Electronic Medical Records - Pros and Cons

The Pros and Cons of an EMR: It seems that it was not too long ago when we were all told how new technologies like cell phones, voice mail and email would make our lives less complicated!

What were we thinking?

In a like manner, there seems to be some confusion as to the financial and operational impact that an EMR will have on a practice. Don’t get us wrong, we think that implementing an EMR can be a good thing – that is, if the following is considered and/or implemented:

Does your staff accurately know the components of an E/M Level that the EMR is recommending? BDA conducts one-on-one training.

1. Providers: when reporting a level, does all documentation appropriately support medical necessity?
2. Back Office: is your back office staff capturing the pertinent history for the visit?
3. Billing and Collection Staff: does the collection staff understand E/M Guidelines when challenging down-codes by carriers?

Does your EMR identify modifiers?

1. It might not identify modifiers if it does not know a procedure was done at the same visit. A missed modifier could cause numerous problems on the back-end.

Does your EMR identify other services or just the E/M?

1. Most EMR’s do not identify the “other” services that are performed during a visit. A “human touch” is still required. Has your staff been trained appropriately to capture these other services? BDA provides a customized training for your facility / providers.

Does your EMR recognize 95 or 97 guidelines?

1. BDA has personally seen an EMR that negatively impacted a group because it recognized 97 guidelines. 95 could also negatively impact a group if it recognizes 1, 2-4, 5-7, 8 or > Exam Components

Who updates your ICD-9 codes?

1. BDA provides an Annual ICD-9 Validation

Who updates your CPT?

1. BDA provides an Annual CPT Validation

If you utilize a Fee Ticket / Superbill, who updates these forms?

1. BDA provides Customized Fee Tickets / Superbills
2. BDA provides training with all staff on the utilization of these tools

Do you have edit processes throughout your clinics / hospital? Are you compliant?

1. BDA provides edit processes identified in each clinic for revenue capture.
   1. Documentation Discharge Check List
   2. Twin Code check lists
   3. Modifier check lists

Does your EMR provide appeal letters for the collection process?

1. BDA provides appeal letters supported by:
   1. CPT Assistant
   2. CPT / AMA
   3. CPT IS

Does your EMR company provide a coding hotline?

1. BDA provides a Coding Hotline / Connection via fax, phone or email

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