Medical Billing-EMR Glossary

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We thought it would be a great idea to give you a list of words and definitions used and
associated with medical IT and practice management. We hope you will call us with any explanations that need more clarity. We are here to help you!


Medical Billing and EMR Glossary
A
ARRA for Healthcare The American Recovery and Reinvestment Act for Healthcare gives physicians incentives of up to $44,000 for Medicare or $64,000 for Medicaid for using EHR technology meaningfull. Physicians can qualify under either a Medicare or Medicaid provision. Payments are made over 5-6 years depending on which provision and when you qualify.

ASP Application Service Provider. ASP modeled software can be accessed over a network. ASP is sometimes referred to as SAS (software as service).

B
BillFlashis a service that handles all of your mailed bills. You upload your electronic statement to BillFlash online, and then BillFlash handles the printing, folding and mailing of your statement.

Bright Note Technology
A feature that allows you to enter information into a patient’s note and have it automatically populate the patient’s chart, eliminating double entry. This is offered in Medisoft Clinical, Lytec, and Practice Partner EMRs. Bright Note Technology conforms to you preferred method of entry. You can enter information by keying it in manually or through voice dictation with Dragon Naturally Speaking software.
C
CCHIT CCHIT stands for Certification Commission for Health Information Technology. CCHIT is an organization that provides standards for EMR software. An EMR is considered CCHIT certified if it is deemed to meet those standards by a board of CCHIT members.

Chart Scanning Chart scanning is the act of physically scanning your paper charts and integrating or attaching them to the electronic charts in your EMR software.

Clearinghouse A clearinghouse handles your electronic claim submission to insurance carriers. A good clearinghouse will scrub the claims prior to submission to check for errors and increase your claim acceptance rate.

Clinical Decision SupportClinical decision support (CDS) is designed to help practitioners make decisions. It connects observations made by physicians with a knowledge database of healthcare to remind the provider about additional information related to a patient’s symptoms. Of course, the provider still calls the shots. CDS is only a tool for physicians.

CMSCenters for Medicaid and Medicare Services.

Computerized Physician Order Entry (CPOE) Computerized Physician Order Entry (CPOE) refers to the act of electronically prescribing medications, lab tests and radiology. By submitting this information electronically, the provider reduces the risk of errors due to misread handwriting, and also helps check for duplicate tests and prescriptions. CPOE is also a requirement of theCPT Code
CPT codes are 5 digit codes that represent medical procedures. CPT codes have corresponding ICD-9 codes.

D
Disease ManagementDisease Management refers to a healthcare system in which patients with a specific condition that requires self-care efforts can communicate with nurses or providers to ensure better care.
The 6 components of Disease Management are:
Population identification process
Evidence-based practice guidelines
Collaborative practice models to include physician and support-service providers
Patient self-management education (may include primary prevention, behavior modification programs, and compliance/surveillance)
Process and outcomes measurement, evaluation, and management
Routine reporting/feedback loop (may include communication with patient, physician, health plan and ancillary providers, and practice profiling

Dragon Naturally Speaking
Dragon software transcribes voice dictation into text in our EMR software. Dragon also allows you to navigate your EMR software with your voice and works great with Bright Note Technology.
E
Electronic Claims refer to medical claims submitted electronically to private insurance providers as well as Medicare, Medicaid, and to individual patients.

Electronic Medical Records / Electronic Health Records (EMR/EHR)used interchangeably to refer to computerized patient charts within software that allows for electronic patient charting, eprescribing, health maintenance and more.

EOB
Explanation of Benefits
. EOB’s are sent to patients to explain their payment responsibility.
ePrescribingmeans prescribing electronically. ePrescribing is a key component of meaningful use and is also referred to as eRX.

ERAElectronic Remittance Advice. An ERA explains details about claim payment and includes information regarding claim statuses and denials.
EMR Stimulus
gives qualifying providers up to $64,000 for using EMR technology meaniningfully.
Fee Schedule
a listing of fees used by Medicare to pay providers.

H
Health MaintenanceA system of tests that help with disease prevention. For example, health maintenance can include sending reminders for follow up appointments. Health Maintenance is a requirements of meaningful use. HIPPA is set of patient security and privacy standards for healthcare professionals.
HITHealth Information Technology.
HITECHThe Health Information Technology for Economic and Clinical Health Act (HITECH) Act is the name given to the American Recovery and Reinvestment Act (ARRA) for healthcare providers. I
Kiosk
A kiosk is a computer workstation in which a patient can input information at a medical practice. This is usually located in the waiting room of a medical practice.

L

LAN
Local area Network A LAN connects all the computers in your office so that you can share files, resources and internet connection.

