The pMD Blog

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pMD Blog...

where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.



Here's The Latest in Health Care:


As the pandemic has created the need to optimize health care delivery, nursing and clinical leadership will need to address three major problem areas; workforce management, capacity management, and patient outcomes. While problems in these areas were present long before the pandemic, the events of the last year have brought them clearly into focus.  Read More

Telemedicine implemented without attention to workflow runs the serious risk of falling into an unsafe “doctor-does-it-all” model. The AMA recently published some recommendations to help provide patient-centered care and create an overall better telehealth experience for patients and physicians.  Read More

CMS will automatically apply the extreme and uncontrollable circumstances policies to all MIPS eligible clinicians for the 2020 performance period because of COVID-19. The automatic exception policy, however, will not apply automatically to MIPS eligible clinicians who submit 2020 performance data as an individual in two or more performance categories or whose practice reports as a group. Read More

Medicare physician spending declined $9.4 billion, or 19%, in the first six months of 2020 due to the pandemic, according to a new report. While spending on physician services declined precipitously, telehealth claims increased dramatically after the federal government increased flexibility for physicians to get reimbursed by Medicare.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.


Information technology is supposed to make work-life more efficient, accurate, and effective. The promise to eliminate duplication of effort and minimize fat-finger typographic errors is the core reason for adopting much of the IT used in the modern medical office. Nothing delivers on these promises more directly than establishing interfaces among the various computer systems in the health care delivery universe.

SHOULD YOU HAVE TO PAY FOR AN INTERFACE?

At pMD, our stated raison d'être is to save patient lives by reducing the risk of medical errors stemming from miscommunication and non-communication resulting in care gaps.  pMD was created to improve efficiency, accuracy, and information exchange among caregivers and patients.  Since interfacing is so integral and critical to achieving this goal, pMD has never charged our clients for an interface.  

When dining at a restaurant, you are paying for the food, but you are not charged extra for utensils or a plate.  When investing in a system to improve business efficiency and accuracy, getting quality data into and out of it should not cost extra.  This principle is at the core of the pMD approach to interfacing with other systems, including hospitals, practice management, answering services, and billing and revenue cycle management (RCM) services.  

Unfortunately, most other participants in the industry have a different view on the subject.  While pMD does not charge for interfaces, the reality is that most Practice Management (PM) System vendors do charge thousands of dollars for them.  Some hospitals and health systems also charge for data feeds to private practices as well, although can vary with the practice’s relationship with the hospital.

INTEROPERABILITY IS IN OUR DNA

Our commitment to core principles drove the way we designed our interfacing technology and continues to drive our methodology.  While many players in the industry are unwilling or unable to modify the format of the data they send or expect to receive, pMD has developed a system that allows us to be very flexible within the HL7 standard for interfacing.  Not only do we not charge providers, but we will flex to suit the needs of the systems we are exchanging data with.  

We have a huge existing and growing library of interfaces to a large number of systems that allow us to implement many interfaces with off-the-shelf modules quickly.  Our approach allows us to easily make adjustments to those existing interfaces for practices with unique requirements and workflows.  We’re also not limited to the systems we’re currently interfaced, we can adapt existing packages to quickly develop new interfaces with systems we have not previously encountered.  

pMD can process data for new and existing office and hospital patients, appointments scheduled in a practice management system, and can of course send charges in pMD back to the PM or RCM systems, customized to their unique requirements. The best part of it all, it is all included in the complete service that pMD prides itself on.

If you are interested in learning more about our interfacing capabilities, please contact us here or give us a call at 800-587-4989 x2. We’d love to hear from you!

To find out more about pMD's suite of products, which includes our charge capture and MIPS registry, billing services, telehealthsecure messagingclinical communication, and care navigation software and services, please contact pMD.



Here's The Latest in Health Care:


The COVID-19 death toll in the U.S. topped 500,000 this week, a staggering number that all but matches the number of Americans killed in World War II, Korea, and Vietnam combined. The U.S. toll is by far the highest reported in the world, accounting for 20 percent of the nearly 2.5 million coronavirus deaths globally.  Read More

COVID-19’s impact on front-line health care staff will unfold for years to come, but it appears to have already had an effect on physicians’ career plans. According to a new survey, a surprisingly large percentage of physicians are considering leaving the practice of medicine entirely, retiring early, or leaving to work for another employer.  Read More

The massive amount of data available in health care makes it a prime area for artificial intelligence (AI) and machine learning (ML) automation. Implementing these technologies has the potential to advance preventive care, but for that to be possible, health systems need to adopt "high-level" AI and ML processes. Read More

Revenues across U.S. hospitals could be at least $53 billion lower in 2021 compared to pre-pandemic levels, according to the American Hospital Association. Health systems are still dealing with the fallout from delaying non-urgent procedures, depressed volumes, higher expenses as well as the physical and mental health toll of COVID-19 on their staff.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.

