- Because of the shift towards a value-based healthcare system, it is imperative to review your RCM
- Adopting an integrated electronic medical record/practice management system will provide many benefits to your practice
One of the biggest paradigm shifts in the healthcare industry is happening right now: the shift from fee-for-service to value-based payment models. Everyone in the health industry—from providers to vendors—should ask themselves do we have the right technology to handle the change, and how is it going to affect our revenue cycle management (RCM)?
The shift towards value-based care is precisely the reason why it’s important to look at your RCM—to see what’s working and what can be improved to handle the change. An antiquated or cumbersome RCM with inefficient and time-wasting procedures can negatively impact and decrease the profits of your practice .
One of the best ways to improve RCM is to adopt a system that provides seamless communication between the financial and medical side of your practice. We look at an integrated electronic medical record (EMR) and practice management system (PMS) as the answer to this. An EMR/PMS system promotes interoperability and organizational efficiency because the software is created and implemented by the same party. This allows for ease-of-use by both clinic and biller because everyone is on the same page—literally. Of the myriad of reasons to choose an EMR/PMS systems, here are the top 3 reasons why you should switch.
1. Expedited Claims Processing
An integrated system ensures accurate information to be conveyed both ways, which is essential for claims processing. Claims processing, as we all know and love, requires meticulous and accurate information to be entered in for acceptance. A slight error can cause a claim to be rejected outright. An integrated system allows billers access to the medical record side of a system when filing a claim—information straight from the proverbial horse’s mouth. Instead of having to contact doctors about claims and medical records, which can cause stress on both ends, billers can get to the records directly.
2. Transparency for Providers
An integrated solution allows doctors to review the financial side of their practice, not just the medical records. Providers who contract with a 3rd party biller are not able to see their claims/accounts receivable (AR)—essentially leaving them blind to their finances. With an integrated solution, providers are able to check their claims/AR at any time, giving them peace of mind as well as better control over their finances.
3. Information Submittal Efficient and Time-Saving
Submitting information for claims can be extremely cumbersome. Take superbills for an example; superbills are used by providers to document rendered services for claims submittal. A superbill that is submitted to a 3rd party biller must have the all the information submitted manually—not only is this tedious, it wastes valuable time. An integrated solution allows for information such as insurance, protected health information (PHI) and CPT charge codes to be entered automatically. An added bonus is not having to deal with the illegibility associated with doctor’s handwriting.
The best time to look for an integrated EMR/PMS system was 5 years ago, the 2nd best time is now. A recent analysis of physician interaction with practice management software (PMS) lends evidence to this, as it shows:
- The majority of buyers preferred a single integration solution of electronic medical record and practice management software
- 70% of first-time buyers value organization and efficiency over as their top concern
- Most practice management software buyers are replacing existing medical software
Perhaps the chief goal of the entire healthcare industry is to achieve the highest level of interoperability possible—an interconnected EMR/PMS is a step towards that. What we are finding in the shift towards value-based electronic healthcare is that there are hurdles to climb within the domain of electronic health itself. Not all EHRs and PMS are created equally. Finding the right one is essential to a practice. Adequately review your RCM, and look for systems which provide the highest level of efficiency to prepare you for the ever-changing health climate.
PrognoCIS offers an integrated EMR/PMS system to its clients. Not only that, it provides expert RCM services for those wishing for the highest level of transparency between the medical and financial side of a practice. At PrognoCIS we strive to provide the highest level of care with the most efficiency, for both billers and providers.
Picture Credit: Money/Flickr