b'CODING Update Technology CanHelp Drive PracticeEfficiency andBy David KeinANJC Coding & Compliance Consultant ComplianceAs the founder and chief operatingThese were then faxed to the billingbilled and create claims automatically, ofcer for a top chiropractic electronicdepartment, and a biller would key in theand then push them directly to an health record/ electronic medicaldiagnosis codes and CPT codes into theintegrated clearinghouse without having record (EHR/EMR) system that includesbilling software to send to the payers.to upload a batch.integrated billing functions, I have hadThis system was time-consuming andProcessing insurance payments: When the opportunity to work with manyinherent to potential errors. The faxesa payment is received from an insurance clinics as they strive to streamline theirwould sometimes be difcult to read,company or other third-party payer, documentation and billing tasks. Greatkeying errors would happen all the time,some programs include Electronic software can simplify documentationmodiers were often either left off or notRemittance Advice (ERA) or auto-and billing workows, link to a patientappended correctly and diagnoses wereposting where the an electronic version portal, help track patient accounts,often mis-reported. Having an integratedof the EOB is essentially posted to each get bills out in a timely manner, scrubsystem would have signicantly reducedpatients account (line by line) with the claims for accuracy, integrate withthe time and effort to send out claimspush of a button. This can be a huge clearinghouses for electronic claimsand eliminated many of these issues.time saver. submission, accept payments, integrateWith the time savings associated with an with credit card merchants, set upintegrated software, staff and providersProcessing patient payments: In payment plans, generate nancialcan reduce administrative burdens andtodays business world, patients nearly reports, and track demographic andspend more time with patients andalways have to pay some, if not all insurance information. collections. Many chiropractic ofces areof their healthcare costs from their One of the biggest benets ofone-man/woman shows, so an effectiveown pocket. Many billing systems can integrated software is the reduction orand efcient systems can make a hugeintegrate credit card processing to elimination of errors. There are a lotdifference on where the provider spendsfacilitate smoother payments. Some can of places for things to go wrong in thehis or her time. even compliantly save credit card data billing processes of a chiropractic clinic,Regulatory agencies are crackingand set up payment plans, saving even some involving user-error and somedown more than ever on healthcaremore time.involving procedural error. A singleproviders. Healthcare is ever-changingPractice management: The reporting mistake can lead to erroneous claim/ and requirements only seem to befeatures included with billing software coding issues and in some instances,getting stricter. The right integratedcan help a practice track critical statistics legal issues, especially if it causes theEHR/EMR can help keep a practice upso that the owner can keep a nger on practice to be reimbursed incorrectly.to date by automating certain functionsthe pulse of his or her business. This Such errors can also lead to deniedthat ensure compliance with federal law,could include aging reports, day sheets, claims, which in turn slows down payerMedicare requirements and insurancedeposit details, claims submissions, reimbursement and overall collections.company reimbursement policies.code usage, patient visit averages, and For example, if a -59 modier isFor example, the right software couldmuch more. Exporting these reports to inappropriately added to a service thatprompt a provider when services bundleother programs for further manipulation doesnt warrant the modier, or it isand identify when a modier is requiredcan also be very helpful.not added when needed, it can lead towith certain code combinations, such asWhen looking for an integrated system, denied claims; and if done consistently,reporting manual therapy at the sameefciency is important but compliance can result in an audit.encounter as a chiropractic manipulativeis key. Documentation should drive the I used to be the compliance and billingtreatment. It can even help the providercoding and billing, not the other way director for a multi-practice clinic withlink the diagnosis to the correctaround. Having an integrated system over 40 doctors and more than 30procedure. This of course would all bethat still requires separate input for based on the providers documentation. ofces. We used a documentationcodes and modiers limits the ability software that was separate fromIntegrated software can include featuresto reduce coding and billing errors the billing software. The practicesuch as: and adds to inefciency. The providers incorporated a system utilizing superGenerating claims: documentation should match the claims bills to record diagnoses and servicesMore sophisticated systems can readthat go out, and a fully integrated that the doctors provided to patients.the notes, determine what codes can besystem can keep checks in place to 10 I Winter 2020 www.anjc.info'