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Practice
Management
The
MedInformatix Billing System is integrated into the charting system and uses a
paradigm different than any other traditional practice management system. The
primary interface used to enter charges is the Decision Tree. It is
intended to be used as a "point of care" entry tool by the health care
provider rendering service (i.e. the Doctor, Therapist, Nurse Practitioner,
etc.), however, requires a team effort between all users to ensure error free
transfer of information from the provider to the printed claim.
The
flow of information begins with the front desk who's staff will typically
enter patient demographics before the physician sees the patient.
Without this information, the patient's chart cannot be established or accessed
in the system. The physician
would then be responsible for entering normal evaluation and management charges
(E&M), orders, billing and other services. Nursing staff may also be
responsible for billing the non-E&M services such as lab tests and
injections.
Because
the patient charges have been entered, the MedInformatix biller takes on the
unique role of an auditor, which is unlike the workflow enforced by typical
billing systems. This workflow allows the biller to spend less time on
data entry and claims processing and spend more time on quality assurance,
reporting efficiencies and identifying inefficiencies.
Processing
claims is a very user friendly and automated workflow process within the
MedInformatix software. It allows the
biller to correct claims from a master screen called "Generate Claims”.
This feature flags specific charges by highlighting them in red, allowing the
biller to spend time auditing items which have specific errors such as invalid
CPT codes, invalid diagnosis codes, and/or invalid facilities. This
information helps in providing feedback to specific users regarding entry
errors, and may be helpful in reducing errors in the future.
Finally,
Insurance payments in MedInformatix are applied on a charge "line
item" basis and retains a detailed historical record of payments and
adjustments to each line item. Guarantor/Patient payments are made on a line
item basis as well, but can be automatically applied from oldest to newest.
Although this level of detail may cause additional work for those practices that
do not currently pay by line item, the current environment demands that
physicians know historical payment patterns by specific procedure. This
information is often required when negotiating or evaluating managed care
contracts or verifying profitability of specific payor businesses (such as
Medicare or Medicaid).
The charting software
also uses sophisticated
techniques that automatically determine if secondary carriers are to be billed,
any amounts that are to be written off, or when the patient becomes responsible,
thus eliminating the need for complex decisions at
the time payments are entered.
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