By, Chris Thorman
We recently penned a post, “Should You Outsource Your Medical Billing,” which compared outsourcing the revenue cycle management process to managing that function in-house with medical billing systems. Assuming you go for the former option – outsourcing – this post will help you make the right choice of medical billing service companies.
How can a provider tell the difference between a fly-by-night medical billing company and one to which they can hand overtheir patient’s medical information with confidence? If a physician knows what criteria by which to judge a medical billing service, they’ll be able to select a company that will significantly decrease their time spent on billing issues and increase their time spent on patient care.
To choose correctly, a provider will need to evaluate these five key criteria when choosing a medical billing company:
* Level of service;
* Industry experience;
* Use of technology;
* Pricing model; and,
* Capacity to take on new clients.
What Functions Will a Billing Service Perform?
Before getting into the selection details, let’s quickly review how a billing service fits into the medical billing process. A medical billing company will be able to take over most billing functions in a provider’s office.
To see a substantial benefit, a provider needs to select a medical billing service that performs at least these functions:
1. Claim generation and submission;
2. Carrier follow-up;
3. Payment posting and processing;
4. Patient invoicing and support; and,
5. Collection agency transfer services.
These functions are the “guts” of medical billing. Following up with insurance carriers and pursuing denied claims are two areas where medical billing services typically excel versus a provider’s in-house staff.
Other services that may be offered include credentialing, medical coding, transcription, insurance eligibility verification and appointment scheduling.
Naturally, as the number of services increases, fees will increase. A provider will want to strike the proper balance between cost and service by honestly evaluating their own capacity to perform these functions.
Criteria #1: Level of Service
In addition to the basics of medical billing mentioned above, there are more details a provider will want to be clear on before choosing a medical billing service. Here are some important functions that a provider and billing service should delineate before they enter into a partnership:
Function
Possible Issues
Pursuing denied claims Will the service pursue denied claims or will the provider have to? If they do pursue denied claims, a provider will want to know what procedures the company has in place to do so to ensure they aren’t being paid lip-service.
Billing follow up If a patient doesn’t pay their bill, who follows up? Many medical billing services will correspond with patients regarding billing issues, which for many providers is a necessary function to outsource.
Complying with regulations By handing over a patient’s medical information to a third-party, a provider becomes responsible for the third-party’s compliance with the Health Insurance Accountability and Portability Act (HIPAA). The billing service must protect patient privacy to the same degree that the provider does.
Reporting and analysis One of the other benefits of a medical billing service is that they’re going to have business insight that a provider doesn’t. Will the service provide feedback about how to improve the practice? Or just send a one-page financial statement each month?
It’s important that a provider and a billing service agree on the level of service before they get started. If the right level of service isn’t chosen, a provider won’t reap the full benefits of outsourcing their medical billing.
Criteria #2: Industry Experience
When a provider evaluates a medical billing service’s experience, they need to look beyond the number of years the company has been in business. Experience includes not only time but also familiarity with certain specialities. Billing certification plays a key role here as well.
Billing procedures will vary by medical speciality, so a provider will want to choose a billing service that is familiar with their specialty. Experience with billing to Medicare and Medicaid will be a huge plus, in any speciality.
Choosing a service with staff members that are certified by the American Medical Billing Association (AMBA) is important as well. The AMBA offers a Medical Reimbursement Specialist certification designed to promote professional medical billing.
The certification implies that the recipient is knowledgeable in the areas of:
* ICD9, CPT4 and HCPCS Coding;
* Medical Terminology;
* Insurance claims and billing, appeals and denials, fraud and abuse;
* HIPAA and Office of Inspector General (OIG) Compliance;
* Information and web technology; and,
* Reimbursement.
Even with a certified staff, the proper procedures and technology will need to be employed to maximize benefits of the provider/billing service relationship.
Criteria #3: Use of Technology
Software for medical billing is allowing billing services to accomplish more with less. However, just because a company is using sophisticated billing software doesn’t necessarily mean they’re going to do an efficient job. They need to have the proper procedures in place to take advantage of everything the billing company software offers.
