ATLANTA – At a time when reimbursements are low and the threat of an audit looms large, it can be hard for physicians to get paid for the value of their services. Practices that have taken the electronic health record plunge, though, may find that interoperable systems that integrate coding and billing are a step toward proper payment.
Atlanta-based MedComSoft unveiled its interoperable EHR during the American Academy of Family Physicians Scientific Assembly, held Oct. 3-6 in Chicago.
The MedComSoft Record, which integrates about 15 components of primary care, can help physicians avoid under-coding and conservative billing, said Sami Aita, MD, MedComSoft’s founder and chief executive officer.
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“Doctors don’t have to be scared and under-code because they’re relying on a subjective code from a provider. Here they know their coding can withstand any auditing,” he said.
Aita estimated that practices using the MedComSoft record have seen increases in revenue of 20 percent to 30 percent.
“What we have tried to do differently here is that all the components flow through each other,” he said. “The coding for the services is done automatically, from the time the patient checks in, all the way to the clinical encounter, and all the way back to the back office for billing.”
An application mapped according to CMS guidelines helps the record codify all care information based on evaluation and management codes, ICD, and other sets, Aita noted.
Alicia Valdez, MD, said the EHR allowed her inner-city San Antonio, Texas-based practice to stay in business. Roughly 80 percent of her patients are covered by Medicare and Medicaid.
“Reimbursement for those programs is about 30 percent of what you bill,” she said. “You don’t break even.”
Moving to an interoperable EHR allowed Valdez to bring billing procedures in-house, cutting $30,000 in annual spending and enabling her to code more accurately. “As I’m charting, it’s picking up all of the billable codes,” she said, “so when I complete my notes, everything I do is billable.”
Despite the attractive possibility of driving up revenues and simplifying and improving care coordination, the fact remains that most physician practices not yet using EHRs are put off by high levels of investment and slow ROI.
“That kind of capital investment is tremendously daunting when you’re treading water,” said David Burwell, MD, who runs a solo family practice in Altoona, Pa.
Burwell said he thinks his version of the MedComSoft system is affordable. His practice transitioned to the system from paper three years ago.
“Some of the EHRs I looked at cost up to four times as much as this,” he said. “As a family physician, there is no way I could afford that.”