting some type of added value above and beyond what their current billing process gives them.

For example, after they have adapted to an EMR-based coding/billing function, do they still receive denials from payers? Probably. Does the EMR coding/billing system they use know when to add a certain modifier for certain payers? Maybe - maybe not. I may not be able to get a practice that wants all the services I offer, but I want to position my business and keep adjusting my business plan to fit what they need today and what they'll need in the future. We do that by constantly keeping track of trends occurring in our business niche. (After all, isn't that what makes this so much fun?!!)

I spend alot of time looking at features billing software vendors are offering to their clients and look for ways to capitalize on what's not working by reading different blogs/opinions/etc. from physicians and other industry experts. I don't think medical billing services will become a thing of the past - we just have to keep reinventing ourselves to keep pace with what our markets want and need.

Just my two cents worth......
Title: Re: Emr system
Post by: arms on June 06, 2011, 06:48:41 PM
I agree, I truly believe there will always be a need for outsourced medical billing services.

EMR's are not that scary.   

EMR's are only a tool and only as good as the information that you plug into it, if the practice staff is not knowledgeable enough in billing they will still struggle and there is no EMR out there that automates claim follow-up and appeals!

If the provider drops you due to getting an EMR they were sadly un-informed and will probably be looking for somebody again when they realize what a mistake they made. I would keep in touch with them for when that happens.


Title: Re: Emr system
Post by: DMK on June 06, 2011, 06:53:45 PM
EMR is going to be somewhat "mandatory" in the future, but it's really only for records and patient notes.  The EMR we used was only as good as what the Doctor input.  He would click on the services he provided, but at the end of the day I still had to read the notes and make sure what he said he did was in the record, and that he billed for what he did. 

When the billing was done, it still required that someone actually push the button and print the claims, send to the secondaries and chase down unpaid and incorrectly paid claims.  EMR can not and will not replace billing services in house or out sourced!

Whatever specialty you decide to pursue, try to be up on the software packages available and the pros and cons for the software.
Title: Re: Emr system
Post by: QueenAlicia on June 06, 2011, 08:01:01 PM
I actually go to a doctor/hospital that does EMR and I think it's great.  They don't have to look up my file thru paper and it's easily accessible. I think that it also requires that the doctor actually chart in updates and what services he provided that day.  This may be an issue for some providers.
Title: Re: Emr system
Post by: Mariana on June 07, 2011, 07:58:01 AM
Guys, i have one more question. If EMR will be mandatory in the future how will the doctors provide information to billing companies? Because i am used now to get the superbills, patient information form all by fax...so if it will be all in their system with EMR how will they provide the information to the billing company? And will there be a need to use my billing software or will we have to use the provider's software by remote access? 
Title: Re: Emr system
Post by: DMK on June 07, 2011, 10:31:11 AM
I think Linda and Michele have addressed this a few times.  Remote access to the doctor's software will always be best, then you can print off notes if needed, and you can really monitor the incoming payments and outgoing billing.  You will still need your own software for the smaller practices (who will likely not be required to have EMR).

I'm not a big fan of national healthcare, but Canada has a great NATIONAL software program for billing that works really well.  The US will balk at that since it would impede the software manufacturers, but for Medicare, Medicaid, and other "national" plans, they will probably have to come up with something that everyone uses and that is cheap or free just for the consistency alone.  The clearing houses are already doing something similar by taking different software data and compiling it into a single format that all insurance companies accept.

These are just my opinions, but this business is constantly changing and will continue to do so.  As the saying goes "changes aren't permanent, but change is...."
Title: Re: Emr system
Post by: PMRNC on June 11, 2011, 07:30:22 AM
Hold on to your hats for what I'm going to tell you....

