Author Archives: Vignesh Eswaramoorthy

How Can Dental Centers Improve Their Patient Referral Workflow?

Did you know? In a year, 15 billion faxes are sent out for referrals in the USA. Practices receive referrals through fax, online forms, direct messaging, email, virtual print, direct walk-ins, and other channels. A typical dental center is a high inbound referral setup. They need an effective referral management solution to manage the increasing inbound referral rates.

Existing Patient Referral Management Workflow in a Dental Center

A typical dental center or dental group is a high inbound patient referral setup. Dental centers receive volume of referrals weekly (ranging from 50 per week to even several hundred per week) depending on the number of patients visiting the center and number of clinics sending referrals to them. An effective referral management solution will help manage small or big volumes of referrals by reducing manual tasks and using automation and structure where possible.

Dental centers usually have a dedicated team of referral coordinators who receive, accept and process the referral requests. These referral coordinators manually key in the necessary details  into an EMR/EHR system and create a referral. The time spent by referral coordinator in a completely manual process can be reduced by using technology. Productivity and efficiency is increased by introducing technology to aid the process. It results in piling up requests that are not yet processed. When the referral coordinator does not have the required information to process the referral, he has to contact the referring provider. This further incurs time and results in slow referral processing rate. This, in turn has a negative impact on patient experience. Hence, patient referral leakage also becomes imminent.

Consequences of a slow referral network

  • The dental center loses its revenue when referrals are not processed in time.
  • Providers stop referring the center thereby harming its reputation.
  • Patients may have severe illness and may need immediate attention. The waiting time may affect their health.

Challenges faced by a Dental Center

  • Referrals flow into the dental center through various channels like fax, online forms, direct messaging, email, virtual print, direct walk-ins, etc. A dental center has no specified source to receive referrals.
  • The dental center receives numerous referrals which are difficult for them to process. This is because there is no single system to consolidate and manage referrals
  • There is no tracking system to understand in which stage of a referral life cycle is any referral is in.

Let us review a typical referral process to elaborate the challenges faced by the dental centers.

  1. Patient visits the PCP – Andrews met with an accident recently. He met his PCP, Dr. John immediately as he was experiencing pain in his jaw. After examining him, Dr.John wanted him to consult a dentist. The doctor then initiated the referral.
  2. PCP initiates the referral – John created a referral in his EMR. He did not have time to do the insurance pre-authorization so he left it to Andrews. He then found a dentist and gave him referral information verbally. Now when he met the specialist, Andrews had to again elaborate his condition and problems to him. This is time-consuming for the specialist as he wastes time on the same information twice.
  3. Specialist requires more information – The specialist, Dr. James is a famous dentist in the locality. After receiving the referral, he schedules an appointment with Andrews. After the appointment, Dr. James wants more information about the patient’s history and diagnostic reports. Now, he has to wait for the PCP, Dr. John to send him the relevant information.
  4. No tracking system for referrals – As Dr. James is a famous dentist in the locality, he receives numerous referrals in a day. There is no tracking system for him to know how many referrals he received, how many were processed, in what status each referral is in, etc. So it is difficult for Dr. James to know understand the analytics of his specialty.

HealthViewX Patient Referral Management solution at your aid

Patient Referral Management is complicated not only by the different sources but also by trying to manage all the referrals manually. The current referral management is no way close to the increasing demands of the referral process. Its inability to communicate between the referring and the receiving ends makes it slow and non-feasible.

