When it Comes to Compliance…. not all EMRs are created equal. In fact, most — despite their claims — lack the robust technology and tools needed to effortlessly manage today’s growing payee regulations.
Since many first-time technology adopters “don’t know what they don’t know,” we’ve listed some of the must-have technologies that your clinic will want to ensure compliance.
1. Regulatory Alerts
Notify users when a record requires a report, modifier, question, authorization, or certification. These vital alerts should include:
- Progress Report Alerts
- Authorization and Re-Certification Alerts
- Unanswered Pain Question Alerts
- Modifier Alerts
2. G-Code Alerts
Automatically appear when needed for a particular visit, reducing G-code-related denials and streamlining manual processes. Alerts should also notify users when they come close to 60 days or any other issues that might compromise prompt payment.
3. A Medicare Therapy Fee Cap
Calculator tracks the therapy fee cap at the Patient Dashboard and Therapist Dashboard level. Users instantly know when they need to add a modifier or submit for a Medical Necessity, drastically increasing compliance and revenue cycles with the ultimate goal of reducing denials.
4. Medicare Compliant Multi-Discipline Billing
Automatically transfers charges properly and ensures assignment of primary G-code so multi-discipline bills are not denied.
5. Automatic Goal Builders
Generate goal templates if using the ICF to choose the functional limitation of the patient to ensure compliance and flexibility.
6. Document Management Lists and Alerts
Indicate what required documents are missing based upon pre-determined rules for specific types of patients or insurance companies. This eliminates the manual process of checking each patient file to make sure all documents have been completed.
7. ICD 10 Functionality
As clinicians enter diagnostic information during the encounter – using simple, standard clinical terms – the number of available ICD-10 codes is narrowed, making code choices easy and accurate.
8. New Evaluation Codes Based on Patient Complexity
Required beginning Jan, 1st 2017. Be confident that your EMR is equipped with automatic alerts to keep you compliant and denials at bay.
CONCLUSION:
If compliance counts in your clinic be sure to closely compare tools and features before rushing into a solution that looks like a value but could cost you thousands of dollars down the road.
Many systems are available today but none meet the extensive customization, adherence to regulations and documentation needs of a larger outpatient rehabilitation facility.
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