Most importantly when it comes to technology, a provider will want to know about a company’s information sharing, data security, recovery procedures, data backup procedures.
Here are some potential technology issues in those realms that will need to be addressed:
* How will superbills and claims be shared?
* How does billing service fit with the provider’s electronic health record (EHR) strategy?
* Does the service have an integrated EHR?
* How does the service ensure data security?
* What are the disaster recovery procedures?
* Where and how is backup data stored?
* Will a provider need to install and maintain software or access the system online?
* Is the technology HIPAA compliant?
Choosing a medical billing service company that employs technology in a way that effortlessly bridges the gap between provider and biller can mean the difference between profit and loss. By choosing a medical billing service that integrates with a provider’s EHR (or provides their own EHR), that gap can be closed even more.
Criteria #4: Pricing Options
When dealing with practices whose revenue is in the millions of dollars, the cost savings between pricing models can be in the hundreds of thousands of dollars.
There are three pricing options offered by medical billing companies and we’ve broken them down in the table below:
Description
Pros
Cons
Percentage-based The service will charge a percentage of collections or they will charge a percentage of gross claims submitted or total collections. The success of the billing company is tied to the success of the practice. Small claims may not be pursued as aggressively due to lower payoff.
Fee-based With this model, the billing services charges a fixed dollar rate per claim submitted. This model is potentially more cost effective. Less incentive for the billing service to follow-up on denied claims.
Hybrid With this model, the billing service charges on a percentage basis for certain carriers or balances and charges a flat fee for others. This model is potentially more cost effective. Less incentive for the service to follow-up on certain claims.
Percentage-based models are most common on the market today. Fee-based models are the next most common option with the hybrid option appearing with less frequency. Many billing companies offer two or three of these options.
Criteria #5: Capacity to Take on New Clients
Finally, a provider will want to get into the nitty gritty of a medical billing company’s performance to evaluate whether the company has the capacity to take them on as a client. Remember, much of the payoff in hiring a billing service comes from the pursuit of denied claims and fee collection. A billing service that doesn’t have the capacity to effectively follow up with outstanding bills will provide minimal benefit.
Determining capacity involves collecting a number of metrics about the company’s performance, including:
* Years in the business;
* Number of employees and reporting structure;
* Number of clients by specialty;
* Gross number of billings; and,
* Number of claims processed annually.
Knowing this information will help a provider determine the level of service a billing company will be able to provide to their practice. Getting even more detailed, a provider will also want to delve into a number of “quality” metrics about billing companies. These include:
* Average number of days in A/R by specialty;
* Coding, submission and follow-up delay metrics;
* By what percentage they’ve been able to increase revenues for existing clients; and,
* By what percentage they’ve been able to reduce payment delays.
How a medical billing service performs on each of these metrics will significantly affect a provider’s bottom line.
Above article publish on http://www.mymedicalbillingoutsourcing.com/evaluate-medical-billing-services/
Friday, May 7, 2010
Thursday, May 6, 2010
Speakers at Boston Conference Highlight Health IT Opportunities
On Thursday, National Coordinator for Health IT David Blumenthal discussed national progress on health IT adoption during a speech at a conference hosted by the Massachusetts Health Data Consortium, Computerworld reports.
Blumenthal highlighted the grants his office is distributing for health IT education and training at regional extension centers. He said federal investment in health IT training could help create between 45,000 and 50,000 jobs over the next five years.
Blumenthal also discussed how federal officials plan to investigate safety issues associated with electronic health records. He said the Office of the National Coordinator for Health IT will prioritize patient safety goals as it works to promote EHR adoption nationwide.
According to Blumenthal, over the next year ONC will focus on:
* Finalizing “meaningful use” regulations for EHRs;
* Helping hospitals and health care providers adopt standards that align with the National Health Information Network; and
* Implementing the “beacon community” grant program to support regional health IT infrastructure and data exchanges (Mearian, Computerworld, 4/30).
Blumenthal said ONC will announce the awards for the beacon community program “very, very soon” (Monegain, Healthcare IT News, 4/30).