Lytec a state-of-the-art medical billing software, made by McKesson, that handles patient appointment scheduling, electronic claim submission and medical billing. Lytec comes complete with key medical billing features and easy appointment scheduling, as well as inventory tracking and revenue management.
Lytec MD
a fully integrated EMR and medical billing software, made by McKesson, that combines the billing and scheduling features of Lytec with electronic medical records.

M
Meaningful Use
refers to the quality standards that must be met in order to qualify for the stimulus.

Medisoft America’s most popular medical billing software that handles all of your billing, appointment scheduling and electronic claim submission. Medisoft, made by McKesson comes complete with medical billing, scheduling and revenue management.

Medisoft Clinicalcombines Medisoft’s medical billing, scheduling and electronic claim submission with electronic medical records.

Medical TranscriptionThe conversion of voice or handwritten dictation into electronic text form.
N
NPI National Provider Identification Number. It is a 10-digit intelligence free number. Intelligence free means that the numbers do not carry information about health care providers, such as the state in which they practice or their provider type or specialization.
O
OCR Optical Character Recognition. The process by which scanned patients charts can be converted to searchable, editable text when converting paper charts to electronic.
P
Portal
A portal is a feature in EMR’s that allows the provider to electronically give patients access to health information and patient education via the internet.

PM or PMS Practice Management System. Software that handles office needs such as medical billing and appointment scheduling. Practice Management can com standalone or it can be bundled with electronic medical records (EMR).

PQRI Physician Quality Reporting Initiative.

Practice Partner
Practice Partner is a fully integrated EMR/practice management system that allows large practice and hospitals to use an EMR efficiently

R

Revenue Manager
Part of a practice management system that allows you to electronically send, edit and error-check claims, as well as post ERA.

ROI Return on Investment
S
StimulusIn regards to healthcare, the stimulus is the government act that gives medical professionals incentives to improve their information technology.

T
Tablet PC A Tablet PC is a hand-held computer that allows you to have use your computer and relevant software at point-of-care with your patients.

Thin Client A think client environment is one in which software is installed on one network computer and can be accessed from other computers or workstations.
W

WAN Wide Area Network.

Iron Comet Consulting is a Platinum certified Mckesson reseller based in Stockbridge, Georgia.  We are a full service medical IT and billing company.
Phone – (770) 506-4383

Meaningful Use: From Evaluation to Implementation

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The Impact of the American Recovery and Reinvestment Act on healthcare was not only created to improve medical care but to be able to get more data about patients and populations which will significantly help to determine trends in disease management.

The idea around “Meaningful Use” is quite simple yet because of government terminology can be confusing. A meaningful EHR user must demonstrate that it is using certified EHR technology, that the technology is connected in a manner that allows for the exchange of healthcare information, and the user can effectively demonstrate the technology’s meaningful use.

With the enactment of the (ARRA) a new era of healthcare in the U.S. was launched. It commits $180 billion for healthcare spending, with approximately $23 billion dedicated to health IT.

With the overarching goal of facilitating the adoption of EHR for every American by 2014, the Congressional Budget Office estimates that the funding will enable approximately 90% of doctors and 70% of hospitals to adopt and “meaningfully use” EHRs in the next decade.

Medisoft Clinical EHR meets all of the criteria for meaningful use and is fully certified to qualify for stimulus dollars. Iron Comet Consulting is a medical IT firm that specializes in helping physicians and their staff streamline office procedures and workflow to help you do what you do best, taking care of patients. You can reach us at ironcomet.com or at our offices in Stockbridge, Ga., 770-506-4383

The cost of doing nothing is significant.

Iron Comet Consulting

Use Dropbox for a free offsite backup for your Medisoft data

Dropbox is a free service that allows you to store and sync files through the web to as many computers or devices as you wish. Free accounts receive 2GB of storage space and you can purchase up to 100GB of storage space.

What makes Dropbox so useful is that it integrates directly with your computer and creates a folder on your desktop. Anything that is copied or moved into this folder is immediately copied to the web and then synced to any other devices that you have installed on. There are no confusing interfaces to learn. It works just like any other folder on your computer. All of the heavy lifting is done in the background by Dropbox itself.
There are currently clients for Windows, Mac, and Linux computers. On the mobile side, there are clients for the iPhone, iPads, Blackberries, and Android devices.

What does all of this have to do with Medisoft? Well you can use Dropbox as a free offsite backup service. Download and install Dropbox on your computer. It will create shortcut to a  folder on your desktop. Run the Medisoft backup utility and set it to save the backup file in the Dropbox folder. When the backup is finished, the file will be uploaded to the Dropbox servers online. The data is encrypted and secure. You can then access it from any other computer you have installed Dropbox on. There you have it, a free offsite backup for Medisoft. If your practice data is larger than 2GB, you will have to purchase additional space from Dropbox.

For more information about Dropbox, please go to http://www.dropbox.com

ANSI 5010

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What is it?

