We are a bit late in sharing this one, but no less stoked. Our first doctor to complete attestation with flying colors back in July! There is a group close behind him but he led the way. Congratulations Dr. Timothy Iehl!

As he found out, the help provided by ACOM Health guiding him through the process was every bit as important as our certified software. Here’s what Timothy had to say about his experience:

“I am very pleased with my choice especially since I successfully attested for this year’s required 90 day EHR incentive through the government.  I anticipate doing the attestation for an entire year will go as smoothly.  The training and support I received has always been great since the very first day ACOM has been installed.  With the implementation of the meaningful use criteria the support ACOM provided went to a new level.”  

Looks like the incentive checks are on the way, we’ll share that as soon as we hear the good news from our doctors. A myth no more, the incentive program and the tools and help to get you there are here, NOW!

Attestation to Meaningful Use, Check! is a post from: ACOM Health Blog

For everybody waiting to see if the payments were really going to go out and the program is for real, the wait is over and it’s for real. The following is from the ONC announcement:

• On May 19, 2011, the Medicare EHR Incentive Program issued the first round of payments totaling $75 million to providers who signed up in the first two weeks of the program. 

“Through the EHR incentive programs, we are helping eligible providers invest in their technology infrastructure,” said Farzad Mostashari, MD, ScM., National Coordinator for Health Information Technology.  “But this isn’t just about technology. The goal is better and safer health care, and that means it’s about patients — about their health care and protection of their information.”

To see the full announcement visit the ONC site here. To learn more about our Certified Complete Chiropractic EHR solution go here.

First ARRA EHR Payments Issued This Week is a post from: ACOM Health Blog

This is a fun post, We’re Hiring! A total of seven new positions in a range of responsibilities around RAPID our flagship Chiropractic EHR software  product. If you’re in the Atlanta area (office is in Duluth a bit NE of Atlanta, but 2 positions can telecommute), we’d love to see what you can do.

Here’s a link to our Careers page, hope to see you soon. Careers Page

Chiropractic EHR Software Rockets Growth – Hiring for 7 new jobs in Atlanta (2 can Telecommute) is a post from: ACOM Health Blog

There are currently two pieces of legislation making their way through Congress that seek to expand access to chiropractic care.  These two pieces of legislation, created with the help of the American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC), would not only increase access for patients to chiropractic services, but would also help chiropractic physicians and students start up their own practices.

H.R. 531
The Access to Frontline Healthcare Act (H.R. 531), introduced by Rep. Bruce Braley (D-Iowa), would change the Public Health Service Act to allow chiropractic care providers (along with other types of care providers) to receive loan repayments in return for establishing and maintaining a practice for at least two years in a medically underserved area, referred to as areas of “frontline care scarcity.”  The Congressional Research Service, a respected nonpartisan arm of the Library of Congress summarized the legislation as follows:

Access to Frontline Health Care Act of 2011 – Amends the Public Health Service Act to direct the Secretary of Health and Human Services (HHS) to establish and carry out a Frontline Providers Loan Repayment Program under which the Secretary agrees to make student loan repayments in exchange for a health professional providing frontline care services for two years in a frontline care scarcity area. Defines “frontline care services” as health care services in the fields of general surgery, optometry, ophthalmology, chiropractic, physical therapy, audiology, speech language pathology, pharmacies, public health, podiatric medicine, dietetics, occupational therapy, general pediatrics, respiratory therapy, medical technology, otolaryngology, or radiologic technology.

The American Chiropractic Association and Association of Chiropractic Colleges worked closely with the sponsor of the bill to ensure that chiropractic physicians are specified in the bill as qualifying for the status of “frontline” providers.  Frank J. Nicchi, the president of the Association of Chiropractic Colleges has specifically thanked Rep. Braley and Rep. Green (author of H.R. 664, the other bill discussed below) for their help and support in expanding access to chiropractic care to patients who normally would not have access to it.

H.R. 664
The other legislation, the Chiropractic Membership in the Public Health Service Commissioned Corps Act of 2011 (H.R. 664), introduced by Rep. Gene Green (D-Texas), would also benefit the public and the profession by requiring the inclusion of chiropractic physicians in the U.S. Public Health Service (USPHS) Commissioned Corps.  The Commissioned Corps is a special group of over 6,000 well-trained, highly qualified public health professionals dedicated to delivering the nation’s public health promotion and disease prevention programs and advancing public health science. Commissioned Corps officers provide health care services in a variety of locations and venues, including providing care to members of the U.S. Coast Guard and community health centers.

The Congressional Research Service provides the following summary of H.R. 664:

Chiropractic Membership in the Public Health Service Commissioned Corps Act of 2011 – Amends the Public Health Service Act to make chiropractic personnel eligible for appointment in the United States Public Health Service Commissioned Corps. Requires the Secretary of Health and Human Services (HHS) and the Surgeon General to ensure that Doctors of Chiropractic are trained, equipped, and otherwise prepared to fulfill public health and emergency response service responsibilities in the Commissioned Corps. Requires the President to appoint no fewer than six Doctors of Chiropractic into the commissioned Regular Corps and the Ready Reserve Corps. Directs the Surgeon General to submit a quarterly report to the relevant congressional committees on measures taken by the President, Surgeon General, and the Secretary to carry out this Act.