With the health care landscape continuing to be impacted by the COVID-19 pandemic, the Merit Incentive Payment System Program (MIPS) has also continued to evolve. The Centers for Medicare and Medicaid (CMS) has released updates to the program that are being implemented for MIPS Year 5. With patient care and safety being the top priority, the pMD team continues to closely follow the changes and keep you up-to-date. 

As a qualified MIPS registry, pMD has been keeping an eye on the changes and requirements for reporting in 2021. We continue to offer our customers the tools to submit their 2021 MIPS data to CMS and navigate some of these changes using our robust dashboard and being in close contact with our excellent account management team.

Interested in what has changed for 2021 MIPS? Please review the updates below. A full list of changes to the Year 5 Final Rule and the most up-to-date information can be found on the Quality Payment Program (QPP) website

Reporting Requirements 

If your practice is unsure of your reporting requirements, the QPP has a readily available tool for determining your eligibility. The QPP Participation Lookup tool provides insight into provider eligibility as well as special status. To review your 2021 eligibility, simply enter your NPI into the tool and review! 

Scoring Requirements

CMS has increased the data requirements and score requirements for 2021 MIPS:

1) Quality measures must meet 70% of data completeness this year. 
2) Improvement Activities must apply to 50% or more physicians within a group to attest.
3) The performance threshold has been raised to 60 points to avoid a penalty and 85 points to get an exceptional performance bonus.  

There also have been changes to performance category weighting for 2021 MIPS:

1) The Quality performance category will be weighted at 40% (5% decrease).
2) The Cost performance category will be weighted at 20% (5% increase).

Promoting Interoperability will be weighted at 25% and Improvement Activities will be weighted at 15% - these are the same weightings as 2020. 

Avoiding the Penalty

With the minimum required score increasing substantially, CMS lists guidelines that will help your practice avoid the penalty: 

1) Groups should submit a combination of quality measures, Improvement Activities, and/or Promoting Interoperability. Groups can review 2021 measures on the QPP site. 
2) Groups should submit 6 clinically relevant quality measures. At least 1 of these measures should be a high-priority or outcome measure. 
3) If your group does not have 6 clinically relevant measures selected, you will be required to submit a specialty measure set. 

Bonus Points

Certain practices and measure selections can help your practice earn bonus points. You can earn bonus points by doing the following: 

1) Submit 2 or more outcome or high-priority quality measures.
2) Small practices that submit at least 1 measure can earn six bonus points for the quality performance category score. 
3) Practices can earn up to 10 bonus points if their quality performance category score improves. 

We are accepting new practices to report MIPS with us in 2022. If you are interested in learning more, please contact us here or give us a call at 800-587-4989 x2. We’d love to hear from you!


To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.


Source: Getty Images

Here's The Latest in Health Care:


In the rush to quickly deploy virtual care programs during the pandemic, basic processes were sometimes overlooked. To ensure long-term success, organizations should assess whether they are delivering the best experience, determine how telehealth fits into the overall care delivery model, and examine the role trust plays in their endeavors.  Read More

The icy blast across much of the U.S. injected more confusion and frustration into the nation's COVID-19 vaccination drive this week. The snowy, slippery weather either led to the closing of vaccination sites outright or held up the necessary shipments, with delays expected to continue for days.  Read More

The shortages of personal protective equipment (PPE) and other critical health and safety material and equipment that have persisted throughout the Covid-19 pandemic have made one thing clear; large organizations need to be much better prepared to operate when future devastating emergencies strike.  Read More

EHRs are one of the top clinician burnout drivers, and especially so among specialists who might need different EHR functions. Specialty-specific or bespoke EHR may be a promising approach to overcoming the limitations of general-purpose EHR and mitigating burnout among physicians by reducing the time spent sifting through large amounts of clinical data for the specific data elements they need.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.

