Medical billing is a complicated system with one simple goal, to ensure that healthcare providers are properly reimbursed for their services. In pursuit of this goal we must take into consideration how an EHR can help practices increase their collections and be more productive. Here we'll cover some common areas where the use of an EHR impacts billing and coding and how your practice can avoid potential errors while maximizing revenue.
The Impact an EHR Has on Your Medical CodingMedical coding plays a critical role in preventing denials, claim rejections, and proper reimbursement. EHR systems have released numerous features over the years to help with things like provider documentation, code look up/search and claims scrubbing.
Insurers have exacting demands for claims, and they frequently change. Denied claims are a major source of lost revenue for medical practices. In fact, denied, rejected, resubmitted and underpaid claims can cost your practice as much as $100,000 per month according to the AMA.
Keeping claim rejection rates low should be a top priority for practices.
EHRs make denial management fairly simple to measure. You should be regularly looking at your practice's denial data to find out the sources of the denials. Identify the top three to five reasons for your practice’s denials and take action.
Physician documentation can play a huge role in denials as well which leads me to my next point- upcoding.
- Be careful what you import from the patient’s previous exam
- Include all the elements of the visit
- Keep your default settings up-to-date
- Always practice accurate and ethical documentation
- Don’t take shortcuts with documentation
- Review before closing notes for accuracy
- Limit copy and paste functions
- Addenda only pertinent clinical information not just revenue based information
- Customize your templates-Build one template for each level of MDM (low, moderate, and high complexity)
How an EHR Helps with the Charge Capture Process
Healthcare organizations keep track of ("capture") a patient's use of hospital resources, such as equipment, medical supplies, diagnostic testing, medication and hospital staff. These charges are recorded and then billed to patients and third-party payers. Often, the use of a resource may be overlooked. The process behind "charge capture" can be complex, making it very important that a system is in place to capture charges completely and correctly, maximizing the potential reimbursement for revenue.
With an EHR system, at least one diagnosis must be captured along with a level of service that documents what was done for the patient at the end of every encounter. Additionally, the EHR includes a list of selectable Current Procedure Terminology codes that allows for easy input and helps reduces errors, ensuring the right code is used.
Most EHRs today will have a mobile technology available to providers that can help with the charge capture process. The provider can enter the patient demographics and visit information on their smartphone or iPad and the device then communicates the information to the practice’s EHR.
Choosing the Right EHR and Medical Billing Software
The possibility of error propagation with EHR systems is considerably outweighed by the advantages these systems confer. The right EHR coupled with the right medical billing software reduces duplication of effort and shortens the healthcare revenue cycle in many ways.
GroupOne Health Source understands the root causes and the solutions to medical billing services errors. We're experts in every aspect of the healthcare revenue cycle and help medical practices of all types improve their medical billing services.