Governor Discusses Massachusetts’ Experience
Also during the conference, Massachusetts Gov. Deval Patrick (D) discussed how health IT initiatives have played out in his state, which requires most residents to obtain a minimum level of health coverage (Computerworld, 4/30).
Patrick said that:
* 45% of Massachusetts physicians have adopted EHRs;
* 50% of state physicians use computerized physician order entry systems; and
* Massachusetts leads the country in electronic prescribing (Healthcare IT News, 4/30).
The governor also said that his state could face challenges in connecting health care providers through health information exchange networks (Computerworld, 4/30).
Above article publish on http://www.ehrexperts.us/speakers-at-boston-conference-highlight-health-it-opportunities/
Blumenthal highlighted the grants his office is distributing for health IT education and training at regional extension centers. He said federal investment in health IT training could help create between 45,000 and 50,000 jobs over the next five years.
Blumenthal also discussed how federal officials plan to investigate safety issues associated with electronic health records. He said the Office of the National Coordinator for Health IT will prioritize patient safety goals as it works to promote EHR adoption nationwide.
According to Blumenthal, over the next year ONC will focus on:
* Finalizing “meaningful use” regulations for EHRs;
* Helping hospitals and health care providers adopt standards that align with the National Health Information Network; and
* Implementing the “beacon community” grant program to support regional health IT infrastructure and data exchanges (Mearian, Computerworld, 4/30).
Blumenthal said ONC will announce the awards for the beacon community program “very, very soon” (Monegain, Healthcare IT News, 4/30).
Governor Discusses Massachusetts’ Experience
Also during the conference, Massachusetts Gov. Deval Patrick (D) discussed how health IT initiatives have played out in his state, which requires most residents to obtain a minimum level of health coverage (Computerworld, 4/30).
Patrick said that:
* 45% of Massachusetts physicians have adopted EHRs;
* 50% of state physicians use computerized physician order entry systems; and
* Massachusetts leads the country in electronic prescribing (Healthcare IT News, 4/30).
The governor also said that his state could face challenges in connecting health care providers through health information exchange networks (Computerworld, 4/30).
Above article publish on http://www.ehrexperts.us/speakers-at-boston-conference-highlight-health-it-opportunities/
Online Patient Portal – Another Innovation of Medical Technology
By Jonathan G Ponting
Latest technology has simplified our lives to a great extent. Internet is helping to simplify many complicated procedures and few examples of the same are exchanging messages, contacting people in distant places using chat and emails, online shopping, reading information of latest events and happenings across the world and collecting information required related to any topic.
One of the most benefited industries from internet is the field of medicine. The latest innovation of medical technology is online patient portals. It is designed to increase communication and relation between patient and health care providers.
Online patient portal helps in efficiently managing the available resources with the local physician or provider to reduce the cost of treatment for both patient and the provider that uses advanced technology. It also enables doctors and providers in transmission of everything that is related to treatment of the patients like medical images for diagnosis, reports, medical date related to patient etc. It is also helpful in educating local physicians online on preventing development of chronic diseases via video conferences.
Online portals are also helping physicians to easily schedule appointment with patients as there is increase in demand for health care services which helps patients in avoiding to stand in lengthy lines. Patient portal helps patients to have better understanding of the disease they are suffering from, with the help of information provided and can also request for renewal of prescriptions at these portals. Patients are also offered to join various groups where other members also suffer from similar chronic diseases which help in lifting of spirits.
Patient portals not only help patients to directly contact with physicians but also to have remote access to mobile tools. Online patient portals are helping to improve quality of health care in remote and rural areas.
Patient portals are best and easy way of contacting doctors for various ailments and getting them treated without waiting for long time. They are best sources of getting advanced treatment for patients’ condition at affordable prices. They are highly beneficial for both patient and the health care provider in offering and availing best of treatments irrespective of geographic location.