I'm not dealing with EMR at all!  Nope, not at all!  I have many reasons, one being I'm just too busy with the other day-to day operations and consulting. All my clients are fine with that and I have a lot of contacts that could use the business and step in for me for that part :)   I know.. crazy isn't it?  But that's just me.  There's no way EMR is going to take business from us at all, and with all changes in the healthcare industry and what I believe is going to happen in the next presidential election, we are going to be so busy we won't have time to deal with EMR.  That's my opinion.   
Title: Re: Emr system
Post by: Michele on June 13, 2011, 06:49:55 AM
We don't have much to do with EMR either.  Only to advise our providers on what their options are.  I agree with Linda.  It really doesn't pertain to us and we are way too busy.  There are always those who try to make more of things than need to be.  EMR can be tied in to billing or it can be completely separate.  EMR companies will use anything they can to make their product look better, including pushing how it will aid in billing.  Billing still needs to be understood to be done correctly and no EMR is going to change that.  JMO
Title: Re: Emr system
Post by: sl1181 on June 14, 2011, 08:38:13 PM
I work for a few pratices that use their EMR only as EMR and not to try and bill. They learned the EMR was only as good as they were at inputting the info and learned quickly it was a billers job. I find the EMR much easier to read than a doctors chart and now its all right on my computer.
Title: Re: Emr system
Post by: PMRNC on June 15, 2011, 07:07:02 AM
My doctors are going to hate me because i am refusing a medical record on my family.. don't want it and I've seen enough of it that I know i won't want it.
Title: Re: Emr system
Post by: DMK on June 15, 2011, 10:13:41 AM
I agree Linda.  EMR packages are "cookie cutter" meaning that there are statements already set up in the software so the doctor only has to push a button and it types in the statement.  The reports we get from other doctors' offices are full of errors.  The notes look more complete, but they aren't correct a lot of the time.  Once again it's Garbage In Garbage Out!  Doctors don't really like EMR, and our patient's keep complaining that all the doctor does is look at his computer now instead of looking at them!
Title: Re: Emr system
Post by: PMRNC on June 15, 2011, 10:40:25 AM
It's going to be interesting for sure to see how doctors handle it for patients who refuse an EMR. I had a nightmare of a problem not once but TWICE and that's 2 times too many for me.
Title: Re: Emr system
Post by: camedbill on June 16, 2011, 03:18:21 PM
I have lost a couple of clients to an EMR  - mainly because that's part of their sales pitch to any clients who use a billing service- that providers will save money because it's so easy to bill out.  What they don't tell them is it's the a/r follow up that is time consuming not the billing out.  Although, soon there may even be software that takes care of most of this issue as well.

I could have explain this to try to retain my clients but unfortunately sometime when they're set to transition, they won't tell you until they've already signed on the dotted line and it's too late.

Even the HMO organizations & insurance companies are partnering with EMR companies to push providers to use EMRs to make it easier for them to process claims and to access for datamining purposes.

Sorry I'm not as optimistic about our industry as others here but one thing is for sure - there is a lot of changes in our industry and we will need to change with it in order to survive. Also another tip is stay in touch with your clients, if not, someone or something else will.
*pattil88* says it best
Title: Re: Emr system
Post by: QueenAlicia on June 16, 2011, 03:48:46 PM
I agree, one of the software systems that I am interested in promotes a certain EMR system.  I think if the provider wants EMR great if not great.  My plan for my business is to be aware and current on all new systems and procedures.  I think the business  has to adapt to the industry. 
Title: Re: Emr system
Post by: PMRNC on June 16, 2011, 03:54:58 PM
In no way should EMR impact our industry, need to look at other factors if it is because they are completely separate from each other. I have, if anything received an influx of questions in regards to EMR, none of which have to do with what we are doing.  My last client came to me from a friend of mine who sold an EMR system to this provider. 
Title: Re: Emr system
Post by: QueenAlicia on June 16, 2011, 03:57:29 PM
I should have said adapt such as ICD-10& CMS 5010 etc etc etc. Sorry for confusion.
Title: Re: Emr system
Post by: DMK on June 17, 2011, 10:50:25 AM
We should always understand the "lingo" though.  Know what EMR really means, it's doctor's notes regarding patient's treatment.  Some EMR systems have billing modules too, but EMR is a separate component.  Many doctor's don't even realize what it is, just that it's expensive, and that they're going to HAVE to use it if they have a certain size practice.
Title: Re: Emr system
Post by: TammyL on July 12, 2011, 10:42:58 AM
Well I just lost an account to this EMR also they had been with me for 8 years this EMR sucks it's going to knock alot of billing services out of business.
Title: Re: Emr system
Post by: PMRNC on July 12, 2011, 12:19:56 PM
Quote
Well I just lost an account to this EMR also they had been with me for 8 years this EMR sucks it's going to knock alot of billing services out of business.

