Optometry Coding & Billing Alert

Up-front costs could give way to savings in many areas.

Streamline your collections system and get your deserved money faster with these practice management tips. Optometrists: Clip and give this monthly section to your claims specialist.

If you've been considering the switch to an electronic health records (EHR) system, you may have heard how one can improve the efficiency of your billing processes, but you might also be frightened by the significant upfront costs.

So how do you balance the benefits with the expense? Follow our experts' advice on how an EHR might benefit the key areas of your practice.

Weigh the Costs vs. Benefits

EHRs are primarily a practice management tool used by physician and medical technicians. But when used to their full potential, EHRs can save you a lot of time on the billing side as well.

On a basic level, an EHR (also sometimes called electronic medical records or EMR) is a computer-based system for storing, retrieving, and managing patient health records over a secure network. But you may also be able to handle data for medical referrals, medical treatments, medications, demographic information, and other nonclinical administrative information.

Billing plus: A good EHR system transmits claims to the insurers in a 24-hour period, calculates the correct level of service (requiring physician confirmation), and matches the number of visits with an equal number of charges -- all huge benefits for billers.

Warning: Some systems may not be right for your practice, and could actually severely hamper your office's efficiency, says Lucy McCabe, owner of LCM Consulting in Mineola, N.Y. Therefore, you should make sure you do your research before selecting an EHR for your practice.

Look for Easier Billing and Appeals

Many EHRs automatically create charges from the notethat is entered into the EHR, which "eliminates the need for charge entry and in most cases also takes care of payment posting as well," McCabe says.

How: When a patient arrives, her information enters a queue in the EHR, which the physician can access when he sees the patient. He can enter the patient's signs and symptoms into the system. "The information is then transferred over to the billing department, who attach the ICD-9 to the physician verified charges which are created by the EHR, and a claim is generated." says Barbara J.Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions, a codingand reimbursement consulting firm in Tinton Falls, N.J., and senior coder and auditor for The Coding Network.

The system eliminates paper charts and documentation, so everyone from your physician, to the front desk, to the biller has access to the latest real-time updates on your patients. This fact might be particularly attractive for third-party billers.

Quick fixes: You "will want a complete daily record of any rejected transmissions -- with clear reasons for the rejected claim," McCabe says. This will allow you to correct any rejected claims and resubmit them as quickly as possible.

When the system is fully integrated into your offices daily routines, "you no longer have these little pieces of paper flying around the office that you have to attach to a chart," Cobuzzi says.

Make Sure Your Doc Likes the System

An EHR can be of particular benefit to your provider,because he will be using it the most. Plus, many systems come with standard diagnosis and procedure codes built in.

There is a learning curve with using new technology,however, as many systems also make use of a touch screen or a handheld wireless tablet. "The physician will be spending a lot more time in front of the computer," Cobuzzi says. Your  doc will need to prepare for the initial time and effort its takes to get familiar with the system.

Ultimately, the physician is the one who has to be happy using the system, Cobuzzi says. You might recommend to your physician that he spend time watching another physician actually using the system.

Assess Your Practice's Needs

Everyone in your practice who will be using the system should spend as much time as possible watching other people use it and learning what they do and do not need.

Just like any technology, EHRs come with all sorts of bells and whistles that may or may not be appropriate for your practice. It's also important to choose an EHR system that will be compatible with other systems your practice might use.

For example, a small family practice office might not need a system which attaches voicemails to the electronic record, but a hospital practice might. "For specialty practices, the physician will want to make sure that the system follows his routine for exam and treatment and that his specialty codes are easy to find and assign," McCabe adds.

Bottom line: "Choose a vendor that has long term experience in medical practice software before making a commitment to any system," McCabe advises. Do your research, shop around, and talk to other practices.