Above article publish on http://www.emrspecialists.com/2010/05/online-patient-portal-innovation-medical-technology/
Latest technology has simplified our lives to a great extent. Internet is helping to simplify many complicated procedures and few examples of the same are exchanging messages, contacting people in distant places using chat and emails, online shopping, reading information of latest events and happenings across the world and collecting information required related to any topic.
One of the most benefited industries from internet is the field of medicine. The latest innovation of medical technology is online patient portals. It is designed to increase communication and relation between patient and health care providers.
Online patient portal helps in efficiently managing the available resources with the local physician or provider to reduce the cost of treatment for both patient and the provider that uses advanced technology. It also enables doctors and providers in transmission of everything that is related to treatment of the patients like medical images for diagnosis, reports, medical date related to patient etc. It is also helpful in educating local physicians online on preventing development of chronic diseases via video conferences.
Online portals are also helping physicians to easily schedule appointment with patients as there is increase in demand for health care services which helps patients in avoiding to stand in lengthy lines. Patient portal helps patients to have better understanding of the disease they are suffering from, with the help of information provided and can also request for renewal of prescriptions at these portals. Patients are also offered to join various groups where other members also suffer from similar chronic diseases which help in lifting of spirits.
Patient portals not only help patients to directly contact with physicians but also to have remote access to mobile tools. Online patient portals are helping to improve quality of health care in remote and rural areas.
Patient portals are best and easy way of contacting doctors for various ailments and getting them treated without waiting for long time. They are best sources of getting advanced treatment for patients’ condition at affordable prices. They are highly beneficial for both patient and the health care provider in offering and availing best of treatments irrespective of geographic location.
Above article publish on http://www.emrspecialists.com/2010/05/online-patient-portal-innovation-medical-technology/
Wednesday, May 5, 2010
Transcription trade groups offer ethics guide
By Joseph Conn
The medical transcription industry, represented by its two trade groups, is preparing for what it sees as the possibility of heightened privacy, security and fraud enforcement by coming up with its own guidebook of ethics and best practices.
The Association for Healthcare Documentation Integrity, an association of medical transcription practitioners, formerly known as the American Association for Medical Transcription, and the Medical Transcription Industry Association, the trade group for transcription service providers, have released their “Manual of Ethical Best Practices for the Healthcare Documentation Sector.”
The release of the full guideline is timed to coincide with the MTIA’s annual conference April 28th-May 1st in Daytona Beach, Fla., according to Peter Preziosi, CEO of the two organizations, which formed what they describe as “a strategic legal partnership” in 2007.
Scott Edelstein, a Washington, D.C., lawyer in the healthcare law practice at Squire, Sanders & Dempsey, was the lead author of the manual for the MTIA and AHDI. Edelstein said that more stringent privacy and security protections in the American Recovery and Reinvestment Act of 2009—which include new breach notification provisions and empower state attorneys general to enforce HIPAA privacy laws—as well as the increased fraud-fighting sections of the recently enacted Patient Protection and Affordable Care Act, will likely yield more government enforcement activities going forward, Edelstein said.
And that prompted the two trade groups to take a pro-active approach in producing the manual. “I think just generally, the tone for this administration is going to be increased in enforcement, because there is increased sensitivity for privacy of information,” Edelstein said.
“Most of the companies in the medical transcription industry tend to be small mom-and-pop operations, but they’re handling such sensitive information,” he said. “The concern is that some of these companies may not have taken all the measures needed under HIPAA and fraud and compliance laws, and this manual was to provide guidance for them.”
Data on the medical transcription industry is somewhat sketchy. The federal Bureau of Labor Statistics places the number of medical transcriptionists in the U.S. workforce at around 100,000, but the BLS figures don’t capture independent contractors, according to Preziosi, “and I’d say a good 50% are independent contractors.”
Add in small physician offices where the office manager might double for an MT and, all told, there may be as many as 250,000 to 300,000 medical transcriptions working full or part-time for 1,500 to 1,700 companies, mostly sole proprietorships, though there also are a handful of “giants,” he said.
