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Accurate ICD-10 Coding Is Critical To The Clinic’s Bottom Line

GE Healthcare’s Centricity Practice Solution, like all business-essential software, helps remove complexity from tasks that would otherwise be unmanageable. For one, the clinic’s EHR software must assist physicians and medical coders in the clinic with the correct choice of ICD-10 codes. With more than 68,000 options in the International Classification of Diseases database today—up from just 13,000 in the ICD-9 standard—the likelihood of human error is too high to proceed without automated assistance.

To provide just one example, “degenerative myopia with retinal detachment” has five ICD-10 codes assigned to it, not one. This granular level of detail helps describe the precise diagnosis. The good news here is we have Clearinghouse tools available in Centricity to help you manage the complexity of ICD-10 coding and maximize revenue.

Improving clinic workflows is another critical aspect in getting ICD-10 right the first time. Data is only as good as the inputs received, which squarely places the responsibility on the clinic’s physicians to make the accurate call at the point of care. You never want the clinic’s coder(s) to guess which code is correct after the fact and input the wrong code or series of codes. That will quickly make for an unnecessary billing logjam. The chain of communications from physician to coder to payer needs to be flawless, or payments will be denied or lost in the system.

“The idea is to minimize billing time, reimbursement time, get a clean claim and get money get faster and improve cash flow,” Denver Wade Harless, who works for the Sacred Heart Health System, told Healthcare Finance News. Harless believes “a lot of clinical legwork needs to be done to get more specific information from physicians.” Our take is, workflow improvements are always highly beneficial, but workflow realignments, in combination with added functionality in the EHR, produce the biggest wins for the clinic.

Four Keys To ICD-10 Coding Success

1) An awareness of the issue and a commitment to solve it
2) Physician training to help identify the right codes at the point of care
3) Customization and optimization of Centricity
4) Select clinic workflow improvements (determined on a case by case basis)

There’s no question that the challenges in value-based care, including keeping up on the latest developments in ICD-10, puts an extra onus on practice administrators and physicians. The complete solution includes hiring talented coders, internal training, process improvement, and software upgrades.

Our implementation team at HealthCo is available to discuss your ICD-10 questions on a call that I am happy to set up fro you. Send me a note at rachaelr@healthcosystems.com.

HealthCo Stacks Its Lineup With Another GE Centricity Pro

TUALATIN—HealthCo Information Systems, a value-added reseller of GE Healthcare software for medical practices, has hired veteran software executive William Giacone to lead the sales organization. Giacone joins HealthCo directly from GE Healthcare, where he served as a top performing Regional Sales Executive on the East Coast until last August.

Before joining GE Healthcare, Giacone was a founder of Virtual OfficeWare (VOW), the next largest GE Centricity VAR, after HealthCo and Quatris. While at VOW, Giacone did many of his own product demos and worked directly with VOW’s early customers before taking on sales leadership and other duties as the organization grew.

Giacone is now the leader of a five-person sales team at HealthCo, and he is excited to bring his consultative approach and industry experience to HealthCo’s customers in ambulatory practices.

“For the past few years, the need for revenue cycle management and financial risk management tools has been great,” says Giacone. “I see that trend continuing as clinics struggle to capture revenue, keep and train staff, and meet their financial performance goals.”

Giacone is also intent on helping clinics that run Centricity begin, continue, or finish their migration to the cloud. “Physicians and practice administrators want to protect their patient data at all costs,” says Giacone. “GE Healthcare and HealthCo both understand their concerns and how to help clinics take the next steps into a more flexible and secure data environment.”

Giacone is a graduate of Hofstra University in New York and a lifelong Mets fan.

Better Data Leads To Improved Care And Higher Profits

Meeting the various reporting and measurement standards imposed by CMS is no cakewalk. On one hand, clinicians must be adept at change management. On the other, they must be technically proficient and knowledge rich.

There can be no doubt that successfully practicing medicine today requires clinicians to overcome several significant challenges. It’s our job to reduce at least one challenge—and we do, by clearing the path to payment under value-based care.