Considering the challenges faced by dental centers, an Electronic Referral Management Software can help them better. After the complete analysis of a dental center’s referral workflow, HealthViewX realized that the crucial part of the problem is the lack of a system to consolidate referrals. On further analysis of their process, HealthViewX Patient Referral Management solution introduced the following features to meet their requirements,

  • Multi-Channel Referral Consolidation – Referrals flowing in through many channels are consolidated in a single interface. It enables easier monitoring and facilitates timely referral loop closure.
  • Referral Tracking – HealthViewX gives a clear picture about how a referral has progressed with the help of a timeline view. Every referral has a status which conveys in which stage the referral is in. With the help of a customizable dashboard, the exact number of referrals waiting to be processed can be identified easily.
  • New Referral Channel – HealthViewX Referral Management solution supports a new channel for sending and receiving referrals. This is called the desktop application. Sources like email, website, direct message, fax, etc are not secure and difficult to handle. On the other hand, desktop application is a secure source for sending and receiving referrals. Also documents can be attached and sent as a referral.
  • Referral Data Consolidation – It has options for printing the consolidated data about the referrals and the referral history of any patient as a hard copy at any time in PDF/excel.
  • Secure Data Management – HealthViewX Patient Referral Management is HIPAA compliant. It manages all patient-related documents securely.
  • Referral Analytics – Helps in tracking the number of referrals and gives complete information about the referrals processed, missed, scheduled etc with the help of a Referral Data-centric Dashboard.

HealthViewX Patient Referral Management solution helps dental centers in managing their referral network and increasing their revenue. Are you a dental center looking to track your inbound referrals very effectively? To know about HealthViewX Patient Referral Management System in detail schedule a demo with our team.

How HealthViewX Patient Referral Management Software Helps People In Different Designations In Healthcare?

Why is Patient Referral Management important for hospitals?

Patient begin a journey with the hospital when they are referred to that hospital to improve their health condition. Their expectation of the referral is usually high as they have sought another hospital for better experience and treatment. So hospitals must try to live up to the expectations of their patients. In order to manage huge volume of referrals, a hospital must have an effective Patient Referral Management System in place. This blog highlights challenges faced by operations manager, revenue cycle manager, healthcare IT department, patient referral coordinators and care providers (physicians and specialists) and how HealthViewX Patient Referral Management Software can help.

Challenges faced by physicians and specialists

Physicians and specialists play pivotal roles in the patient referral process. Physicians or PCPs hold the responsibility of initiating referrals. A patient visits the PCP and it is the discretion of the PCP to refer the patient to a specialist. What problems do physicians face in a referral process?

  1. Manual and time-consuming process – The process of creating a referral is too manual and time-consuming. In every stage of the referral, the physician has to put in a lot of effort. Here are few instances,
  • The physician has to wait for the insurance pre-authorization process to be done
  • Finding the right specialist takes a lot of effort from the physician’s side
  • After sending the referral, the physician has to wait for referral updates from the specialist.

From a specialist’s perspective the referral process is cumbersome. A specialist faces the following challenges,

  1. Multiple referral channels – For the specialist/imaging center who receive referrals face more difficulties than the referring provider. The receive referrals through various channels like fax, email, direct message, website, user-filled forms, etc. Managing and tracking all of it manually is a tedious task. The chances of missing out on a referral are high.
  2. Poor communication framework – The existing referral process has no quick mode of communication to contact the PCP or referral coordinator for missing information. The specialist has to wait till he/she gets the necessary information before starting with the referral process.

Challenges faced by referral coordinators

After a referral request is initiated, then it is the job of the referral coordinator to create a referral. A referral faces the following challenges,

  1. Insurance pre-authorization – A referral coordinator has to consult the insurance company if the diagnosis prescribed meet the insurance requirements of the patient. This process takes time as the referral coordinator has to wait for the insurance company to respond.
  2. Finding the right specialist/imaging center – The next big step after insurance pre-authorization is finding the right specialist or imaging center for the patient. The referral coordinator has to consider many factors like the patient’s convenience, specialist’s availability, new specialists in the locality, etc. This is time-consuming as there will be many specialists and imaging centers. Narrowing down the search manually will be difficult for the referral coordinator.
  3. Handling multiple software – A referral coordinator has to handle an EHR, fax system, appointment scheduling software all at the same time. The coordinator has to
    • Collect the patient information and demographics from the EHR
    • Do the insurance pre-authorization
    • Find the specialist
    • Send out the referral as a hard-copy fax

Handling so many things at the same time is tedious for the referral coordinators

Challenges faced by an operations manager

  1. Patient Referral Leakage – An operations manager will be primarily worried about how many patients are referred out of the network. Patient referral leakage is a determining factor in a referral network. In many cases, the patients are referred out-of-network even when there are appropriate specialists within the network.
  2. Referral Analytics –  As a large number of referrals flow in and out of the network, it is difficult to track the exact number. It is also tedious to track the number of referrals in various status and to close referral loops. The operations manager also needs to know how many referrals were sent or received, how many were processed, how many are yet to be processed, etc.