The manual offers a best practices check list, copies of the codes of ethics of both organizations, guides on billing practices and the rules on hiring employees vs. independent contractors, roughly 170 pages devoted to compliance with Health Insurance Portability and Accountability Act privacy and security rules, a how-to section on establishing a HIPAA-compliant home-based office, and a “50-state data privacy survey,” according to a listing of the manual’s contents on the AHDI website.
Such guidance doesn’t come cheap. Copies of the manual cost $4,000 for non members of the two associations, with prices ranging between free to $750 for MTIA members and $750 or $950 for AHDI members.
Above article publish on http://www.medicaltranscriptionoutsource.com/transcription-trade-groups-offer-ethics-guide/
The medical transcription industry, represented by its two trade groups, is preparing for what it sees as the possibility of heightened privacy, security and fraud enforcement by coming up with its own guidebook of ethics and best practices.
The Association for Healthcare Documentation Integrity, an association of medical transcription practitioners, formerly known as the American Association for Medical Transcription, and the Medical Transcription Industry Association, the trade group for transcription service providers, have released their “Manual of Ethical Best Practices for the Healthcare Documentation Sector.”
The release of the full guideline is timed to coincide with the MTIA’s annual conference April 28th-May 1st in Daytona Beach, Fla., according to Peter Preziosi, CEO of the two organizations, which formed what they describe as “a strategic legal partnership” in 2007.
Scott Edelstein, a Washington, D.C., lawyer in the healthcare law practice at Squire, Sanders & Dempsey, was the lead author of the manual for the MTIA and AHDI. Edelstein said that more stringent privacy and security protections in the American Recovery and Reinvestment Act of 2009—which include new breach notification provisions and empower state attorneys general to enforce HIPAA privacy laws—as well as the increased fraud-fighting sections of the recently enacted Patient Protection and Affordable Care Act, will likely yield more government enforcement activities going forward, Edelstein said.
And that prompted the two trade groups to take a pro-active approach in producing the manual. “I think just generally, the tone for this administration is going to be increased in enforcement, because there is increased sensitivity for privacy of information,” Edelstein said.
“Most of the companies in the medical transcription industry tend to be small mom-and-pop operations, but they’re handling such sensitive information,” he said. “The concern is that some of these companies may not have taken all the measures needed under HIPAA and fraud and compliance laws, and this manual was to provide guidance for them.”
Data on the medical transcription industry is somewhat sketchy. The federal Bureau of Labor Statistics places the number of medical transcriptionists in the U.S. workforce at around 100,000, but the BLS figures don’t capture independent contractors, according to Preziosi, “and I’d say a good 50% are independent contractors.”
Add in small physician offices where the office manager might double for an MT and, all told, there may be as many as 250,000 to 300,000 medical transcriptions working full or part-time for 1,500 to 1,700 companies, mostly sole proprietorships, though there also are a handful of “giants,” he said.
The manual offers a best practices check list, copies of the codes of ethics of both organizations, guides on billing practices and the rules on hiring employees vs. independent contractors, roughly 170 pages devoted to compliance with Health Insurance Portability and Accountability Act privacy and security rules, a how-to section on establishing a HIPAA-compliant home-based office, and a “50-state data privacy survey,” according to a listing of the manual’s contents on the AHDI website.
Such guidance doesn’t come cheap. Copies of the manual cost $4,000 for non members of the two associations, with prices ranging between free to $750 for MTIA members and $750 or $950 for AHDI members.
Above article publish on http://www.medicaltranscriptionoutsource.com/transcription-trade-groups-offer-ethics-guide/
CHIME Offers Input on Electronic Health Record Certification Plans
In a comment letter sent Friday, the College of Healthcare Information Management Executives stressed the importance of ensuring that the electronic health record certification process can adequately handle the demand to certify EHR systems, Healthcare IT News reports (Merrill, Healthcare IT News, 4/30).
CHIME also said EHR systems that receive certification under the temporary certification program being established this year should be able to have that certification carry over to the permanent program that will be established in 2012 (Goedert, Health Data Management, 4/30).
The comments are in response to the Office of the National Coordinator for Health IT’s Notice of Proposed Rulemaking on EHR certification.
