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Will Medical Billing Systems Fail Under ICD-10 Phase 2?

Posted on April 6, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The people at CureMD sent out this tweet and image with a pretty powerful assertion about the future of medical billing systems.
Medical Billing Systems Fail Under ICD-10

I’d like to know where CureMD got the stat in their tweet. That’s a pretty strong assertion about medical billing systems. Based on my knowledge and experience, I’m not sure I agree with them. If they’d have said that ICD-10 in general would cause 50% of medical billing systems to fail, I would have thought it was high but possible. It’s not clear to me how phase 2 of ICD-10 will be so much worse for medical billing systems. Maybe they’ll share in the webinar.

I have seen a bunch of medical billing systems that were running on fumes heading into ICD-10. There was no one really actively developing these systems and they weren’t worrying about ICD-10. They were just sucking whatever revenue they could out of their existing clients and they were going to end of life the product once they ran out of clients. They’re like medical billing system zombies.

Turns out that there are a lot more of these types of systems in healthcare than you probably realized. In fact, I’m surprised we haven’t heard more about their demise after ICD-10’s implementation last year. Whenever I’d talk to doctors, they’d often tell me which EHR they had or which EHR they were considering. Then, I’d ask them which PM system they used and they’d tell me about some software I’d never heard of before. They knew it. They liked it. Many of them would happily say that “you could pull it from their cold dead hands.”

It’s interesting to see CureMD predict that it may be time for us to start doing just that. What are you seeing? Are medical billing systems going to have trouble with the 2nd phase of ICD-10? Will we see a bunch of them finally close up shop? What do you see?

A Medical Software Billing Company Story

Posted on May 31, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I did a post on EMR and EHR called Medical Billing Software Lost in the EHR Mix and then cross posted it to a group on LinkedIn. In that group, I got the following story from Daniel McDonald who works at a practice management software vendor. The response was so interesting I had to share it with more people:

We have been a PM vendor for more than 20 years and we made the decision to not pursue our own EMR as we are a small company with very close ties to our customers. My partner even supported them prior to our 20 years. Some have been with her for 27 years.

We built both an API process and a HL7 process to do the necessary information exchange and pull back the charge and diagnosis data to our PM software. Originally we were under the assumptio this process was supposed to be all about the ability to share data with physcians as well as others involved in patient care.

Unfortunately we have customers who were never told by the EMR vendor they had the ability to share the needed data because it would limit the salespersons commision even though this would limit the disruption in the office and limit larger than needed expenditures on software, training and conversions. The large companies only cared about their stock prices and not about making the process of the implementation quicker, easier by keeping one big part the offices were comfortable with and knew so well. The PM software ultimately affected the entire office and is making the transitions a nightmare. We even have groups paying us to host their data in the event they pull the plug.

We have an office with an attorney fighting the fact the office asked about an interface and the vendor said it was all or nothing. A week later at a luncheon the office manager found out all of the other doctors that bought that package were continuing to use their original PM and were not changing.

So far all this has done is made the fat pockets fatter, disrupted the office, and is pushing the smaller PM vendors customers they have had for 27 years. For the last two years we have not been able to focus solrly on our PM. We found several economical solutions we interface with to meet MU but several customers have been scarred by verbage used by the fat cats in their sales presentations and tactics.

Everyone of our customers were happy and got their calls returned promptly and on the same day. We also have a medical billing company so our software customers would call us with their questions about billing, credentialing and what affects getting a CT or MRI might require or how to bill a code they had never billed before. Now they call an 800 number and they get someone who is hard to understand only to be told they will be placed in the queue and that initial call is not always even on the same day. We know our product like the back of our hands as we developed our own in 1994 so not only do they get a prompt call, they get an answer.

As best I can tell, the comment is about the ProvidrSoft practice management software. I’ve seen some of the practices that Daniel mentions in his above comment. I’m not sure it’s just the big EHR vendors that are telling them that they need an integrated EHR and PM. That message has gotten out far and wide.

As I read the comment above, in the back of my mind I could see a hundred other practice management software companies in my head who could probably share a similar story. I’m not sure how this is all going to play out, but I know that many doctors love their practice management software. They’ve been through many battles together and they won’t leave it behind on the battlefield.

Medical Billing Software Lost in EHR Mix

Posted on April 20, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the many things that seems to be getting lost in the mix of all the noise about EHR software and the EHR incentive money is medical billing software. As I think through all of the presentations from EHR vendors and discussions I’ve had with doctors, consultants and other professionals in the Healthcare IT industry, I think the practice management system is getting lost in the EHR shuffle. Let me ask some important questions:

Does anyone care about the billing software now? What if the billing software that comes packaged with your EHR sucks?

A regular reader of my sites John Brewer often talks about how many of the benefits we like to talk about with technology in a practice are coming from the practice management system, not the EHR. These days most people seem to consider the EHR and PM one package. Yet, I’ve seen people spend little time really understanding whether the billing side of the EHR is going to work for their practice.

In contrast to this comment though is that I haven’t seen an uproar of people complaining about implementing an EHR and their billing going down the tubes. Does this mean that medical billing software has basically become a commodity that every EHR vendor has done to a reasonably sufficient level that no one has a problem? Or maybe we don’t hear about it much because most doctors aren’t business people.

While I don’t have anything but anecdotal evidence of the disregard to medical billing software, I think this is going to eventually come back to bite us. Although, in our generally provider driven world the EHR matters more in the daily workflow and so this isn’t a surprise that we see the EHR bias during medical software selection. Once the physician sees the reimbursement levels lower, they’ll likely wake up to the reality that you need both a solid EHR and a solid PM.