Aiden Spencer

Six Things to Know About Community Health Systems EHR

Community Health Centers (CHCs) are also known as Community Health Systems. These are organized as non-profit clinical care providers that operate under comprehensive federal standards. There are two types of clinics that meet CHS requirements are those that receive federal funding under the Public Health Service Act and those that meet all requirements applicable to federally funded health centers and are supported through state and local grants.

Uniquely in community health centers, at least 51% of all governing board members must be patients there. A sliding fee scale based on income is implemented to decrease the cost of care. The purpose of these stipulations is to ensure that health centers improve access to care and serve the community.

To operate effectively and efficiently the Community Health Systems require EHR. Electronic medical record (EHR), refers to the systematized collection of patient and population electronically-stored health information in a digital format. These records can be shared across different health care settings and can help in the data collection, manipulation and representation.

Integration of health care services is a major focus in CMS which is why Community Health Systems EHR is required to perform the following functions:

  • Identify and maintain patient records
  • Manage patient portals and databases
  • Maintain symptoms and illness lists
  • Manage medication lists
  • Provide the options for generating format specific reports
  • Capture external clinical documents
  • Present care plans, guidelines, and protocols
  • Manage guidelines, protocols and patient-specific care plans
  • Generate and record patient-specific instructions

Community Health Systems EHR is thought of platforms that were intended to offer care coordination. Care coordination offers significant benefits to patients, providers and payers by improving both clinical and business outcomes. Here are seven things the vendors should know about the Community Health Systems EHR and the care coordination:

Community Health Systems EHR’s care coordination capability is limited: EHRs have the basic features that can facilitate the care coordination. These features usually facilitate the discharge planning and utilization management of the centers which then becomes identical to the inpatient case management which renders the image of care coordination. But however, there is no evidence that care coordination is the sole purpose of the CHS EHRs.

Community Health Systems EHRs were not originally designed for care coordination: These EHRs were developed to basically enhance the productivity by connecting all dots for the doctors, nurses and the hospitals and to facilitate the patients. This facilitating nature evolved over the period of time and shaped into care coordination.

Certain features and data is required for care coordination: Different types of care coordination are required for different outpatient specialties so that the patients can be catered with. This is why there is a need for different protocols and procedures that are specific for each kind of specialty.

Accreditation has laid down the criteria for the requirement of Community Health Systems EHRs to have care coordination: Meaningful use is the major reason why more modules for the care coordination are being added so that the patient navigation is made easier and barriers for patients can be reduced.

Interoperability and data sharing are dire for clinical outcomes: The reason why the CMSs use EHRs is that they have invested heavily in the these EHR and they intend to take advantage by consolidating all the activities and reducing the IT complexities.

Interoperability and data sharing are serving as a bigger challenge: AMA (American Medical Association) has called on for EHR’s complete interoperability. This is why the big vendors, offering EHRs, are trying to offer more features for data sharing.

We can conclude that the greater the care coordination is the better it is for the CMS. This is because that the Community Health Systems EHR helps the hospitals to impart care coordination. This trend for enhancing the care coordination will definitely increase with the increasing maturity of the market.

Aiden-SpencerAuthor Bio: Aiden Spencer is a health IT researcher and writer at CureMD who focuses on various engaging and informative topics related to the health IT industry. He loves to research and write about topics such as Affordable Care Act, electronic health records, Medical Practice management and patient health data. You can get in touch with him on Twitter: @AidenSpencer15  

Challenges the Medical Billing Industry Could Face in 2016

As the year of 2015 draws to a close, those in the medical billing industry might be wondering what will be in store for them in 2016. There have been so many changes in the industry within the last few years, between coding and healthcare insurance regulations, we are all hoping for a chance to catch our breaths.

While there are no signs that more major changes will be coming our way, the challenges from 2015 can carry over into the New Year. Here is what you need to know for medical billing in 2016, and how you might be able to prepare your billing team for such challenges.

Having Enough Staff Members

As more institutions outsource their medical billing, thanks to the implementation of ICD-10, this is great news for the booming industry of practice management system in 2016. However, while the idea of more business is exciting, you will need to consider whether or not you have a large enough staff to support the amount of work that will be coming in. According to the Bureau of Labor Statistics, there is a job outlook growth for medical records technicians of 22 percent by 2022, which makes it safe to say that the medical billing industry is rapidly growing.

If you do find that you will need to add more members to your team, then of course this is something that will have to be factored into your budgeting. Because of regulatory changes in coding and billing, there might be a certain amount of training that these professionals undergo before you let them work on their own. Depending on whether your particular billing company uses the calendar or fiscal-year for tax purposes, you might onboard these new employees at the start of your new tax year.

Keeping Up with Regulatory Changes

The International Classification of Disease, ICD, implemented the new coding system on October of this year. ICD-10 comes with a multitude of changes from its predecessor, ICD-9. This new coding has probably already affected your billing company and will continue to do so into the New Year. The Centers for Medicare and Medicaid Services (CMS) recognize this and announced that there is a one-year grace period for ICD-10 slip-ups until everyone has the new, regulatory changes under their belts.

However, it is best to prevent these mistakes from happening in the first place, because we all know that it makes processes move that much more smoothly. Of course, still adjusting to the changes in healthcare insurance, on top of ICD-10, does not make things any easier. Moving into 2016, your staff should be more familiar with these specific changes, but you will have to remain on the lookout for regulatory changes, as it seems that they are consistently ongoing.

Staying Current with Software

Entering 2016 means that we are that much closer to electronic healthcare records (EHR) being the standard for the medical billing industry. A large portion of healthcare facilities use these systems in order to store patient data, but there are still a number of offices that use written records. Because there is a mix of electronic and paper data, it can be difficult to keep processes consistent and efficient in your own office.

Even if all facilities were to use EHR, there are still different versions of software that can be used to best support the practice’s needs. So, as a medical billing solution, it is your job to keep employees current on all forms of this software so that there are no snags during billing. For example, keeping up with regulatory changes, staying up to date on your technology can help improve efficiency for your company, which can boost customer satisfaction as a result.

Navigating Payment Collections

Along with new technologies, mobile device-friendly patient portals are being introduced into the market as a way for patients to make payments on their medical billing. Unfortunately, with complex healthcare insurance and the changes in coding, it can be challenging to come to the correct billing solution.

If the patient in question refuses to make their payments for whatever reason, tracking them down in 2016 won’t be any easier than it has been. However, we are hoping that with these mobile solutions, billing will be made easy for patients, and they will be more likely to pay their bills, in-full, on time. With that being said, this will be another new system you will have to incorporate into your processes.

Overview: Medical Billing in 2016

While there are advances that we will see in 2016, keeping up with it all can get overwhelming. If you have a large enough staff that is competent with the new regulations and technologies, things should be okay for your medical billing company. However, if you find that you and your team are in a pinch, a third party solution might be able to help you through these transitioning times.

Author Bio: Aiden Spencer is a Healthcare IT Researcher who focuses various engaging and informative topics related to the health IT industry. He loves to research and write about topics such as Practice management system, EHR, revenue cycle management, Medical Billing and security of patient health data. You can get in touch with him on Twitter: https://twitter.com/Aidenspencer15