Challenges faced by a revenue cycle manager

  1. Patient no-show rates – After receiving the referral, the specialist/imaging center schedules appointments with the patient. In some cases, the patients are not notified clearly about the appointment. When patients do not show up, it is difficult for the specialist/imaging center to track. It results in revenue loss and patient dissatisfaction.
  2. Costly software – As mentioned earlier, a referral process needs an EMR/EHR, appointment scheduling software and a fax integration system. So many softwares for a single process is not efficient.

Challenges faced by an IT strategist

  1. Handling sensitive patient data – Patient data must be handled securely. Considering the current manual process, it is difficult to maintain data security.

How can HealthViewX solution add value to the process?

    1. Insurance pre-authorization process – HealthViewX automates the insurance pre-authorization process. The provider need not coordinate with the insurance company for prior authorization. The HealthViewX solution will do it for them. This reduces the manual effort of the referral coordinators.
    2. Intelligent Provider Match – The HealthViewX “Smart Search” feature makes it easy for the referring provider in finding the right provider. It has smart filters and search options that help in narrowing down the specialist based on the requirements. This saves a lot of time for the referral coordinators.
    3. Timeline View to track referrals – With the help of a referral status, the referring provider can get to know what stage the referral is. A timeline view shows a history of stages through which the referral has progressed. The chances of a referring provider missing out on referral updates are very less.
    4. Referral closure and feedback – The referring provider can close the referral when it gets completed. The receiving provider and the patient can give a feedback on the referral process to the referring provider. Thus the referring provider can make it easy for the other the next time.
    5. Multi-channel referral consolidation – The HealthViewX solution can capture fax, phone, email, online form referrals or any other referrals in a single interface. It makes it easy to monitor and manage all channels of referrals in a single queue.
    6. Patient coordination framework – After finding the receiving provider, the referral coordinator refers the patient. When the receiving provider receives the referral, the provider will get notified of the referral. Even the patient will be notified of the referral. The receiving provider can schedule appointments based on the patient’s comfort. This will cut down patient no-show rates.
    7. Referral Analytics – Helps in tracking the number of referrals and gives complete information about the referrals processed, missed, scheduled etc with the help of a Referral Data-centric Dashboard. It helps the operations manager in taking informed decisions.
    8. HIPAA compliance – The solution is completely HIPAA compliant which enables secure patient data exchange.

HealthViewX Patient Referral Management solution smooths the referral process and solves challenges faced by people in different designations in healthcare. Do you want to know more about HealthViewX HIPAA compliant Patient Referral Management solution? Schedule a demo with us.

Why do Federally Qualified Health Centers need a Referral Management Software In Addition To An EMR?

Patient Referral Management is crucial for Federally Qualified Health Centers (FQHCs). With the advent of the Patient Protection and Affordable Healthcare Act, Electronic Health Records have been widely adopted across many FQHCs. There are many benefits to EHRs like improved,

  • Accessibility to patient data
  • Charge capture
  • Preventative health

Let us look into each of them in detail to understand an EMR/EHR implementation better.

Pros of EHR/EMR

1. Improved data accessibility

Before EHRs, access to medical charts required a fair amount of physical labor. For example, every time a patient visits the physician’s clinic or hospital, physician physically pulls their file from a storage space. As a result of this back and forth exchange, there was a greater chance of human error and charts would sometimes be missing information or be chronologically out-of-order.

EHRs, on the other hand, have eliminated the physical transporting, sifting and filing charts, making data available at all times. Additionally, for systems that allow remote access to charts, clinicians can even be offsite and still securely access patient files.

