Type of study conducted The two year quantitative retrospective cohort study to determine if the ability to copy and paste documentation if diabetes education and care resulted in inflation of electronic evaluation and management (E&M) coding for insurance billing. The areas of research included, education in the area of lifestyle modification (diet, exercise and weight loss). The multinomial logistic regression model utilized clustering of individual providers and patients and adjustment for patient encounters. The primary outcome variable of E&M charges submitted from primary care physicians. The final results revealed that the ability to copy and paste documentation of education did not result in inflation of the billing E&M code. The …show more content…
This approach would have allowed for the justification of a higher E&M billing based upon built in mechanisms. This area of weakness is possibly reflective of providers under billing for education services. The lower coding of E&M by providers could be associated potentially be due to fears of accusation or audits associated with higher charges. This fact may have skewed the results in the favor supportive of under billing. I have worked in the past with providers fearful of this and as result they chose a lower billing code they knew would be …show more content…
E&M codes range from level 1 (associated with the lowest payment) to 5 (highest payment). The payments for different E&M code levels vary between different insurance companies and between different localities and providers. The difference between the payments for the highest vs. lowest E&M code levels can be as high as 10-fold (Zhang, Shubina, Morrison, & Turchin,
Hundreds of thousands of physicians have already seen these benefits in their clinical practice.” This is proof that in Canada we should continue to introduce electronic health records and help smaller practises with policies to help with funding. The benefits of electronic health records can drastically improve the quality of health and health
Historically, physicians and nurses documented patients’ health information using paper and pencil. This documentation created numerous errors in patients’ medical records. Patient information became lost or destroyed, medication errors occur daily because of illegible handwriting, and patients had to wait long periods to have access to their medical records. Since then technology has changed the way nurses and health care providers care for their patients. Documentation of patient care has moved to an electronic heath care system in which facilities around the world implement electronic health care systems. Electronic health records (EHR) is defined as a longitudinal electronic record of
Many new technologies are being used in health organizations across the nations, which are being utilized to help improve the quality of health care. Electronic Health Records (EHRs) play a critical role in improving access, quality and efficiency of healthcare ("Electronic health records," 2014). In order to assist in expanding the use of EHR’s, in 2011 The Centers for Medicaid and Medicare Services (CMS), instituted a EHR incentive program called the Meaningful use Program. This program was instituted to encourage and expand the use of the HER, by providing health professional and health organizations yearly incentive payments when they demonstrate meaningful use of the EHR ("Medicare and medicaid," 2014). The Meaningful use program will be explored including its’ implications for nurses, nursing, national policy, how the population health data relates to Meaningful use data collection in various stages and finally recommendations for beneficial improvement for patient outcomes and population health and more.
It is true that all EMR’s may not have the same functionality, but the overall outcome should be the safety and wellbeing of the patient. Standardized billing is an excellent way to make good use of the EMR. The ability to capture revenue in a faster and more concise manner is always a benefit for any healthcare facility. Monies that were once considered lost or “written off” expenses can now be captured due to the EHR.
The case study by Elizabeth Layman (2011) is a very comprehensive compilation of the implementation of electronic health records, in relation to the Health Information Services Departments. Through this study Layman documents the conditions to be implemented to achieve satisfactory application of the change-over from the conventional pen and ledger system to computer documentation of patient’s records maintained by health networks.
Diabetes Programs: The Scripps Whittier Diabetes Institute Experience. Curr Diab Rep Current Diabetes Reports, 14(2). Doi:10.1007/s11892-013-0462-0
In order to best understand why implementing such a loan program would be most beneficial to the students one must understand why textbook prices have spiraled out of control. The problem lies with textbook pub...
This paper will identify the use of Electronic Health Records and how nursing plays an important role. Emerging in the early 2000’s, utilizing Electronic Health Records have quickly become a part of normal practice. An EHR could help prevent dangerous medical mistakes, decrease in medical costs, and an overall improvement in medical care. Patients are often taking multiple medications, forget to mention important procedures/diagnoses to providers, and at times fail to follow up with providers. Maintaining an EHR could help tack data, identify patients who are due for preventative screenings and visits, monitor VS, & improve overall quality of care in a practice. Nurse informaticists play an important role in the adaptation, utilization, and functionality of an EHR. The impact the EHR could have on a general population is invaluable; therefore, it needs special attention from a trained professional.
Jerant, A. F., & Hill, D. B. (2000). Does the use of electronic medical records improve
Hospitals were reimbursed using a fee-for-service standard, sanctioning all insurance companies to pay the same prices for hospital services offered by different providers. Due to removing restrictions on hospital prices, hospitals now negotiate reimbursement rates for each payer, thus, causing a substantially difference in prices among payers.
Under the new system, the payment to a hospital was based on national and regional costs for each DRG, not on the hospital's costs. Moreover, the national and regional averages were to be updated, so that if hospitals improved their cost performance, they would be subject to stricter DRG-related payment limits.
In 2009 President Obama, through the American Reinvestment and Recovery Act, pledged to provide incentives to the nation’s physicians and hospitals to convert to an electronic healthcare system in attempt to improve the quality of care and reduce cost (Freudenheim, 2010). By converting to an electronic system, we have the opportunity for improved communication between all healthcare providers and decreased cost to our healthcare system. The goal is to improve communication across all aspects of the service chain (Horan, Botts & Burkhard, 2010). Almost two years later, the conversion progress continues to be slow. Only one in four physician’s offices, mostly large groups, have implemented the electronic record system (Freudenheim, 2010).
Case 1 -- You work in a busy multi-specialty clinic with a high patient volume. The physicians enter the type of code that will yield the greatest reimbursement. You suspect the codes are not accurate.
“There are two concepts in electronic patient records that are used interchangeably but are different-the electronic medical record (EMR/EHR) and the electronic health record. The National Alliance for Health Information Technology (NAHIT) defines the EHR as the electronic record of health-related information on an individual that is accumulated from one health system and is utilized by the health organization that is providing patient care while the EMR accumulates more patient medical information from many health organizations that have been involved in the patient care. The Institute of Medicine (IOM) has been urging the healthcare industry to adopt the electronic patient record but initially
Collecting funds from the state’s taxes is an effective solution because students get more academic support programs, which decreases dropouts. In Discounted Dreams, journalist, John Merrow interviews Kay McClenney who explains, “I do think it's a concern students tell us year after year that the most important service is academic planning and advising”....