 

At the time of writing this blog, Valentine's Day was right around the corner. Love was in the air, teddy bears and chocolates had blossomed all over my Amazon Prime homepage, and a flurry of statistics and fun facts about the holiday had hit my news feed:

*9 million proposals were expected to be made on Valentine's day 
*1 million people were expected to change their relationship status on social media

That’s a lot of commitment!

Recently, at pMD, I’ve been working with physician practices on another area of commitment: who to entrust with their revenue cycle. Health care practitioners rely on their billing teams to send out health insurance claims and patient statements to keep their practices functioning. Practices are heavily dependent on the effectiveness of their revenue cycle to keep their doors open and to track their financial health. When looking at an existing or potential partnership with a billing team, how do you know if it’s the forever commitment or if it’s time to re-evaluate?

Will U B Mine?

Choosing the right billing team can feel a lot like speed dating with potential billing companies, certified coders, and billing specialist candidates. Thirty minutes to an hour-long conversation with multiple candidates to determine if this is the right long-term fit for your group is a huge investment of time but at the same time doesn’t seem like enough. However, most groups are hard-pressed to make a decision quickly for fear that accounts receivable will just back up and incomes halt to a dead stop. When there is urgency and a need, it can be tricky to sort through exactly what you are looking for. At the end of the day, they will all get your insurance claims out the door, right? 

There are three key elements that you can use to evaluate to see if your current or future billing service is the one for you. 

Trust

Do you trust this billing team? Making sure you have communication flowing both ways is key. pMD is built on a passion for communication and that remains a foundational item for us in revenue cycle management. Clear communication helps practices by keeping clinical and administrative teams on the same page with updates, changes, and opportunities for improvement. 

Another element to look for is expertise in the industry, and I don’t just mean the amount of time spent in billing. Health care practices come in all shapes and sizes. There are specialty-specific and regional considerations when it comes to billing claims. Having a partner that understands the intricacies of your practice from the revenue side as well as the clinical side will allow for trust and ultimately help your practice grow. 

Transparency

Do you know where you stand financially? As a practice owner, there shouldn’t be a challenge in getting a report for your data. Knowing where your business is financially is critical to making sure you are hitting the benchmarks and goals you have planned for. Are you able to see where the inefficiencies are in your revenue cycle? Identifying the source of creeping charge lag, the root cause of an increase of a specific denial, or even trends in payment amounts is the first step to set your practice up with a plan to correct it. 

Partnership

Can you count on your billing team to support your goals? Medical billing has a ton of data flowing through the system and your billing team is the closest to that information. Their insight can help identify and propose solutions to address items that are holding you back from your full potential. These are the specialists that can help educate your team on best practices or provide background information on why different elements are important to claims. Your billing service is the team supporting you and your practice and is the one you need to be invested in your success. 

At pMD, we want to see you succeed! Let’s chat more about our billing service offerings and what we can do to help you.


To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.


Source: Getty Images

Here's The Latest in Health Care:


The long-awaited E/M coding and documentation changes, which are the first major overhaul to E/M guidelines in nearly 30 years, have now officially gone into effect and are expected to have a significant impact on revenue cycles. The goal is to increase efficiency while reducing administrative burdens and ultimately improve patient care.  Read More

Multiple EHR usability factors lead to clinician burnout, highlighted by total EHR time, after-hours EHR time, and EHR documentation time, according to a new study. The study also found that clinician burnout costs health systems roughly $250,000 to $1 million per clinician who quits due to burnout or job dissatisfaction.  Read More

As much of the world locked down in an effort to stop the spread of the virus, save lives and reduce pressure on hospitals, there are indications the COVID-19 pandemic may be associated with longer-term indirect effects on population morbidity and mortality through pathways such as halted drug development.  Read More

Automating common healthcare administrative transactions, such as prior authorization, has reduced annual costs by $122 billion, finds the 2020 CAQH Index. However, the industry is still leaving $16.3 billion in potential savings on the table. In addition, the costs associated with some manual and partially electronic portal transactions are also increasing.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.

Can you recall the glorious feeling of getting immersed in the groove of an extra productive working session, or reading the best book that you just can’t put down, only to glance up for a quick second to check the clock and realize you're 20 minutes late for your next meeting, or dinner, or an appointment?

Generally, outside of the unpleasant initial shock of realizing how much time has passed in your trance, the effects of being late are usually minimal and easily remedied. 

But this isn’t always the case with certain commitments. Take doctor’s appointments, for example. Missing an appointment can not only mean that you have to wait another week or two to see your health care provider, but it can also result in dreaded no-show fees. With many in-person appointments being moved to telehealth visits, it can be even more difficult to make sure you’re on-time for your medical appointments when you’re not physically having to go into a doctor's office.