2. Computerized physician order entry

CPOE allows physicians to place lab and imaging orders, prescriptions and other notes electronically. This reduces the error of handwritten orders and allows the patient’s other physicians within the same network access to the order.

3.Preventative health

EHRs allow prompts for preventative health screenings. During routine doctor or urgent care visits, the physician has access to preventive health records conveniently in one place. If the patient is due for a cancer screening (such as mammogram or colonoscopy), or blood pressure testing, the referral coordinator can easily look this up via the EHR system and schedule an appointment for the patient.

4. Ease sign off for PAs and NPs

While this varies from state-to-state by law, physician assistants and nurse practitioners are typically required to have their notes approved and signed off on by their supervising physician. EHRs allow the revision and cosigning of notes to happen electronically as opposed to physically moving and signing the paper.

5. e-messaging between providers

As any referral coordinator can attest referral information, telephone tag between providers can be common and is a big time-waster. With EHR software, physicians can e-message across practices. One situation that benefits in particular from e-messaging is referrals. Rather than playing telephone tag to get an appointment scheduled, the physician electronically sends a message to schedule the appointment.

How can a Patient Referral Management Referral Management work in cohesion with an EMR/EHR system?

FQHCs prefer working with EMR/EHR systems because they are comfortable with it. So they do not wish to move out their EHR/EMR system. 

How great it would be if a Patient Referral Management software could integrate seamlessly with an EMR/EHR system? It can help in ensuring end-to-end Patient Referral Management without disturbing the existing system.

An EHR/EMR system has many advantages but when it is complemented with a Referral Management software practices can experience many more benefits.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. The patient demographics, diagnostic reports, test results or any sensitive information can be transferred safely. The solution is HIPAA-compliant with complete data security. It has the following features,

  1. Outbound Referrals – HealthViewX Referral Management Solution can integrate with both the receiving and referring end. For inbound referrals, it helps in channelizing various sources into one single queue. In case of outbound referrals, it facilitates integration with the existing system to read the patient data and send out referrals.
  2. Referral Timeline – In HealthViewX Referral Management System, any referral has a timeline, to capture and notify the progress of the referral to all the stakeholders. A referral will be mapped to a status which helps in tracking it better. For e.g. – If a patient does not show up for the appointment, the status of the referral can be changed to no-show and an appropriate reason can also be given. With the help of a referral timeline, the providers can always be aware of what is going on with the referral.
  3. Workflow and Task Management – A workflow can be defined on how the referral flow must be(business rules). Providers can create tasks to manage referrals by assigning it to the respective person.
  4. Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
  5. Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
  6. Seamless Integration – The solution can seamlessly integrate with any EMR/EHR/RIS or Third Party application thus providing minimal disruption in the existing referral flow.
  7. Referral History Consolidation – The consolidated data regarding the referrals and the referral history of any patient can be printed as a hard copy at any time in pdf/excel.
  8. Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
  9. Referral Data Analytics – Referral data-centric dashboard gives complete data regarding the number of referrals flowing out, the number of referrals in various status, patient follow-ups, etc.

HealthViewX Referral Management solution helps in building a secure referral network in no time. Our expert team will guide you in changing to a Patient Referral Management Software with minimal effort. Schedule a demo with us to know more about our solution.

 

 

Reference

University of California—Davis. “UC Davis study finds e-medical records have varying effects on productivity.” Dec. 2010. http://www.news.ucdavis.edu/search/news_detail.lasso?id=966

How Can Hospitals Improve Their Patient Referral Management By Complying With Meaningful Use

What is meaningful use?

Meaningful use (MU) is a health information technology (HIT) term that defines minimum U.S. government standards for

  • Using electronic health records (EHR)
  • Exchanging patient clinical data between health care providers, between health care providers and insurers, and between healthcare providers and patients

It has a set of rules known as meaningful use measures or meaningful use criteria. It determines whether or not a healthcare provider receives federal funds from the Medicare EHR Incentive Program, the Medicaid EHR Incentive Program or both.