How did you lose a client due to EMR?   Personally I don't see this happening when they say it will..first of all they have not ironed out all the kinks in terms of patient rights.. for example, I've not had one of my doctors explain what happens since I have voiced my own concerns that I will not have an EMR for myself or my family. That is within my right, but this hasn't been addressed.. the second reason I think it won't happen on time is common sense. When was the last time you saw a govt due date go ahead on schedule?? I think we are looking at about 2015 is my guesstimate.  But as a whole.. EMR should NOT be impacting billing companies on ANY level.
Title: Re: Emr system
Post by: Michele on July 12, 2011, 01:58:05 PM
I agree with Linda.  Unfortunately the EMR companies are trying so hard to sell their product and they are looking for any way to make theirs look better.  Some are using the billing aspect saying that it makes the 'whole process easier'.  Only uneducated providers fall for this.  I feel that if you (as a billing service) are doing a good (or Great) job and you have a good relationship with your provider, they should come to you before switching and you can educate them.  We are going to lose some, but those are ones we would have lost for another reason anyway.  Probably to a salesman on the corner selling snake oil!
Title: Re: Emr system
Post by: PMRNC on July 12, 2011, 02:24:24 PM
Michelle, i think you hit it.. i think the software vendors are making it look good to sell their systems.. It's up to us to educate our clients, take a pro-active approach to this if you think it's a hindrance. Personally I have not seen any difference or even a hint that EMR will take any business from us.  Keep your clients a step ahead and educated!
Title: Re: Emr system
Post by: TammyL on July 12, 2011, 04:14:40 PM
Thanks Linda and Michelle I agree with you both I truly believe I lost this client to in house billing because it was a cheaper way for them to go or she was on the husband side to bring inhouse since I lost his account back in Nov 2010 and he found someone to do his billing in house instead of outsourceing. It's there lost not mine like they say when one door closes another always open so I will continue to think postive
Title: Re: Emr system
Post by: rdmoore2003 on July 12, 2011, 04:59:51 PM
I love EMR.  I have used it since 2007.   Less time trying to figure out "chicken scratch" better known as the doctor's writings.    lol
Title: Re: Emr system
Post by: PMRNC on July 12, 2011, 05:29:40 PM
Quote
Thanks Linda and Michelle I agree with you both I truly believe I lost this client to in house billing because it was a cheaper way for them to go or she was on the husband side to bring inhouse since I lost his account back in Nov 2010 and he found someone to do his billing in house instead of outsourceing. It's there lost not mine like they say when one door closes another always open so I will continue to think postive

Oh trust me, they only think it's cheaper.. Keep them happy in parting because they will be back <g>
Title: Re: Emr system
Post by: Michele on July 13, 2011, 06:55:49 AM
 We have had a couple clients leave only to come back.  Most times when they come back they are must more appreciative of your service.  Some however, don't learn and will leave yet again.  We actually had one provider do it 3 times!  We didn't take em back that last one.  Definitely their loss, and it hits them in the wallet.  They may pay a little more for my service than an $8 an hour employee in the office, but they get what they pay for and their accounts receivables tell the story.
Title: Re: Emr system
Post by: TammyL on July 14, 2011, 07:17:05 PM
Michele I agree with you 100% I don 't know why some doctors are so cheap but like you say they get what they pay for because the A/R don't lie it tells the truth and nothing but the truth when ran and the doctor can tell right off the bat who's doing there job and who's not.
Title: Re: Emr system
Post by: DMK on July 15, 2011, 10:45:15 AM
I'll answer your question about why doctors are so cheap!  Being that my husband's the doctor and I'm the biller.  I also worked with EMR at the last office that we shared.

Understand that the doctors in the US are CONSTANTLY being nickeled and dimed by the insurance companies, the patients, and by their personal insurance companies (for their own health insurance, liability insurance, malpractice insurance, work com insurance etc).  They HAVE to find ways to reduce their overhead to absorb the insurance cuts and the people who don't pay their bills as well as improve their collections to cover their own personal and professional expenses. 

It is SO frustrating as a business owner alone, how many things are MANDATED but there is no consideration to the cost of the mandates to the providers!  So we look for ways to do things in house, ourselves, to keep costs down and to keep a direct handle on our income and outgo.

As a biller (and I can put that hat on now) you need to sell the fact that you're saving them employee expenses and it's YOUR JOB to keep an eye on their billing to keep it correct, and be their watch dog to make sure they get every nickel they are supposed to be paid.  That's your SOLE job!  You will help reduce their overhead if you do a good job because YOU will chase down the money, YOU will take the time to make the calls to chase down the claims, YOU will free up their time and their staff's time so they can see more patients and make more money.  In our business that's MY job, and I take it seriously.  If we ever got to a point where I didn't do that job we would use a service, because not everyone would take the responsibility seriously.
Title: Re: Emr system
Post by: Michele on July 16, 2011, 11:28:06 AM
Very good points DMK.  You are right.  Drs are nickled and dimed to death.  And most patients believe they are way overpaid and are just greedy.  Most of the drs I know, that is not the case.  There are some out there who do try to save a dime in the wrong place, their billing.  They don't understand how crucial it is to have someone who truly knows what they are doing.  But like you said, you need to explain to them that they will save money on employee expenses AND bring in all the money that they should be by hiring an expert.  Some cannot be taught, those are the ones you walk away from.  And there are a few that do have a good office set up for billing and wouldn't benefit as much from outsourcing.  I don't try to convince someone who doesn't truly need my service.
Title: Re: Emr system
Post by: Conrad Wysor on July 17, 2011, 06:04:38 PM
We have a client provider who uses an EMR system. Supposedly the EMR sales folks told them how easily it would integrate with the Practice Management software - but it doesn't seem to be that "seamless" yet.

