While the Centers for Medicare and Medicaid Services (CMS) gave HIPAA-covered entities a reprieve by extending the date for ICD-10 implementation from October 1, 2014 to October 1, 2015, healthcare organizations that use medical billing software need to start the process of becoming ICD-10 complaint if they have not already done so. This transition requires upgrading or replacing current medical billing software in order to accommodate the new ICD-10 codes and training the staff how use the new software, in addition to how to do ICD-10 coding. Moreover, CMS recommends 12 months of internal testing of the ICD-10 compliant systems and 11 months of external testing with business partners. Furthermore, healthcare providers need to make contingency plans in the event there are problems with third party payers during the switch to ICD-10 codes.

With all the upcoming changes to requirements for Medicare and Medicaid reimbursements, meeting Meaningful Use standards, and the possibility moving away from fee-for-service reimbursements, many healthcare providers have found themselves overwhelmed by the information related to the transformations in the healthcare industry. As a result, some healthcare professionals are confused by contradictory reports about what they need to do to meet the new procedures required of them. One of the changes that will have a significant impact is the change from ICD-9 to the ICD-10 coding, which will affect all professionals in the healthcare who are required to follow HIPAA regulations.

A recent study of 39 health insurers published in Information Week provides another reason that your practice needs EHR. Third party payers of all types plan to switch transition from a fee for service model to a value-based reimbursement system. This means provider payments will be based upon that quality, efficiency, and outcome of patient treatment as opposed to the services that health care professional provide.

While many of the larger urban area behavioral health centers have adopted electronic health records (EHR), smaller clinics and solo providers have lagged in their rate of adoption of behavioral health EHR. Now that the October 2014 deadline is getting closer for Medicare and Medicaid providers to start using EHR or face a 15 percent reduction in reimbursements, professionals have started taking a second look at behavioral health EHR. Additionally, with security improvements in cloud-based EHR, the cost of entry and ownership of EHR software has decreased significantly.

One of the most time consuming and tedious aspects of any medical practice is submitting claims to third party payers and then sending bills to patients for any remaining balance. Given the detail need to claims correctly, it is almost impossible for even a solo provider to complete the forms manually. Medical billing software ensures claims have the information required for seamlessly submitting and tracking claims so the provider receives reimbursement for services in a timely manner. Given the variety of medical billing software on the market, it is important to find the medical billing tools right for your practice or revenue cycle management (RCM) firm.

While podiatrists can certainly benefit from the streamlined administrative functions offered by electronic health records (EHR), the use of this form of health information technology provides a means of capturing and transmitting various clinical quality measures. In addition to being one of the requirements to meet Stage II meaningful use requirements to be eligible for incentive payments from the Centers for Medicare and Medicaid Services (CMS), the American Board of Podiatric Surgery (ABPS) now requires podiatrists to report variety of clinical quality measures as part of their Maintenance of Certification program.

Most behavioral health providers have some degree of familiarity with capturing and reporting clinical quality measures as CARF, COA, and the Joint Commission have required this data as part of the accreditation process. Clinical quality measures are the metrics used to measure the efficacy, efficiency, and safety of the services that patients receive from providers. As part of the Center for Medicare and Medicaid Services (CMS), behavioral providers are required to report a certain number of clinical quality measures in order to qualify for incentive payments. While providers can reports these metrics by using the attestation process through 2013, in 2014 healthcare professional will need to provide their clinical quality measures electronic through the use of electronic health records (EHR).

One of the specialty areas that have been slow to adopt electronic health records (EHR) is the addictions field. Part of the reason is that some addictions professionals, such as Licensed Clinical Social Workers and psychologists, are not eligible for incentive payments from the Centers for Medicare and Medicaid Services. The good news is that there is some movement in correcting this oversight. Additionally, addiction centers that employ physicians and licensed nurse practitioners can receive the CMS incentive payments as long as their caseloads include at least 30 percent Medicaid patients. By participating in the CMS EHR incentive payment programs, a substantial part of the cost of entry of the EHR software can be offset.

One of the greatest time sinks and cost centers in the management of any medical practice is the billing of patients and third-party payers for services. Each of the different health insurance providers has slightly varied billing practices, which increases the complexity of filing claims. These variations, along with the intricacies of ICD-10 coding, make the billing process highly prone to errors when claim processing is done manually. These errors can disrupt the cash flow of the practice due to denied or delayed claims. Additionally, billing errors are also one of the triggers for payment recoupment during Medicaid and Medicare audits.

According to a study published in the New England Journal of Medicine in 2011, obstetrics and gynecology practices are one of the ten medical specialties at risk for malpractice suits. The primary way that these practices can defend themselves in these suits is having detailed and well-organized documentation of all the services provided to their patients. Given the complexity of ob/gyn services, documentation in paper charts is likely to be lost or misfiled, which can be problematic in the event of a malpractice suit. With electronic medical records (EHR), all critical patient information is entered into a patient’s chart electronically, which minimalizes the risk of missing patient data in the event of a legal chart review.