Almost 99% of the hospitals in the U.S. use EHR systems. It is a huge leap by EHRs compared to 31% of hospitals back in 2003. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment history of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. EHRs can:

  • Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results
  • Allow access to evidence-based tools that providers can use to make decisions about a patient’s care
  • Automate and streamline provider workflow

Impacts of EHR on Care

Electronic Health Records create a greater and more seamless flow of information within a digital healthcare infrastructure. It encompasses and leverages digital progress and transforms the care delivered. With EHRs, hospitals experience improved,

  • Patient Care and participation
  • Care Coordination
  • Diagnostics and Patient Outcomes
  • Practice Efficiencies and Cost Savings

Three stages of Meaningful Use (MU):

Meaningful use is divided into three stages.

Stage 1, which began in 2010, focused on promoting the adoption of EHRs.

Stage 2, finalized in late 2012, increases thresholds of criteria compliance and introduces more clinical decision support, care-coordination requirements and rudimentary patient engagement rules.

Stage 3, which the CMS is writing from late 2014 through early-to-mid 2016, will focus on robust health information exchange as well as other more fully formed meaningful use guidelines introduced in earlier stages.  

What are the incentives and penalties for meaningful use?

Under the HITECH Act enacted under the 2009 Recovery Act, incentive payments are available to eligible professionals who successfully demonstrate meaningful use of certified EHR technology.

The Recovery Act specifies three main components of meaningful use: The use of a certified EHR technology

  • In a meaningful manner
  • For electronic exchange of health information to improve quality of healthcare
  • To submit clinical quality and other measures

According to Medicare and Medicaid EHR incentive programs, the practices receive incentives if they meet the meaningful use requirements. If they do not meet the meaningful use requirements, they will be penalized.

Medicare EHR Incentive Program

Medicare incentive payments are equal to 75% of a practice’s annual Medicare Part B allowed charges up to a maximum yearly amount.

After 2015, providers who were eligible for the Medicare Meaningful Use program but did not successfully demonstrate Meaningful Use were penalized. The penalty started at 1% of Medicare Part B reimbursements and increased each year to a maximum of 5%.

Medicaid EHR Incentive Program

In the case of Medicaid patients, a practice can earn up to $63,750 in incentive payments over the six years that they choose to participate in the program.

If you start in 2015, you can earn incentives through 2020. Practices can consult their state’s agency for information about a specific payment schedule.

Providers who are eligible for Meaningful Use under the Medicaid program are not subject to payment penalties unless the provider is also eligible under the Medicare program.

How can a Patient Referral Management Referral Management enhance an EHR system to achieve meaningful use?

FQHCs prefer working with EMR/EHR systems because they are comfortable with it. So they do not wish to move out their EHR/EMR system. An EHR/EMR system has many advantages but when it is complemented with a Referral Management software practices can experience many more benefits.  

How great it would be if a Patient Referral Management software could integrate seamlessly with an EMR/EHR system? It can help in ensuring end-to-end Patient Referral Management without disturbing the existing system.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. It also enables easy and safe transferring of patient demographics, diagnostic reports, test results or any sensitive information. The solution is HIPAA-compliant with complete data security.

HealthViewX can enhance a practice’s EHR capability by making it achieve meaningful use. The practice’s scoring can also improve by using HealthViewX Patient Referral Management solution.

HealthViewX Patient Referral Management solution features

It has the following features,

  • Inbound and Outbound Referrals – HealthViewX Referral Management Solution can integrate with both the receiving and referring end. For inbound referrals, it helps in channelizing various sources into one single queue. In case of outbound referrals, it facilitates integration with the existing system to read the patient data and send out referrals.
  • Referral Timeline – Any referral has a timeline, to capture the progress of the referral. It is common to the referring and receiving provider. A referral will be mapped to a status which helps in tracking it better. For e.g. – If a patient does not show up for the appointment, the status of the referral can be changed to no-show and an appropriate reason can also be given. With the help of a referral timeline, the providers can always be aware of what is going on with the referral.
  • Workflow and Task Management – A workflow can be defined on how the referral flow must be(business rules). Providers can create tasks to manage referrals by assigning it to the respective person.
  • Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
  • Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
  • Seamless Integration – The solution can seamlessly integrate with any EMR/EHR/RIS or Third Party application thus providing minimal disruption in the existing referral flow.
  • Referral Data Consolidation – The consolidated data regarding the referrals and the referral history of any patient can be printed as a hard copy at any time in pdf/excel.
  • Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
  • Referral Data Analytics – Referral data-centric dashboard gives clear figures regarding the number of referrals flowing in and out, the number of referrals in various status, patient follow-ups, etc.

