Probably not. Not for optimizing your financial performance, anyway. As we start 2016, it is clear that more and more provider groups are making the case that stringent Meaningful Use regulations have left physicians spending too much time grappling with their Electronic Medical Record (EMR) systems. They are not necessarily opposed to EMRs; in fact eight out of 10 practices have adopted the technology. It is just that the definition of medical record has shifted from being a concise record of a person’s care to being a complex amalgamation of data by which a provider’s performance is judged. And when that data isn’t clean, billing and claims processing suffer.
Tony Schwartz, chief executive of The Energy Project, recently wrote in a New York Times column that “most companies invest in building the skills of their employees. Few of them systematically invest in building people’s capacity to perform at their best. Medical groups and hospitals are no different. A 2014 study in the International Journal of Health Services found that doctors spend close to 17 percent of their work week on billing, insurance, and other administrative work. As one California doctor complained in a comment to the Let Doctors Be Doctors site, “I am one expensive data entry clerk.”
Things that EMRs do well are sharing information about patients, leaving behind legible notes for the medical team, viewing x-rays, tracking medications, creating order sets and checklists and making templates for notes.
The EMR exists mostly to document a patient’s visit to the office and to capture the procedure and diagnosis codes related to those services. Unfortunately, that is not enough to guarantee that the insurance claim for those services will be paid. Accurate clinical documentation is essential for good patient care. Clean, accurate financial and administrative documentation is required to receive full reimbursement. Medicare alone publishes thousands of billing and coding guidelines that must be complied with in order for a medical claim to be paid correctly. Physicians already burdened with higher documentation requirements surrounding Meaningful Use, do not want to also learn the extraordinarily complex rules of financial billing and insurance processing.
So, not only are doctors doing the expensive data entry requirements outlined above, but they are paying their business office staff to manually review these electronic charges and augment the clinical encounter with the necessary billing and administrative requirements. Clearly, there must be a better way.
Imagine a successful system that automates EMR charge passing and claim scrubbing, helps lower your staff costs, enhances clean claim rates, cuts denial rates and reduces bad debt. It exists in RCxRules — a robust, intuitive rules engine that sits at the front end of your revenue cycle process, seamlessly integrating with your existing EMR and RCM systems, allowing for the automated review and correction of charge and patient data —before they hit your financial system.
RCxRules is healthcare’s only predictive rules engine, delivering unprecedented automation and business results you may not have previously thought possible.
See how RCxRules can help you clean up your RCM system and smooth the way for a productive relationship with your EMR system. We’ll see you soon!
