Medical billing services must deal with additional complications in evaluating EHR options for their clients and service. If your clients cover a wide range of sizes and areas of medicine, you may have difficulty finding a single product that can meet a wide range of needs.
Your evaluation process needs to overlay the needs of your client base with the requirements of your medical billing organization and your EHR strategy:
Features for Clients
EHR products must provide charting tools to document patient services as well as workflow tools to manage patient visits and services. Additionally, medical practices need patient service tools to take advantage of the clinical information to manage and inform patients on care items. For example, you need a tool to identify patients who may be overdue for a pap smear as well as view open orders on the patient summary screen.
Features to Accommodate the Medical Billing Organization
In addition to interfacing with the EHR to provide demographic and appointment information and receiving charge information from the EHR, a medical billing friendly EHR solution should include features that will facilitate services for your practice clients.
The necessary features will depend on your client base as well as the services you would like to provide. For example, you may need a collaboration strategy with the EHR vendor to insure that the EHR product and your medical billing tools can interact with patients through a common patient portal: clinical issues would be routed to the EHR and administrative issues routed to your billing software.
Additionally, you should consider EHR management tools that will help you help clients succeed with an EHR. For example, you need management views of the clinical messages and workflow to advise your clients on workflow issues as well as overdue services items or unsigned notes. Such tools allow you to provide added value services to your clients and well earned additional revenue opportunities.
Working Relationship with the Vendor
Not all EHR vendors are eager to work with medical billing services. In some cases, the EHR vendor has an RCM division that competes with your organization. In other cases, vendors sell the complete billing and EHR as a pair and seek to eliminate the need for your billing services. If you are interested in offering a combined product, that may be helpful. However, if you plan to continue use of your own billing software, then you will want to choose from the numerous stand alone EHR options that interface with other billing options.
EHRs can increase the added value of your coding and collection services. For example:
- Better access to the underlying patient notes and the EHR E&M coder will help you verify the code level and review ad hoc notes that could justify a higher E&M code.
- Access to the workflow tool may help you identify uncoded charges and services. For example, a patient who was routed to the radiology department should have a related charge.
- EHRs may allow your coders to provide audit and validation services that are not possible with a paper record.
You may also be able to provide added value EHR management services. For example, your billing service may provide first line EHR support and clinical end of day services to insure that the EHR is well maintained and managed. Your organization may also conduct monthly review sessions on EHR use and quality.
However, all of these options are contingent on the willingness and interest of the EHR vendor to work with your organization. Ideally, you should define your plan for EHR services and use that plan to refine your selection criteria and interactions with your EHR vendor prospects. You should discuss how the vendor will support the evolution of your EHR based services.
You will need to decide what level of EHR provisioning and support you plan to provide as well as the willingness of the vendor to accommodate your strategy. For example, you may wish to offer EHR hardware hosting and management services, but rely on the EHR vendor for product support.
Even with the best plans and strategy, working with an EHR and your medical billing software can be a challenge. For example, many EHR products do not effectively handle multiple entities within the same database. Thereby, you may need to set up a separate database for each client. Even more challenging, you may have a client that has several entities. For example, you may have a clinical client that has a related ASC or therapy entity. Many EHR vendors propose EHR setups that fail to adequately maintain a complete patient record for each entity.
You have a variety of strategic and tactical options to become involved in the EHR efforts of your current clients and use EHR services to attract new clients. For example:
- You could offer a wide range of general EHR advice, transition support, and/or product specific help to your clients,
- You can provide front line product training and support or assume a more passive role and rely on the EHR vendor for more EHR specific efforts.
Either way, you should have a strategy and plan to guide the evaluation of an EHR option that can meet the needs of your medical clients and help you help your clients achieve EHR success.
Ron Sterling (800-967-3028, www.sterling-solutions.com) publishes the popular EHR Blog Avoid-EHR-Disasters.blogspot.com, and authored the HIMSS Book of the Year Award winning Keys to EMR/EHR Success. He is an independent EHR consultant.