HealthViewX Referral Management solution helps in building a secure referral network in no time. Our expert team will guide you in changing to a Patient Referral Management Software with minimal effort. Schedule a demo with us to know more about our solution.

 

Reference

https://www.healthcare-informatics.com/news-item/ehr/survey-nearly-all-us-hospitals-use-ehrs-cpoe-systems

How Can The Healthcare Industry Equip Their Senior Patients For Chronic Care Management?

Healthcare organizations and chronic illness

By 2029, estimates show that senior patients will make up 20% of the population and a considerable share of healthcare spending. As it stands now, senior patients and patients with chronic illness make up to 5% of the population but nearly 50% of healthcare spending. How can healthcare organizations cap these rising costs.

According to a report from BDO Center for Healthcare Excellence & Innovation, healthcare organizations are taking more responsibility when it comes to older adult care and chronic care management,

From NEJM Catalyst survey, it was found that healthcare organizations are looking into

  • Home health services
  • Strong chronic disease plans
  • Health IT

to address the needs of a growing aging population.

How can healthcare organizations achieve patient-centric and value-based care?

As mentioned earlier, healthcare organizations are looking into home health services and care plans to treat patients with chronic diseases.

Home healthcare services – Home healthcare is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility. Examples of home health services include:

  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

In general, the goal of home health care is to treat an illness or injury. Home health care helps you:

  • Get better
  • Regain your independence
  • Become as self-sufficient as possible
  • Maintain your current condition or level of function
  • Slow decline

Strong chronic disease plans – Patients with one or more chronic diseases need doctor’s attention almost every day. The physicians create care plans for such patients with vitals, measurements, activities, pain, etc that need to be monitored. This will help in keeping chronic patients healthy if they follow the care plan strictly.

HealthViewX Care Management and Chronic Care Management solution to ease the process for healthcare organizations

Information technology helps in making the process simpler for healthcare organizations by reducing their time and effort. HealthViewx software provides Care Management and Chronic Care Management solutions which help in providing home health services and also care plans for chronic patients.

HealthViewX Care Management solution supports the following features,

  • Care plans to enable remote care – A provider can create a care plan for a patient depending on the vitals, treatments, measurements, etc that need to be tracked. The patient-centric application helps in logging data for the vitals specified in the care plan. If needed the care plan can also be printed.
  • Customizable dashboards to suit the need – Dashboards comprising of graphs and tables show a comprehensive data of the number of patients in different care plans depending on the patient diagnosis.
  • Scheduler to keep track of the appointments – An inbuilt scheduler keeps track of the appointments and sends timely reminders to both the patient and the provider. The chances of missing out an appointment are very less.
  • Audio and video calling features – HealthViewX Care Management solution support inbuilt audio and video calling features which help in connecting with the patients for follow-ups.
  • Patient-reported data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the providers in monitoring the patient vitals. The patient records can be anytime printed in pdf or excel report form.
  • Health device integration – HealthViewX Care Management solution can integrate with any wearable device like Fitbit, apple watch, etc. Hence the patients need not waste time in logging data in the application if they are already using wearables.

HealthViewX Chronic Care Management solution supports the following features,

  • Automated call log feature – After a call, care plan creation or any action related to CCM health services, the system automatically adds call logs. It reduces the physician’s manual effort is logging the call logs.
  • Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
  • Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
  • Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the Medicare reimbursements.
  • HIPAA compliance – HealthViewX Chronic Care Management is HIPAA compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

HealthViewX Care Management and Chronic Care Management solutions have features that suit healthcare organizations best. To know more about our solutions, schedule a demo with us.

