Essential Insights On Electronic Medical Records

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Author(s): 
Bruce Werber, DPM, FACFAS

   The system needs to have full integration with the medical record portion in order to facilitate the coding captured during the patient encounter. This will facilitate immediate submission to the clearinghouse and speed up payment for your services. It is helpful if the EMR automatically adds the G code to billing so the practice gets credit for electronic submission and receives the 2 percent Medicare bonus.

How A Solid EMR System Can Streamline Billing

   When the practice submits billing claims to an insurance company, the EMR set-up should be able to receive an electronic remittance and automatically post payments to the patients’ accounts. This only requires the staff to review that the system has posted the payments correctly and the practice has received correct payment. Staff should have the ability to pull up a patient account and send out statements.

   Electronic medical records should automatically check that payments occur according to the established fee schedule and the practice receives correct payment. If not, the system should flag the transaction for staff to investigate the under- or overpayment. The system should also prompt and automatically electronically bill any secondary payors listed on the patient’s account.

   The frequency of billing should be flexible with the capability of sending out bills daily or weekly. The more frequently you send out bills, the better your cash flow. Each day, invoices go out for any patients who came in and did not pay the co-pay or have an outstanding balance.

   The system should allow billing notes on each patient, when staff submitted and resubmitted the claim, and any additional documentation included. It should keep track of when the practice contacted the patient about the outstanding balance, when staff called the insurance company and to whom the staff person spoke. Document the outcome of the conversation and the date of the next follow-up.

   The system should send collection letters to the patient with different letters based on how long the balance is outstanding. A better method would be automated reminders to staff via internal messaging.

   The computer should allow one to send or fax notes electronically, including scanned documents to requestors such as insurance carriers, workers compensation reviewers and attorneys. The system should record the time and date that staff sent the notes, who requested the notes and to whom the staff sent the notes.

   The system should allow scanning on non-electronic explanation of benefits (EOB) to each patient’s record. The goal is to improve the ability to retrieve and send out EOBs if requested, and also to eliminate clutter in the office.

Ensuring Better Tracking Of Office Revenue

   The EMR program’s business reports should include a daily report on office production, charges and income, as well as a daily bank deposit report. The daily “dashboard” report should show accounts receivable totals for all insurance companies and patients for 30, 60 and 90 days. This report should track the number of both new and follow-up patients tracked per day, per week, per month and per year. The dashboard report should also list average income and charges calculated per patient per day.

   Monthly reports are very similar to dashboard reports with additional details. These reports can be sorted by doctor and location. The report should list accounts receivable by insurance company and patient. The system should also keep monthly tabs on income averages and charges per patient.

   Presenting the above information in a graphical format is very important. It gives the doctors a quick overview of the health of the practice. If data is present for a comparison of previous years, the system should generate reports to evaluate the year over year production of the practice.

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