Beware your EMR could land you in a tight spot !

There is a lot of dust raised about EMR’s again. According to recent reports an EMR can lead to inflated costs and fraudulent billing. Allegedly, physicians have added about 11 billion more to their fees, over the last decade alone. The Center for Public Integrity’s “Cracking the code” series, has found that the usage of EMR/EHR’s have resulted in widespread billing malpractices.

More to it than meets the eye…

Healthcare experts argue that this a strong marker of the negative impact, wishy-washy rules can cause. It can not only make physicians vulnerable to fraud and abuse charges, but also be potentially life threatening for patients. Mostashari, the National Coordinator for Health IT rues that “documenting care that didn’t occur, that’s not just fraud, it’s really dangerous medicine.”

It is being argued that the system is flawed. And it is high time the government sat up and took notice before it snowballs into a huge issue and causes irrevocable damage.

Has coding higher become par for the course ?

Upcoding is rampant. And emergency rooms in particular have been pulled up for assigning high level codes, despite the treatment not warranting it. Whistle-blowers  worried physicians and confused patients are making one collective demand. For, strong auditing tools, and transparent uncomplicated regulations.

The new CMS directive !

The centers for Medicare and Medicaid have issued a new directive to restrict billing malpractices. Federal authorities will be keeping a close eye on EMR users to curb this unhealthy trend.

Where the cracks appear…

Physicians are unusually busy people. Most doctors fume that EMR’s have reduced them to efficient machinery. Nobody likes to sit, and copy paste information. Or, working with straight out of a can, point and click templates. Long loading times and a maze of options can drive physicians round the bend. Impatience with the system, more than the willful intent to over-bill  might be the reason behind improper billing.

A quick guide to bill right !

• Train your billing team to work closely with your EMR/EHR system.
• Use an accredited medical billing software.
• Conduct regular in-house financial audits.
•  Ensure the same information isn’t entered again. Redundant data is the major cause of over-billing.
• Educate your practice about CMS guidelines and updates.