How Is CMS Changing The Face Of Remote Patient Monitoring And Patient Access?

CMS has finally issued its 2019 Physician Fee Schedule Proposed Rule. It has highly anticipated new reimbursement policies for telehealth, remote monitoring, with a stronger focus on patient access to health information.

The new codes for Patient Remote Monitoring

The 2019 Proposed Rule offers three codes through which providers can get reimbursements for integrating remote monitoring data into their practice.

The first two are practice expense codes, which include resources providers spend such as office rent, supplies, and medical equipment. The third code tracks the amount of time a care provider spends managing patient care using the remote monitoring data.

  • 990X0 – Remote monitoring of physiologic parameter(s). Covers the time providers spend on setting up the technology and explaining to patients how it works.
  • 990X1 – Remote monitoring of physiologic parameter(s). Covers device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.
  • 994X9 – Remote physiologic monitoring treatment management services. Covers 20 minutes or more of clinical staff, physician, or other qualified healthcare professional time in a calendar month. The code requires interactive communication with the patient and/or the patient’s caregiver during the month.

There are some challenges in the proposed codes. These codes only cover the exchange and interpretation of “physiologic” data; yet many providers today would agree that there is a wealth of patient data that is helpful at the point of care, including patient-reported outcomes or behavioral data, that would fall outside the definition of physiologic.

Further guidance may be helpful to determine exactly which providers on a care team can spend time working with remote monitoring data. While the code definition states “clinical staff, physician, or other qualified healthcare professional,” elsewhere in the PFS proposed rule refers to the term “practitioner,” which “is used to describe both physicians and non-physician practitioners (NPPs) who are permitted to bill Medicare under the PFS for the services they furnish to Medicare beneficiaries.”

New Reimbursement for “Communication Technology-Based Services”

CMS acknowledges the evolution of physician services furnished through communication technology. So Medicare enacted the telehealth services statutory provision for patients with chronic conditions. Recognizing the many statutory restrictions on telehealth in Section 1834 (m) of the Social Security Act, CMS has taken the interpretation that there are physician services that involve interaction with a patient via remote communication technology that are not considered telehealth services and therefore are not covered by these restrictions.

CMS proposed several new HCPCS codes that are not considered “telehealth” services and as such, not subject to the conditions of Section 1834 (m):

  • HCPCS code GVCI1 – Brief Communication Technology-Based Service, e.g. Virtual Check-in. This would include the kinds of brief non-face-to-face check-in services furnished by a physician or other qualified healthcare professional, using communication technology, to evaluate whether or not an office visit or other service is warranted.
  • HCPCS code GRAS1 – Remote Evaluation of Pre-Recorded Patient Information. This covers physician time spent reviewing patient-submitted video or images to determine if a follow up visit is needed.

CMS acknowledges modern communication technology that allows for “the kinds of brief check-in services furnished using communication technology that are used to evaluate whether or not an office visit or other service is warranted.”

Beginning January 1, 2019, CMS is proposing to pay providers for utilizing these types of preventative technology services, even in cases where the activity means that a follow-up office visit is not scheduled. Where the check-in services precede an office visit or follow a visit within the previous 7 days, they would be bundled into the payment for the visit, but where the service does not lead to an office visit, there could be a separate payment.

CMS is seeking comments on the implications of this approach, as well as more information from industry about the types of technologies in use today to achieve these goals. Additionally, CMS seeks insight from industry as to if,

  • These services are appropriate for new patients
  • They are only for existing patients
  • Patient consent is required

Health Information Technology to simplify the process

Information Technology can greatly simplify the process by making remote patient monitoring easy for the hospitals. HealthViewX is a healthcare product that provides solution for remote patient monitoring, chronic care management and referral management. Our product has many unique features that simplify the workflow and improves patient satisfaction. To know more about our solution, schedule a demo with us.

References

https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14985.pdf