In my personal experience, my health care providers have used telemedicine systems that require me to log into a website or keep track of a link sent days in advance that I would have to click on at the time of my visit. There have been plenty of times I’ve looked up at the clock and realized I’m 15 minutes late to a telehealth visit and have to scramble quickly to find my login or video link, all while keeping my fingers crossed that I don’t get a no-show fee or have to reschedule. Even if I do make it to my appointment on time, I find that my internet connection might not be the best at my house, or the camera on my computer doesn’t always have the quality I’d like. 

With pMD’s telehealth solution, our team designed our product a little differently with patients and ease-of-use as top of mind. There’s no need to log into a website or search emails for a link that may have been sent days in advance. Our mobile app is easy to download on the patient’s phone, just like any other app, except that it’s encrypted, secure, and HIPAA-compliant. At the time of the appointment, the provider initiates a call to the patient through the secure app and the call rings directly to the patient's mobile phone - allowing the patient to use either wifi or cellular data for the best connection and video quality. So regardless of what patients are up to at the time, they’ll be notified right away of their appointment. pMD does all this while continuing to protect providers' privacy by not displaying their personal information. 

After the video appointment is complete, pMD also provides patients and providers a way to securely communicate via our chat feature, keeping the provider in control of how long the line of communication stays open. So say a patient has received the first dose of the COVID-19 vaccine and you want to make sure they don’t forget to receive the second dose. The practice can message them directly via the pMD mobile app, or better yet, set up an automated reminder, to remind the patient when it’s time to receive the second dose. By downloading a mobile app on their phone, patients not only have a secure and virtual way to carry out their appointment but they also have a more direct way of receiving important information from their providers about their health or updates from the practice. 

At pMD, we love providing a robust and seamless telemedicine solution that provides patients and practices with intuitive tools to better communicate about patient care. Submit your information here if you’d like to learn more about how pMD’s telehealth solution could benefit your practice.

To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.



Here's The Latest in Health Care:


Endocrinologists and gastroenterologists were the specialty clinicians that used telemedicine the most last year during the onset of the pandemic. The new study comes as the health care groups are pressing Congress to make some of the flexibilities given by the federal government for telehealth during the pandemic permanent.  Read More

The COVID-19 pandemic has permanently changed the health care business model, causing providers to rely more on scale and efficiency to maintain financial stability in 2021 and beyond. Remote work and the explosion of virtual care are leading executives to rethink the number of in-person care sites they need to deliver high-quality, patient-friendly, affordable care.  Read More

Telemedicine utilization by condition and medical specialty during the early phase of the coronavirus pandemic sheds an interesting light on deferred care according to new research. Despite the uptick in telemedicine use, overall medical visits dropped substantially, which raises concern about deferred care.  Read More

Interoperability continues to improve in health care, with 67 percent of providers in 2020 reporting they often or nearly always have access to needed records, up from 28 percent in 2017, according to a recent KLAS Research and College of Healthcare Information Management Executives report. The EHR interoperability trends report analyzed data from a survey of healthcare executives to determine the top 10 themes in health data sharing among providers.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.


Here's The Latest in Health Care:


As part of a broader strategy to ramp up vaccinations, the Department of Health and Human Services (HHS) will allow doctors and nurses that recently retired or are inactive to administer COVID-19 vaccinations. In addition, the Public Readiness and Emergency Preparedness Act will be amended to permit anyone licensed to vaccinate to administer a shot across state lines.  Read More

Just as revenue cycle executives are coming up for air from the CMS price transparency mandate, they have another date to add to their compliance calendar. On January 1, 2022, the No Surprises Act goes into effect, which will protect patients from surprise medical bills and establishes an independent dispute resolution process for payers and providers.  Read More

During the COVID-19 pandemic, hospital and health system CEOs have faced unprecedented challenges related to the deadly and unpredictable coronavirus, many of which have led to some positive unintended outcomes such as enabling a rapid acceleration of organizational learning and adaptability.  Read More

The Centers for Medicare & Medicaid Services (CMS) has made corrections to the 2021 Physician Fee Schedule, opening the door to improved reimbursement for remote patient monitoring. CMS amended a requirement for RPM coverage that had drawn criticism from telehealth advocates, clarifying how healthcare providers will be paid for using RPM platforms to gather physiologic data from patients at home.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.