Shiv Gopalkrishnan, GE Healthcare’s General Manager of Enterprise Financial Management Solutions, addresses one problem head-on when he asks, “How can we deliver solutions faster through the cloud?”

In busy clinics, resources are limited, which puts an extra onus on technology to do more of the heavy lifting. As Centricity migrates to the cloud in 2018 and beyond, physicians and practice managers will begin to benefit from the “no touch, low touch solutions” that help drive automation, which leads to optimized workflows and a notable reduction in workloads around the clinic.

Gopalkrishnan says, “Whether it is clinical outcomes, financial outcomes, or operational outcomes, we know with value-based care, these are all going to be tied together. You’re going to get paid because you demonstrate clear clinical outcomes and quality of clinical outcomes.” He adds, “It’s very important that we deliver a solution suite that helps clinics achieve these net financials.”

In order to deliver the results our partners in clinics count on, GE Healthcare and HealthCo bring a true understanding into provider workflows and reporting requirements. Thanks to our years of experience working in clinics and with clinics, we also understand the pressures involved (in making big changes) and how to relieve them.

Let’s recap. The “Triple Aim” of value-based care can be summarized like so:

    1) Reduce the cost of healthcare
    2) Enhance the patient experience
    3) Improve population health

At HealthCo, we are on board with all of the above. We also come to work each day ready to deliver on these core promises:

    4) Enhance care quality
    5) Improve provider efficiency
    6) Strengthen financial performance

We know the move from fee-for-service to value-based care is a big change, and the entire transition cannot normally be made all at once. It takes time, a solid plan, and reconfiguration of systems to properly record the numerous measures of quality that help determine the overall health of your patient population.

Remember, you need to demonstrate improvement to get paid today.

According to RevCycle Intelligence:

Value-based reimbursements are calculated by using numerous measures of quality in determining the overall health of populations. Unlike the traditional model, value-based care is driven by data because providers must report to payers on specific metrics and demonstrate improvement. Providers may have to track and report on hospital readmissions, adverse events, population health, patient engagement, and more.

We are happy to help you refine your tracking procedures and update your workflows to meet the need of value-based care. Measuring the full set of outcomes that matter most to patients is indispensable to better meeting patients’ needs. It is also one of the most powerful vehicles for lowering health care costs. Let’s work on it together. Better care at a lower cost is a promise for the future that is within reach today.

It’s Conference Season and We’re Headed To Bend, Boise, and New Orleans

Bend, Oregon is a favorite destination for golfers, mountain sports enthusiasts, and people in search of the sun. This week, The Riverhouse in Bend will also host hundreds of practice administrators from around the state at the annual Oregon MGMA Conference.

Some of the key sessions we’re looking forward to:

  • Benchmarking Your Key Performance Indicators
  • MACRA – State of Affairs and Updates

HealthCo will also have a booth on the exhibitor floor at the Riverhouse. Please stop by Booth #501 and say hello. We are also giving away three fully loaded gift baskets!

Directly on the heels of Oregon MGMA in Bend, the HealthCo team heads to Boise for Idaho’s annual MGMA Conference. The Idahoans are always great hosts and this year is no exception. The event kicks off with a golf tournament at Warm Spring Golf Course. Whether you’re an expert golfer or have never played, come and enjoy a morning of fun, prizes, contests, and the excellent company of your peers.

When we get down to business in Boise, there will be incredible programming available. In fact, all three of these of the following presentations are in the same time slot (forcing one to make a tough choice):

  • Good Clinics to Great Clinics
  • Mentoring: The Key to Professional Development
  • Engaging Physicians

After returning from these key annual pilgrimages, we will begin to prepare for CHUG Fall 2017, which is in New Orleans this October.

I sense beignets in our future.

The keynote speaker at CHUG is Dr. Kavita Patel, a co-founder of Tuple Health, a physician-led company focused on practical clinical solutions to bring care back to health. Dr. Patel was previously a Director of Policy for The White House under President Obama and a senior adviser to the late Senator Edward Kennedy.

