Comment Re:EMR is much more than record keeping. (Score 1) 98
The only way doctors are going to go to EMR systems is when they improve the bottom line.
I believe 2014 is the target date to decrease physician reimbursement by 5% for not using EMR software
I currently do my patients records on paper. I bill much lower than I could, because I'm scared about penalties associated with being caught over-billing.
You should NOT be billing defensively! You need to have competent chart-audits regularly and bill for what you actually perform. You need to keep meticulous notes to verify your charges. Just because your office is "going EMR within the next year" and "amount you bill will increase" means absolutely NOTHING. They will still pay you the UCR rate in your area for whatever you bill for. Couple that with the fact that major insurers and Medicare/Medicaid are probably going to start paying a set fee on the diagnosis because of things like PQRI (see below), chances are you'll never make that up.
Case in point:
We have a doctor that bill $4000.00 for arthroscopic knee surgery. He only gets $600.00 and is very unhappy about it. We told him to stop doing surgery altogether and just do joint injections instead because they (payers) actually pay for that what it's worth, plus he'll save on malpractice insurance. If he takes our proposal seriously, he'll make more money for less work. Software won't give you that.
We have another doctor that tried out PQRI but for that extra 2% reimbursement it takes an extra 20 minutes of reporting per claim by the doctor herself. A chart-audit showed that all she had to do was bill her initial visit (9920X's) and she'd increase her monthly revenues by 7-15% (dermatologist - lots of new patients a month).
A different doctor (Psych) of ours asked about PORI and with what we came to the conclusion that it is nothing but research and for quantifying the data into a database to be able to start paying on the DX and not on the actual work performed. If you're a GP/Internist and you have a diabetic patient you're getting office visit reimbursement now. In the future you won't. You'll get a set-fee for the year and if it takes 2 visits, well maybe you're ahead on that patient but if it takes 20 visits you're out quite a bit of revenue... It's hard to stay on top of the reimbursement game.
Is EMR going to reduce the cost of health care? Almost certainly not. It will likely allow physicians to drill down into their database of patients to see:
Any decent billing software allows you to do the same exact thing. Even if it can't do it out of the box, chances are you can find someone who can get that data out of it with simple SQL queries. Our software does for the most part but since it is SQL based, I can extend any reporting easily either with CrystalReports or SSRS (SqlServerReportingServices) and in no time at all. Need to know reimbusement percentage? easy... Need to know detailed reimbursement analysis by CPT code and Insurance Company? easy... Need a recall list with specific parameters, again easy...You don't need EMR software to do that.
I don't presume to know your actual payer mix but if it's the normal 55% Insurance/ 45% the two M's/ 10% other you need a competent certified coder/biller/auditor who plays by the rules and investigates trends. You'll still end up with EMR down the road though some old-timers who still use ledger cards won't, but until more providers use it or it's a requirement to actually get paid... I'd wait.
