Insight to the Industry, Part 2

This post is a continuation of the Midtown Business Radio interview series. Eric Christ, CEO of PracticeAdmin, was invited to come speak on Atlanta’s Midtown Business Radio show, hosted by C.W. Hall. Christ offered some insight about PracticeAdmin software, services, along with information about the future of the medical billing industry. Read Part 1 of the interview series, or continue with the interview below. CW Hall: Now the practice management software that we’re talking about, it’s more facing the back side of the office, right? The business side more than the clinical side? So it links in with an electronic medical record? Eric Christ: That’s exactly right. So in the industry today, you have three offerings: you have an EMR only, you have a practice management only, and then you do have some bundled solutions where companies have put the two pieces together and offered an integrated platform. At PracticeAdmin we focus just on the practice management piece; just the patient accounting and billing, the collections follow-up with the patient. Some people might say, “Why not buy an integrated solution from a single vendor?” We would say, “Well that would be like hiring someone to do your plumbing and your electrical work in the same place.” We would argue there’s benefits with something as highly complex as billing, insurance claim management, to have a best-of-breeds solution. Generally what you see is you have EMR companies say, “I can add a billing module to my software.” And then in a well run practice, the billing staff is going to tell you that’s a whole separate function with its own complexities. CWH: Well you can certainly leak a whole lot of revenue very quickly with inefficient coding, I certainly know that. I don’t have to have my hands on it very much at all, really none at all in our practice, though I’m familiar with the process they go through. I can certainly understand the temptation to get a jack of all trades master of none program in place, just from a training and simplicity perspective. But this is really where the rubber meets the road as it relates to the financial viability of your practice; whether or not you retain these employees that you have as part of your practice supporting you. So I can only imagine that that’s important here. EC: Yes, where the two systems really touch are the patient data, in terms of…the patient demographic data: your name, address, date of birth; you need those on both sides because when you file the claim you need “patient,” “date of birth,” “address,” “their insurance information.” So that piece of information flows back and forth between those two systems. There are some nice industry standards in terms of interfacing between EMR and a billing system. The other thing we see is that some EMRs also offer charge capture. So if you’re the physician in the EMR, as you’re checking off your procedures, your CPT codes, so that you’d want that information to electronically flow back into the practice management system so that the billing staff didn’t necessarily have to re-key that. Today you still see lots of physicians practices where they use the encounter form, the super bill, where the physician at the end of the visit has that one sheet of paper, which we’ve all seen that have these strange code numbers on it, and he circles a couple things that he did to you while you were there in the office. Then that goes to the billing staff, they look up the patient, and they punch that in. so with a practice that has an EMR in place, that has a charge capture capability, it is certainly convenient for the practice to have that information come over. But what we would say is you still want a trained biller looking at that information. You don’t necessarily want that to automatically go out as a claim to the insurance company because you might be under billing, deleting money on the table, or you might be over billing, which then opens you up to an audit. Medicare in particular, because it’s all of our tax dollars at work, they have a group of folks out there called Recovery Audit Consultants, who get paid as a percentage of what they find that you over billed. CWH: I’m sure they look really hard! EC: They look very, very hard! And while our software of course can’t guarantee or prevent you from under billing or over billing, we like to think that having it all electronic and being able to follow a good process is one of the hallmarks to trying to accurately bill. CWH: We’re talking with Eric Christ of PracticeAdmin, and as part of your program, obviously we’re talking about you have practice management software, but you also provide some actual professional services. [Can you] also provide that billing expert as a part of what you do in addition to the software? Interview continued on Insight into the Industry, Part 3 next week…