CHIME also recommended that ONC:
* Ensure that the certification program has the capacity to handle demand;
* Focus on EHR certification before expanding to other technologies (Healthcare IT News, 4/30);
* Provide details on how it will coordinate the EHR testing and certification process with the National Institute of Standards and Technology;
* Explain what constitutes a self-developed EHR;
* Require vendors to disclose what functions their products are certified to perform and any known compatibility issues; and
* Give vendors adequate time to recertify their products if a certifying body loses its authority to certify products (Health Data Management, 4/30).
Above article publish on http://www.myemrstimulus.com/chime-offers-input-electronic-health-record-certification-plans/
CHIME also said EHR systems that receive certification under the temporary certification program being established this year should be able to have that certification carry over to the permanent program that will be established in 2012 (Goedert, Health Data Management, 4/30).
The comments are in response to the Office of the National Coordinator for Health IT’s Notice of Proposed Rulemaking on EHR certification.
CHIME also recommended that ONC:
* Ensure that the certification program has the capacity to handle demand;
* Focus on EHR certification before expanding to other technologies (Healthcare IT News, 4/30);
* Provide details on how it will coordinate the EHR testing and certification process with the National Institute of Standards and Technology;
* Explain what constitutes a self-developed EHR;
* Require vendors to disclose what functions their products are certified to perform and any known compatibility issues; and
* Give vendors adequate time to recertify their products if a certifying body loses its authority to certify products (Health Data Management, 4/30).
Above article publish on http://www.myemrstimulus.com/chime-offers-input-electronic-health-record-certification-plans/
Tuesday, May 4, 2010
Webinar: Leadership is crucial in e-prescribing initiatives
Leadership and vision are crucial for an e-prescribing initiative because effective leadership is necessary to build commitment across a team, according to Diane R. Jones, JD, vice president of policy and programs at e-Health Initiative during an informational webinar on the current and future states of e-prescribing.
“The staff needs to be open to change and appreciate the benefits of [e-prescribing], but the leadership is going to be crucial [as well as] what the team hopes to accomplish through e-prescribing and that vision should encompass an understanding of the functionality and the benefits offered by e-prescribing,” stated Jones.
The webinar, sponsored by health organization Open Health IT Exchange, sought to teach attendees about the Medicare Improvements for Patients and Providers Act (MIPPA), the HITECH Act and related facts surrounding incentives, penalties, timelines and qualified system definitions.
Jones, quoting a 2009 report from e-prescribing company Surescripts, stated that approximately 85 percent of community pharmacies in the U.S. are connected for prescription routing and the number of prescribers routing prescriptions electronically has grown from 74,000 to 156,000.
To give context and clarity, Jones defined e-prescribing as the transmission of electronic media of prescription or prescription related information between a prescriber, dispenser, pharmacy benefit manager or health plan, either directly or through an intermediary including an e-prescribing network.
One challenge of deploying e-prescribing for Sidney Clinic in Sidney, Mont., is that the facilitiy’s e-prescribing application currently doesn’t have “cancelation” or “change in medication directions” options, said Pam McGlothilin, clinical information systems coordinator at Sidney Clinic. To provide a peer prespective, McGlothilin noted that their faciltiy, which serves a region of 5,000 people, currently has five providers using e-prescribing to order 50-75 prescriptions a day.
McGlothilin noted that most pharmacies in her region support e-prescribing and that within a 50 mile radius, 15 pharmacies will accept e-prescriptions. Anecdotally, McGlothilin said that e-prescribing has been helpful in that it is faster than faxing orders so providers are more prone to use the system, especially with electronic refill requests.
“Our practice has benefited by doing this earilier; once meaningful use comes out…we’ll be ahead of the curve,” said McGlothilin, who added that within the coming weeks, a cancelation button option will be added to the e-prescribing system.
In addition to assessing organizational readiness and defining practice needs, Jones stated that when following through with an e-prescribing initiative, the provider should also evaluate the costs and financing of a system and undergo a peer review or test a system before deploying it.
