Maximizing Billing and Reducing costs Through the Use of HIT. Daniel Mather Practice Manager Oswego County OB-GYN, P.C.

Transcription

1 Maximizing Billing and Reducing costs Through the Use of HIT Daniel Mather Practice Manager Oswego County OB-GYN, P.C.

2 Topics for Discussion Inefficiencies in Practice Management How inefficiencies can be improved with HIT Reduce the overhead costs of your practice HIT adoption will Improve claim submission to increase revenue Accounts receivable can be managed in more efficient manner Improved clinical visit coding to maximize reimbursement

3 Oswego County OB-GYN, P.C. 4.5 Physicians Board Certified OB/GYN 3 Certified Nurse Midwives 1 Nurse Practitioner 1 In House Ultrasound Tech 2.5 Office Nurses Medical Assistants and Clerical Staff 3 Office Locations 200 patients per day 700 deliveries per year

4 Inefficiencies in Practice Management Character Based Practice Management system on PC server with Dumb terminals Accomplished scheduling and accounts management 9600 baud Dial up Modems 70,000 Paper Charts MA s carry charts per provider per day betweeen locations Providers see patients without a Chart (Medical Record) Procedure Codes missed on Superbills Insurance verification slow and inefficient

5 Moving to an Electronic Medical Record System Aspects of the System Single Integrated Database Document Clinical Encounters Scheduling Communications Account Management Claims Processing E-Presriptions Laboratory and Radiology Results Insurance and Eligibility Approvals

6 Return on Investment (ROI) Study Gates Moore & Company Atlanta, GA Pre Implementation study November 2002 Post Deployment study Summer 2004 Anticipated ROI - $ 436,000 Actual ROI - $ 385,000 or 85%

7 Inefficiencies Improved or Eliminated Doctors increase Patient Time and decrease paperwork Review patient labs within 3 hours from time they saw the patient, 24 hours per day, between patients, at lunch, between surgical cases See more patients per day Electronic Prescriptions Increased Communications In Office Task System Patient Portal

8 What an EMR System Can do for your Practice Reduce amount of paper generated and handled Eliminate Transcription Services Enhance Information to Referring Providers Enhance scheduling Huge increase in Communication Enhance Quality of Documentation and Increase Legibility of records Reduce redundancy and inefficient processes Eliminate Manual Tracking Processes- Ex; Paps, Labs, Referrals, etc.

9 Improved claim submission and reconciliation to increase revenue Charges go from Physician template to Biller Claims are Accurate when submitted to Insurance Plan Less chance for denial 80 % of our Outstanding balances to Insurance are within 30 days 10 % days Reports can be run in a variety of ways to help identify Problems with certain carriers Procedures that are underpaid

10 Accounts receivable can be managed in more efficient manner Reports can be run in a variety of ways Statements run weekly Staff can view statements that were sent to patients Robust Collections system Pop-up flags alert Staff of Outstanding balances

11 Improved clinical visit coding to maximize reimbursement Change from E&M coding to Preventative Visits results in increased revenue of over $ 50,000 in one year Software Counts bullets for coding and suggests a CPT Code Most charges billed same day as patient seen E&M coding increased by one level Documentation supports coding increases Additional codes not missed

12 Summary Practicing without an EMR system is Inefficient Inefficiencies can be improved with an EMR system Overhead costs can be reduced HIT adoption will Improve claim submission and reconciliation to increase revenue Accounts receivable can be managed in a more efficient manner Clinical visit coding will help to maximize reimbursement

13 Questions?

14 Contact Information Daniel J. Mather Practice Manager Oswego County OB-GYN P.C. 42 Montcalm Street Oswego, New York (315)