However do find the EMR really helps in looking up info on a patient, their insurance, encounter info, notes, etc. Like others have commented its only as good as the info input to it. Instead of requesting this info from the office staff - who are usually really busy - we can log in and look up this info ourselves - really speeds things up when we have a question related to a claim.
Title: Re: Emr system
Post by: Alice Scott on July 19, 2011, 04:50:51 AM
More great advice!
Thanks
Title: Re: Emr system
Post by: messijack on September 12, 2013, 07:17:26 AM
EMR system allows doctors to document a patientís visit and automating the task associated with the charting patient. In EMR system, the accounts receivable follow up helps to monitor the patientís revenue collection in regular basis. The EMR system simplifies the process of tracking patientís
Title: Re: Emr system
Post by: RichardP on September 13, 2013, 12:31:11 AM
In EMR system, the accounts receivable follow up helps to monitor the patientís revenue collection in regular basis.

An Eletronic Medical Record (EMR) system tracks what is wrong with the patient (diagnosis codes) and what is done to fix it (procedure codes).  That is all an EMR does.  Revenue collection is of no concern to the Federal government, and is therefore not part of the EMR.  Figuring out best practices is of concern to the Federal government - for a given thing that is wrong, what procedures best fixed it?  The EMR tracks these things, so best practices can be determined.

Revenue collection, and the monitoring of the same, belongs to what is called the Practice Management System.  It is a rare software system where the EMR and the PM parts are both anchored to the same database.  Usually, the EMR system has one database, and the PM system has another (and are usually from different companies).  Although that seems to be starting to change with the cloud-based systems.
Title: Re: Emr system
Post by: samronald on September 20, 2013, 06:18:50 AM
Numerous advantages of implementing Electronic Medical Records (EMR):

The ability to quickly transfer patient data from one department to the next is a huge asset
The space saving benefit of a digital records environment
The ability to ultimately increase the number of patients served per day for enhanced patient workflow and increased productivity
Improved results management and patient care with a reduction in errors within your medical practice
Reduced operational costs such as transcription services and overtime labor expenses
Customizable and scalable electronic medical records that can grow with your practice
Advanced e-Prescribing and clinical documentation capabilities
Plus an improved bottom line of the healthcare practice, enhanced through the ability to more accurately and efficiently process patient billing
Title: Re: Emr system
Post by: RichardP on September 20, 2013, 02:22:45 PM
The ability to ultimately increase the number of patients served per day for enhanced patient workflow and increased productivity

Our experience matches what has been reported in a number of different surveys.  Our clients who have adopted EMRs spend about 30% of their day entering data into the EMR.  A job that used to be outsourced to a low-paid data entry clerk is now required to be performed by a highly-paid doctor.

If 30% of the physician's time is tied up in data entry, that means he is seeing fewer patients.  That translates into lower income, not higher - and lower productivity on the part of the doctor, not higher.

EMRs were always about allowing the government to collect statistics so they could determine, and then impose, best practices.  EMRs have never been about increasing the efficieny of the doctor.

Advanced e-Prescribing and clinical documentation capabilities

Most of our clients have not adopted EMRs, and have no plans to.  We have provided them a stand-alone product that processes e-Prescribing.  Don't need an EMR to do that.

Plus an improved bottom line of the healthcare practice, enhanced through the ability to more accurately and efficiently process patient billing

EMRs have nothing to do with billing.  They in fact complicate the process, rather than simplify it, if the EMR does not "talk to" the PM system - which most of them don't (although this situation is begining to improve).  When the EMR does not talk to the PM system, as is the case with several of our clients, they have to type all the codes into the EMR - then they have to turn around and provide us with paper copies of the codes that we then enter into our billing program.

You have presented to us a list of "nice to haves".  That list represents mostly wishful thinking.  It certainly does not represent current reality.
Title: Re: Emr system
Post by: samronald on September 23, 2013, 07:54:11 AM
There are several free EHR systems available, including Practice Fusion, Hello Health and Kareo, but their revenue-generating models all differ. Practice Fusion, for instance, has said it relies on advertising to help keep the system free. The physician will see a small ad on the bottom of the screen that might be targeted to what theyíve diagnosed.
Title: Re: Emr system
Post by: RichardP on September 23, 2013, 12:03:15 PM
Practice Fusion is an EMR that did not have a billing package built into it.  I don't know if that has changed over the last six months.  I know they never did resolve the problems of their EMR being able to "talk to" Kareo.

Kareo was a billing program that, until recently, did not have an EMR attached to it.  They have recently added an EMR, but I don't know if that EMR shares a common database with their billing program, or if it is an add-on.

I don't know anything about Hello Health.