E-prescribing will be a key component of meaningful use requirements, according Michelle Allender-Smith, RN, nurse consultant/government task lead for the Centers for Medicare & Medicaid Services (CMS). Any medical professional defined as “eligible” by CMS may participate to receive MIPPA incentives, Allender-Smith noted.
In July of 2008, Congress passed MIPPA in an effort to prevent mandated cuts in Medicare payment to physicians for approved services, stated Allender-Smith. In October of 2008, the five-year e-prescribing incentive program was implemented to provide eligible professionals with incentive payments each year, if they meet requirements for being a successful e-prescriber.
Allender-Smith stated that a qualified system should be able to:
* Generate a complete active medication list (with information from pharmacy benefit management organizations or pharmacies if available);
* Select medications, print prescriptions, transmit prescriptions electronically using the applicable standards, and warn the prescriber of possible undesirable or unsafe situations;
* Provide information on lower-cost, therapeutically-appropriate alternatives; and
* Provide information on formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan.
Each incentive payment is based on the covered professional services furnished by an eligible professional during the reporting period (one year) which began in January 2009. The last reporting period will be in 2013, added Allender-Smith.
However, because eligible professionals cannot both receive Medicare and Medicaid HITECH Act incentive payments, beginning in 2011 providers must decide between MIPAA and HITECH Act incentives, according to Allender-Smith.
Those that choose not to adopt an e-prescribing system by the year 2012 will be subject to a payment differential, in which their fee schedule payments will be reduced for each year after, stated Allender-Smith.
Allender-Smith also noted that there is a current Interim Final Rule (IFR) published in the March 31 Federal Registar on providing a mechanism that supports e-prescribing on controlled substances. The IFR is currently in a 60-day public comment period but because it is a “major rule,” Allender-Smith it is subject to congressional review. Therefore, its effective date could be delayed.
Above article publish on http://www.eprescriptionservices.com/webinar-leadership-crucial-eprescribing-initiatives/
“The staff needs to be open to change and appreciate the benefits of [e-prescribing], but the leadership is going to be crucial [as well as] what the team hopes to accomplish through e-prescribing and that vision should encompass an understanding of the functionality and the benefits offered by e-prescribing,” stated Jones.
The webinar, sponsored by health organization Open Health IT Exchange, sought to teach attendees about the Medicare Improvements for Patients and Providers Act (MIPPA), the HITECH Act and related facts surrounding incentives, penalties, timelines and qualified system definitions.
Jones, quoting a 2009 report from e-prescribing company Surescripts, stated that approximately 85 percent of community pharmacies in the U.S. are connected for prescription routing and the number of prescribers routing prescriptions electronically has grown from 74,000 to 156,000.
To give context and clarity, Jones defined e-prescribing as the transmission of electronic media of prescription or prescription related information between a prescriber, dispenser, pharmacy benefit manager or health plan, either directly or through an intermediary including an e-prescribing network.
One challenge of deploying e-prescribing for Sidney Clinic in Sidney, Mont., is that the facilitiy’s e-prescribing application currently doesn’t have “cancelation” or “change in medication directions” options, said Pam McGlothilin, clinical information systems coordinator at Sidney Clinic. To provide a peer prespective, McGlothilin noted that their faciltiy, which serves a region of 5,000 people, currently has five providers using e-prescribing to order 50-75 prescriptions a day.
McGlothilin noted that most pharmacies in her region support e-prescribing and that within a 50 mile radius, 15 pharmacies will accept e-prescriptions. Anecdotally, McGlothilin said that e-prescribing has been helpful in that it is faster than faxing orders so providers are more prone to use the system, especially with electronic refill requests.
“Our practice has benefited by doing this earilier; once meaningful use comes out…we’ll be ahead of the curve,” said McGlothilin, who added that within the coming weeks, a cancelation button option will be added to the e-prescribing system.
In addition to assessing organizational readiness and defining practice needs, Jones stated that when following through with an e-prescribing initiative, the provider should also evaluate the costs and financing of a system and undergo a peer review or test a system before deploying it.
