By: Vanessa Best, CCS-P, CPC, AHIMA ICD-10 Trainer, CHTS-IM
According to Forbes, more than 50% of all adult Americans own a smartphone. Is your phone a smartphone? Well, if your phone and/or tablet can take pictures and videos, tweet, search the internet, connect to apps, log onto programs, play games, send and receive text messages, send and receive emails, and also actually make telephone calls, then you have a smart phone! All of this is possible due to technology.
Technology has also made it possible for patients and doctors to benefit from the HIT Highway. That same smartphone and/or tablet in the hand of a doctor enables the clinician to use a handheld computer to check a patient's medication history, write a prescription and electronically send it to the pharmacy, document a patient visit and send it to the cloud to be integrated by the billing department, send a referral, collaborate with other healthcare professionals, and view test results. So the question is: "Should my practice jump on the HIT Highway?"
Has technology helped the business of practices as it relates to medical billing and coding?
Yes, let's look at three HIT Highway exits:
Exit - Format and Processing With ANSI 5010
Remember the old HCFA-1500 that was changed to the CMS-1500 and now the electronic format HIPAA ANSI 5010. HIPAA laws required new electronic standards and doctors and other healthcare providers benefit from clean claims being processed many times within 14 days!
Exit - Electronic Remittances
CMS (Center for Medicare and Medicaid Services) along with many other insurance plans will electronically directly deposit checks to your bank account. This will require forms to be completed and verification of your bank account information; however, your deposit will sometimes appear prior to the Explanation of Benefits!
Exit - Electronic Remittance Advice
Save a tree and dump the paper EOB (Explanation of Benefits)! Most Insurance Companies will provide an electronic format of the EOB called an ERA (Electronic Remittance Advice). In addition to viewing the file as a commonly familiar EOB, the ERA (electronic EOB) can be posted automatically to your billing system. So the hours spent paying a biller posting an EOB goes from hours to minutes! Check with your software vendor for enrollment and specifications.
Does the HIT Highway have functional benefits for a doctor or other healthcare provider?
Yes, let's look at three more exits on the HIT Highway:
1. Exit #1 EMR
Most doctors entered medicine for their love for patients. But mountains of paperwork, filling out charts and billing forms, then subsequently finding those charts and billing forms have left physicians pressed for time when seeing patients. In fact, paperwork can take up to one third of a doctor's day, according to the Annals of Family Medicine. With electronic health records, with one touch of a button, doctors can access all the care a patient has ever received and then figure out possible illnesses. Doctors can collaborate with other physicians thereby making critical life-saving data transparent. In essence, it allows a provider to provide the best care possible, and stay connected to the practice. There are many online references. One of note is www.healthit.gov. This site provides much information from CMS on accessing and preparing your practice.
2. Exit #2 E-Prescribe
We have heard it many times, the question "Patient, what medication are you currently on?" the answer "Nothing," the reality, "Something the patient forgot about that was prescribed by another doctor!" Electronic prescribing provides doctors with potential risks, contraindications, and alerts. This is one of the easiest HIT processes to implement. The bonus, many companies provide the service at no cost. For example, visit http://www.nationalerx.com/
Exit #2M Medication Applications
There are other newly designed mobile apps that have made a difference in patient care related to medication. See below. This case study retrieved from "How is Mobile Technology Changing HealthCare?" at http://worldofhealthit.org/2012/how-is-mobile-technology-changing-healthcare/
St. James's Hospital, Dublin, Ireland, has recently implemented a mobile phone application (app) for hemophilia patients so that they can record their medication usage at home by scanning barcodes on the pack prior to self-administration. Patients are alerted to any potential risks (wrong medication, passed expiry date, on a recall list). The initial phase of the study has demonstrated that it is conceptually and technically possible to design, develop, and implement a medication management system (medication scanning app) that integrates smartphone technology, barcode scanning, and an electronic diary to record and optimize medication compliance for patients. Initial findings include:
- Improved timeliness of medication administration
- Improved compliance
- Reduced medication wastage
- Patient empowerment
- Immediate real-time location of all medication in the event of a recall
3. Exit #3 ICD-10
Known as the International Statistical Classification of Diseases, the ICD-10 is the latest revision of this diagnostic tool. As of today, implementation is October 2014.
Why is ICD-10 necessary? Specificity! Both the healthcare industry and insurance payors agree that our current system of ICD-9 does not accurately reflect current medical treatment and technology. This new system will allow us to trace and accurately identify diagnoses and procedures. This classification allows illnesses, unusual findings, external causes, and symptoms to be coded to a greater degree of specificity.
Our current ICD-9 codes will blossom to over 76,000 codes with ICD-10.
After October 1, 2014, some payors will no longer accept ICD-9 codes, so as not to interrupt cash flow, providers must comply. ICD-10 will change many things in a practice from registration to referrals, physician documentation, and even insurance contracting. It will require training and education on how to follow the new guidelines and specificity needed in charting. The time to prepare is now! Many specialty associations offer instruction. Just to mention a few, training is also available online thru CMS www.cms.gov/icd10 and World Health Organization http://apps.who.int/classifications/apps/icd/icd10training/
AHIMA (American Health Information Management Association) approves expert trainers that can help with training and implementation of ICD-10. AHIMA-approved trainers must have a minimum of three years of direct experience in coding, fulfill other rigorous requirements, and complete an advanced program including two online courses and three days of face-to-face training. Upon completion, the candidate must then complete and pass an assessment in order to receive an AHIMA Trainer Certificate.
In an increasingly digitally connected world, unlike any other time in history, we have new technology that allows the field of healthcare to make drastic changes that streamline the entire system. Software programs and mobile technology can be leveraged to enable population statistics to be tracked and can help with detecting, monitoring, and managing outcomes of diagnoses.
In addition, new billing methods and tracking procedures make it easier to identify a patient's past treatments. Overall, this reduces the amount of paperwork, increases the rate of successful treatments, and allows practitioners to look at the entire population when treating an epidemic.
It is clear that despite all of these new developments, it is the trained physician's skill that ensures quality healthcare. Isn't that the reason why physicians entered medicine in the first place? Their love for patients. When it comes to treatment, all of the technology, apps, and most sophisticated tools in the world can only help if the doctor is skilled enough to perform an assessment followed by treating their patients. So, to our doctors and other healthcare professionals, why not let technology enhance and add to the skilled hands of our doctors? Will you get on the HIT Highway?
Vanessa Best CCS-P, CPC, AHIMA ICD-10 Trainer, CHTS-IM, is President of Precision Healthcare Consultants with offices in New York, Florida, and Atlanta. She provides marketing, billing, coding, ICD-10 implementation, and EHR solutions for practices. Contact her at Vanessa.Best@precisionhcc.com or visit www.precisionhcc.com (888-265-2547)