HIPAA law requires the U.S. Department of Health and Human Services (HHS) to use standards for covered entities concerning transactions electronically. These transactions include claims, remittance advices (ERAs), and eligibility information. Under these guidelines, covered entities include health plans, clearinghouses, and health care providers.

The current standard is known as ANSI 4010A1. The Centers for Medicare & Medicaid Services (CMS) has mandated that the industry upgrade to ANSI 5010.

The purposes for this transition are as follows –

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  • To increase uniformity in submitting transactions
  • To provide support for a pay-for-performance system
  • To streamline the reimbursement process and transactions
  • To provide support for ICD-10


What you need to know –

On January 1, 2012 all systems must be able to transmit using ANSI 5010. Those system that are not capable of doing so will not be able to submit electronic claims.

All versions of Medisoft prior to version 17 are NOT ANSI 5010 compliant.

What you need to do –

If you are using Medisoft, then you must upgrade to version 17. This is critical. This will be similar to when the NPI number was made standard and all providers had to upgrade their software.

It is important to act now and not wait until the last minute. The purpose of this coming year is to provide physicians with time to test their software and make sure claims are going through without issue before the deadline.

Contact your Medisoft reseller or Iron Comet Consulting, Inc. for help.

CCHIT 2011 certified – McKesson Medisoft Clinical

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McKesson’s Medisoft Clinical 17 has achieved CCHIT 2011 certification. For more information, click here – CCHIT 2011

>Windows 7 Support

>McKesson has added Windows 7 support for Medisoft Clinical. This includes both 32 bit and 64 bit support. This is in Medisoft Clinical 9.4.1.

If you have had any issues with Windows 7 and Medisoft Clinical, contact your reseller to get this upgrade.

Free PDF writer

Often times when using an PDF EMR, you need to save reports or documents in a format that is easily saved. Adobe PDFs are one of the most common formats. An easy way to make use of this is the free program CutePDF. It can be downloaded here – CutePDF.

Once installed, it will allow you to save your documents as files. It will install as a printer onto your computer. To make use of it, print your document and then choose your printer, Cute. This will allow you to save your document.

Medisoft user accounts to Audit for New Client

We received a new client practice from another reseller recently. When we arrived on site the first day to start work, we looked through the Medisoft user accounts. Not surprisingly, we found an account for the previous reseller. But what was surprising is that we found 2 accounts for the previous 2 resellers. That was 3 unnecessary accounts. We brought this to the attention of the practice manager and asked her to look through the list and let us know of any other accounts that could be removed. She found 9 other accounts that were from employees and even a provider no longer with the practice. Employee turn over is a common occurrence in medical practice. But it is a good idea to go through your Medisoft users and remove the accounts that are no longer needed. HIPAA requirements are pretty strict about who has access to patient data, so its always a good idea to keep the accounts in your system to only those necessary.

Medisoft-EMR Backup Strategies

While we are a Medisoft reseller, we are also an IT company. So we are in a good position to make recommendations to practices on how to secure their data. In this post, I am going to give you a brief overview to some solid backup strategies that you can use to protect your practice.

The first thing you need to do is stop thinking of backups as a single item. In today’s world, you will need more than one method of backup to ensure that your data is safe. The main method of backup should be an external hard drive. These are inexpensive and can have very large capacities. Your data is written from your server onto this drive. This protects you from hard drive failure in your server. It allows you to quickly restore your data in the event you need it. Also, if set up correctly, you can keep several copies of your Medisoft data to allow you to go back many days.

The second part of your backup strategy should be an off site backup. This can be as simple as having a second external hard drive, swapping the two daily, and taking the other one off site nightly. You can also use off site backup services like Carbonite and Mozy to backup your Medisoft data to their servers. The reason for having an off site backup is to protect you from larger disasters such as your office burning down or having everything stolen. Services such as Mozy and Carbonite shouldn’t be used as a primary backup as they take time to download your data to restore it. In a crisis, you want speed and off site backup services don’t offer that. These are to be used as a final line.

Backups for EMRs are a little different. Due to the amount of data that is being backed up, you will need to use large external drives. We normally use 2 or more 1TB external drives for our sites. This allows us to make multiple backups of both the Medisoft-EMR data on each drive. Also, as more and more of patient data becomes electronic, the more important it becomes to have solid backups.

One last tip. Be sure to monitor your backup. The only thing worse then not backing up, is thinking you did but not having one. Check your backup logs to make sure that there are no errors in your backups. Also, every so often, restore your data using a backup to ensure that the data is valid. The best way to know you have a good backup is to test it.

>Welcome

>Iron Comet is launcing our blog. We will be adding tips and tricks for Medisoft and Medisoft Clinical users. We will also include information we come across that may be useful to medical practices concerned about their software and computer hardware.

If you have questions, please feel free to respond and we will try to get the answered.

Thank you!