E-prescribing will be a key component of meaningful use requirements, according Michelle Allender-Smith, RN, nurse consultant/government task lead for the Centers for Medicare & Medicaid Services (CMS). Any medical professional defined as “eligible” by CMS may participate to receive MIPPA incentives, Allender-Smith noted.
In July of 2008, Congress passed MIPPA in an effort to prevent mandated cuts in Medicare payment to physicians for approved services, stated Allender-Smith. In October of 2008, the five-year e-prescribing incentive program was implemented to provide eligible professionals with incentive payments each year, if they meet requirements for being a successful e-prescriber.
Allender-Smith stated that a qualified system should be able to:
* Generate a complete active medication list (with information from pharmacy benefit management organizations or pharmacies if available);
* Select medications, print prescriptions, transmit prescriptions electronically using the applicable standards, and warn the prescriber of possible undesirable or unsafe situations;
* Provide information on lower-cost, therapeutically-appropriate alternatives; and
* Provide information on formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan.
Each incentive payment is based on the covered professional services furnished by an eligible professional during the reporting period (one year) which began in January 2009. The last reporting period will be in 2013, added Allender-Smith.
However, because eligible professionals cannot both receive Medicare and Medicaid HITECH Act incentive payments, beginning in 2011 providers must decide between MIPAA and HITECH Act incentives, according to Allender-Smith.
Those that choose not to adopt an e-prescribing system by the year 2012 will be subject to a payment differential, in which their fee schedule payments will be reduced for each year after, stated Allender-Smith.
Allender-Smith also noted that there is a current Interim Final Rule (IFR) published in the March 31 Federal Registar on providing a mechanism that supports e-prescribing on controlled substances. The IFR is currently in a 60-day public comment period but because it is a “major rule,” Allender-Smith it is subject to congressional review. Therefore, its effective date could be delayed.
Above article publish on http://www.eprescriptionservices.com/webinar-leadership-crucial-eprescribing-initiatives/
Monday, May 3, 2010
Medical records system benefits from stimulus funds
By Liv Osby
Stimulus money to the tune of $5.6 million was awarded to Health Sciences South Carolina with a goal of getting 1,000 primary care doctors in the state to adopt the new electronic medical records system.
The funds will be used to set up a regional program called the Center for Information Technology Implementation Assistance. HSSC worked with the state Department of Health and Human Services to develop a statewide strategy for forging ahead with EMR.
“CITIA-SC will play a key role in supporting medical professionals throughout the state as they adopt and expand health information technologies in their practices,” said DHHS Director Emma Forkner.
DHHS spokesman Jeff Stensland said the University of South Carolina estimates about 60 percent of physician practices and 42 percent of hospitals have fully-integrated EMRs.
DHHS recently got a $9 million grant for its statewide health information exchange, which gives hospitals, doctors, clinics and other health care providers access to medical records.
HSSC is a partnership between universities and hospitals in the state to foster economic growth and improve health.
Above article publish on http://www.myemrstimulus.com/medical-records-system-benefits-stimulus-funds/
Stimulus money to the tune of $5.6 million was awarded to Health Sciences South Carolina with a goal of getting 1,000 primary care doctors in the state to adopt the new electronic medical records system.
The funds will be used to set up a regional program called the Center for Information Technology Implementation Assistance. HSSC worked with the state Department of Health and Human Services to develop a statewide strategy for forging ahead with EMR.
“CITIA-SC will play a key role in supporting medical professionals throughout the state as they adopt and expand health information technologies in their practices,” said DHHS Director Emma Forkner.
DHHS spokesman Jeff Stensland said the University of South Carolina estimates about 60 percent of physician practices and 42 percent of hospitals have fully-integrated EMRs.
DHHS recently got a $9 million grant for its statewide health information exchange, which gives hospitals, doctors, clinics and other health care providers access to medical records.
HSSC is a partnership between universities and hospitals in the state to foster economic growth and improve health.
Above article publish on http://www.myemrstimulus.com/medical-records-system-benefits-stimulus-funds/
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