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Several changes to the Merit-based Incentive Payment System (MIPS) track of the Quality Payment System (QPP) are outlined in a proposed rule for 2020 revisions to payment policies under the Physician Fee Schedule (PFS). Most of the proposed changes come as no surprise, but there is one proposal, in particular, that will make a huge […]
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Changes to payment, coding, and documentation policies for evaluation and management (E/M) services finalized in the 2019 Physician Fee Schedule (PFS) final rule are necessary to align with the American Medical Association’s (AMA) revisions to the 2021 CPT code set for office/outpatient E/M visits, according to the Centers for Medicare & Medicaid Services (CMS). The proposed policy changes for E/M […]
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Is your outpatient facility on board with new regulations for the ordering and furnishing of advanced diagnostic imaging services? Advanced diagnostic imaging services have long been under scrutiny by the Office of Inspector General for Medicare fraud and abuse, and the Centers for Medicare & Medicaid Services (CMS) responds to the watchdog’s recommendations each year […]
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Use the next two years to prepare for new documentation guidelines and payment rates. On Nov. 1, 2018, the Centers for Medicare & Medicaid Services (CMS) finalized in the 2019 Physician Fee Schedule final rule significant changes to documentation requirements and reimbursement for evaluation and management (E/M) office visits (CPT® 99201-99215). The most significant changes […]
The post Changes Ahead for CMS E/M Requirements and Reimbursement appeared first on AAPC Knowledge Center.
The most common question I get writing this column is: ‘Why is it taking so long to implement electronic medical records?’ Our initial 18-mo project turned out in about three years, instead. Though this seems a bit cautious to some colleagues, people in IT and project management industries commended our careful approach to the situation. It’s well-known that Internet Technology system implementations (such as EMR) fail up to 50 percent of the time. A solid plan must be in place, taking into account any unforeseeable circumstances which could change the time frame. For example, our journey included two new associates, two hurricanes, and a departure of an associate.
Your electronic medical records vendor should be able to refer someone to guide you through implementation. However, this person can be either a person with EMR experience or someone who knows about the system itself, though not so much about roll-out at a medical office. I strongly recommend taking on the services of a certified PM (Project Manager). One important thing a PM can do is turn your project into a dynamic process which can take a series of setbacks or delays. The standard calendar can’t really do much to ensure this sort of follow-through.
We first implemented a Project Manager to plan the location for our new office. Our employees could use what was learned from the process, which includes how to use mind-mapping software. We have used these techniques for all major projects at our practice since then, including implementation of the electronic medical records (EMR).
For meetings and other minor projects I recommend Getting Things Done by David Allen.
The primary advantage of using a work breakdown structure is that any glitches that pop up don’t completely ruin your goal to successfully implement the EMR system. Of course, at a small practice there is more schedule flexibility. A hard deadline should most certainly be set, as part of the plan for EMR roll-out. However, with a proper plan structure your plan can roll on with the punches instead of simply rolling over.
When we finally arrived a a place when staff had training, we posted the hard deadline to go live. There was a simulation date on a Saturday which occurred two days before launch; both dates were mandatory to attend.
Although theoretically we could have pushed the launch date back, these dates helped to keep us working together and exposed risks that were faced. Now we’re about 5 months into our roll-out. The stress levels have begun to settle a bit, and we’re now tweaking our templates and getting ready for the next wave of patients to introduce to electronic medical records.
Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. He is managing partner of Ocala Eye, a large multi-specialty ophthalmology practice. Find more useful articles and podcasts at http://www.medicalpracticetrends.com
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