We’re always interested in seeing our customers at these key industry events, and hearing from industry leaders about important topics in healthcare IT and practice management. If you’d like to schedule a time to chat during these upcoming events, let’s do so now.

Protect Your Patients and Your Clinic with Centricity™ Practice Solution

A clinic’s EMR is like its circulatory system—damage it in any way and everyone in the clinic, including your patients, suffers the consequences. Alarmingly, there are thousands of clinics running faulty EMR software today.

You might have heard that the executives at eClinicalWorks agreed to pay $155 million in fines—rather than face trial—in order to settle a False Claims Act lawsuit brought by the Department of Justice?

The lawsuit claims that the company willfully “caused the submission of false claims for federal incentive programs,” among other serious violations.

At a time like this, it’s only natural to ask:

  • Can you trust that your patient data is accurate?
  • Is patient safety in question?
  • Is my EMR vendor a partner or a potential liability?
  • Can the clinic successfully attest?
  • Will your technology partner be around tomorrow?

To complicate matters, some eClinicalWorks customers are now complaining that the company is not supplying the clinic’s patient data when asked to do so. “We’ve been held hostage for a year and a half. I battled them,” said Laura Williams, practice administrator at North Spokane Women’s Health in Washington. “It’s a nightmare with them.”

“The IT people at eClinicalWorks never were able to fix the program errors, but our IT guy came up with a solution that at least has us able to access our patient records,” Williams said. “If I can get my patient data migrated to Centricity that will be enough.”

If you’re currently finding workarounds for your EMR, it’s time for a new EMR. Put eClinicalWorks behind you. We’re here to help steady your clinic’s healthcare IT infrastructure today, earn your trust, and support your clinic for years to come.

Schedule a Centricity demo today. It’s the first critical step on the path to clinical and financial well being.

Previously on the HealthCo Blog: Clinics Trust GE Healthcare for Good Reason

Clinics Trust GE Healthcare for Good Reason

Trust between physician and patient is sacred. Trust between clinic and EHR provider is as well. That’s why news that top executives at EHR software provider, eClinicalWorks, willfully manipulated their software to achieve federal certification has rightfully sent shockwaves across the industry.

Clinic admins and physicians are now all asking the tough questions:

  • Are quality incentive payments at risk for my clinic?
  • Has my EHR vendor done something similar?
  • Should I consider moving to another platform?

Let’s admit that we sometimes compete with eClinicalWorks. Let’s also admit that we’re nothing like them. HealthCo is a value-added reseller for GE Healthcare’s Centricity Practice Solution. GE Healthcare is not a startup, nor the kind of firm that risks its reputation. GE Healthcare is a multi-billion dollar division of GE and a globally respected brand with way too much to lose to play fast and loose with the truth or federal regulation.

The False Claims Act lawsuit brought by the Department of Justice alleges that eClinicalWorks hardcoded drug codes into its EHR software to comply with certification testing; did not adequately manage imaging orders or drug interactions; and failed to meet data portability requirements. In addition to a $155 million fine, the company has entered into a five-year Corporate Integrity Agreement (CIA).

Making matters worse, the company also settled a case that stated eClinicalWorks paid customers in exchange for recommendations of its software to potential customers, a violation of the Anti-Kickback Statute.

“Electronic health records have the potential to improve the care provided to Medicare and Medicaid beneficiaries, but only if the information is accurate and accessible,” said Special Agent in Charge Phillip Coyne of HHS-OIG. “Those who engage in fraud that undermines the goals of EHR or put patients at risk can expect a thorough investigation and strong remedial measures such as those in the novel and innovative Corporate Integrity Agreement in this case.”

The CIA requires eClinicalWorks to give customers the option to transfer their data to another EHR software provider without penalties or service charges. While current eClinicalWorks customers don’t necessarily need an added incentive to make the move, this savings is helpful to take the first step.

When trust is violated in this manner, it can cast a shadow on the entire industry. We welcome any and all questions that you might have about the case, and how the overall quality and safety of your clinic’s medical records are assured through HealthCo’s hands-on consulting and GE Healthcare’s superior technology and corporate integrity.