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Archive for the ‘EMR’ Category

Improvements for Payers, Billers and Providers: Part 2

Thursday, August 11th, 2011

A myriad of issues affect medical bill management companies. Earlier this week, we discussed challenges facing billing and insurance companies, patients and providers, so here is the rest of the list:

Challenge: Incorrect claims adjudication based on the specialty of a physician.

Solution: Implementation of a mechanism that better enables claims adjudication for physicians with dual specialties.

Challenge: Loading of contract payment terms across multiple systems is inconsistent.

Solution: It is important for payers to make sure contract payment terms are loaded consistently across systems. Also, clearly identify the correct arrangements so provider staff can verify that the claims are paid accordingly.

Challenge: Websites are outdated.

Solution: Payers can help reduce most of the inaccurate claims submissions stemming from inaccurate or outdated information by providing physicians with real time information on their members eligibility and claims history.

Challenge: Authorization systems are outdated.

Solution: Replace the ineffective system—in which PCPs fax authorizations for specialists—with automated information technology so payers can help reduce the amount of paper, facilitate reimbursement and speed things up.

Challenge: Credentialing processes are unregulated.

Solution: Payers could increase the speed and efficiency of the present system (from several months to just 60 days) by applying a consistent process for enrolling or credentialing physicians.

Stay tuned for more from the official Integrated Medical Management Inc. blog!

All About Integrated Medical

Friday, July 8th, 2011

We have been specializing in billing and collections in Las Vegas and Henderson for more than 16 years, using cutting edge technology to make sure claims are submitted very quickly. According to the Medical Group Management Association (MGMA), the average percent of accounts receivable over 90 is 21.56%–but ours is less than 8%, and we have an average days to payment of 21.

Providers choose us for the following reasons:

  • Automated Claims Follow-up Processing
  • On-Line Patient Payment 24/7
  • Real-Time Access to Account Data 24/7
  • Reimbursement Tracking
  • Recurring Internal Audits
  • Automated Accounts Receivable Management
  • Electric Document Storage and Retrieval
  • Fast Turnaround Time for Electronic Claims Submission
  • Staff Training
  • Automated Concurrency Tracking
  • Ad Hoc Reporting Capability
  • HIPAA Complaint
  • Reduced Employee Headaches
  • Custom Reports at No Cost

Contact us for a free audit to see how we can help you with medical revenue management!

What You Need to Know About E-Prescribing

Wednesday, June 8th, 2011

Want to stay current on the latest news when it comes to e-prescribing and everything else in the medical billing world? You have come to the right place! Las Vegas’ Integrated Medical Management has all of the latest news, including news about e-prescribing.

According to recent reports, physicians seeing Medicare patients now have additional opportunities to avoid being penalized for failing to prescribe medications electronically by the June 30 deadline, issued under a proposed rule via the Centers for Medicare & Medicaid Services. This is welcome news for eligible physicians who don’t expect to report at least 10 electronic drug orders to CMS by June 30.
Medicare will reprimand those doctors that don’t meet 2011 e-prescribing requirements by reducing payments by 1% in 2012 and said on May 26 that doctors would be given a second chance to avoid the penalty post-deadline. Said physicians are allowed to claim one of the hardship exemptions online through October 1.

Additionally, the proposed rule would apply to physician practices that have already adopted certified electronic medical record systems—which could be used to satisfy the e-prescribing requirements, too—in an effort to earn Medicare or Medicaid meaningful use bonuses. Practices that use certified EMRs to send paperless drug orders will satisfy the e-prescribing requirement under the current program, as long as the system meets four functionalities. EMRs will be acceptable for e-prescribing in future reporting years (even if they don’t meet the four specific functionalities) if the proposed rule is finalized later this year.

“Eliminating unreasonable penalties and burdensome requirements, and providing physicians with more flexibility through an exemption process, will help ensure more physicians are able to successfully participate in the e-prescribing incentive program. The AMA has continually stressed to CMS that these changes were essential and is pleased to see them become a reality in a rule that will be finalized later this summer,” said AMA president Cecil B. Wilson, MD.

Market Growth Predicted to Surge as a Result of Anesthesia Data Management Systems

Friday, May 27th, 2011

In related anesthesia billing news, sales of anesthesia information management systems will result in a surge in the need for anesthesia, respiratory and sleep-management devices. A report from iData Research reports that the market will expand to around $4 billion by 2017.

The report revealed that the market for anesthesia, respiratory and sleep-management devices was valued at over $2.5 billion last year, representing a 3.7% increase over 2009. As additional companies enter the market, industry leaders will have to lower their prices in order to remain competitive.

“The market for anesthesia information management systems will increase by over 50% in 2012 as hospitals automate their anesthesia departments” (before health IT deadline included in the 2009 federal economic stimulus package), says CEO of iData Research Kamram Zamanian.

Additionally, iData Research released a companion report estimating that electronic health records and medical billing records will rake in over $7.4 billion in annual support revenue and sales by 2017, according to InformationWeek.

EMR AND BILLING

Wednesday, September 15th, 2010

ELECTRONIC MEDICAL RECORDS AND BILLING

Nearly every doctor’s office is frantically analyzing electronic medical record (EMR) software companies to get their share of the government money. The clinical side of many of the programs is slick. The bells and whistles are exciting for you and your staff. But what about billing?

Many EMR systems added a billing component almost as an afterthought to provide a ‘complete’ software system. Unfortunately, some key elements are usually missing.

Here are a few items to consider when speaking with a potential EMR vendor:

1. Can you load all your contracted rates?
2. Can you run a report of claims paid less than the contracted rate?
3. Can you run a credit balance report?
4. Can you ‘hold’ patient statements if you have returned mail?
5. Are you able to track the reasons for denials?
6. Can you put an ‘alert’ on the account for the front desk, i.e. wrong insurance/address on file?
7. Is there an audit trail by user?
8. Does the system accept electronic remittances?

While keeping the above in mind, make sure to have your billers see a demonstration of the EMR you like. They are the best ones to determine if the billing component is worth the extra money.