Along with the Access to Frontline Health Care Act, ACC President Frank J. Nicchi believes that the Chiropractic Membership in the Public Health Service Commissioned Corps Act is “critical to the integration of chiropractic care in every federal health care program.”  He stressed that “chiropractic students and alumni will benefit immensely from the opportunity to provide care to citizens in medically underserved areas and to participate in the Commissioned Corps.”

While all in the chiropractic industry are excited about the new legislation, some think it does not go far enough.  One commentator, Dr. Michael Austin, stated that “this is a great initiative by Rep. Braley but it falls short.  Placing ONE Chiropractor in a large VA Health Care Center is a disservice. The staff doctor will be overwhelmed and patients will be waiting for months.”  While satisfied with the overall content of the legislation, he encourages chiropractors to contact the legislators responsible for the act and “inform them of the understaffing issue inherent in the bill.”

At any rate, these two pieces of legislation are extremely important to the practice of chiropractic in the United States.  They can clear the way for increased access to chiropractic care among all citizens and can spawn greater opportunities for chiropractic service providers to start their own practices and pay off their student loans.  H.R. 531 and H.R. 664 are nothing but good news for chiropractors.

Chiropractors on Capitol Hill – New Legislation is a post from: ACOM Health Blog

Setting priorities involves achieving a balance between accomplishing daily tasks and working toward reaching long-term goals. It’s easy to become so focused on the things you need to do each day that you never make time for, or even forget about, the things you need to do to reach goals or accomplish bigger projects.

1. Make a List

Alert: very cool free tool here: http://teuxdeux.com

It’s important to write tasks down on a to-do list, rather than trying to remember them in your head. If you go off your memory alone, you’re very likely to only accomplish pressing, urgent, day-to-day tasks that must be done now, always neglecting tasks that can be put off for one more day, causing you to stop working toward long-term goals.

2. Find a System that Works for You

Once you have a list going you can work on prioritizing your tasks. There are a number of different ways you can do this, depending on how well you stay on top of day-to-day tasks and how many long-term goals and big projects you’re working on.

One system of prioritization is to assign each task on your list into a category of “high,” “medium,” and “low” priority, being careful not to leave all the tasks that will help you reach your long-term goals in the “low” category. High priority tasks should be important ones that need attention today. Medium priority tasks should be attended to soon, but can wait until tomorrow. Low priority tasks can be put off for several days or longer, but must be moved into the medium and high categories in due time.

Another system is to rank each task on your list by assigning it a number, with number one being the most important task on your list that you will attend to first, number two being the second most important task that you will get to next, etc. But you must include a threshold number in your list that serves as the cutoff for “must do” and “can wait one more day.”

The Teux Deux tool is great for prioritization, simply drag and drop tasks in the order you want them, there is even a holding area for those “someday” tasks so even if you don’t want to do it now you won’t forget about it.

3. Understand the Difference Between Important and Urgent

An urgent task is something you must attend to immediately, and a lot of urgent tasks in one day can mean putting off ones that are important and very often have higher priority than an urgent task. For example, a phone call from someone you’ve been trying to get in touch with can take urgency over an important task, even though it may be more necessary for you to finish the important task than to take the call.

If you find yourself constantly putting off important tasks with high priority in order to deal with urgent ones, it’s time to start saying no to urgency and strike a balance between the two. You may want to set aside a time block of one or more hours during the day when you work on important tasks without any interruptions, and make very few or no exceptions.

Organizational management expert Stephen Covey’s Urgent-Important Activity Matrix identifies the differences between these two types of tasks, and can also help us recognize that sometimes they are one in the same. Covey organizes tasks into four categories that show how each group takes priority over the next:Important and Urgent

• Important but not Urgent
• Not Important, but Urgent
• Not Important or Urgent

The distinction lies in recognizing that the urgency of a task does not make it important, and that sometimes important tasks should take priority over seemingly urgent ones that can actually be put off, such as a phone call you could return later, at your convenience.

4. Learn to Work Toward Long-term Goals on a Daily Basis

The these tasks may not be pressing or urgent, there’s no time like the present to start working toward making them happen. Start by making a list of all the long-term goals you want to reach, and then begin listing the smaller tasks you need to accomplish to reach each of these goals. A good rule to follow is to accomplish one task per long-term goal each day, however small, so that you are constantly working toward reaching your goals and gauging your progress. Seeing your accomplishments add up toward the larger goal over time can be very rewarding.

5. Understand that You Can’t Do It All

Since some of the items on your list are there as nothing more than a friendly reminder, for now at least, accept the fact that you will not accomplish every task on your list. Make sure you give top priority to items that will make you feel like a failure at the end of the day if you don’t accomplish them, and attend to these items first. At the end of the day, you want to feel like you’ve made progress by crossing the most important items off your list.

5 Tips to Set Priorities is a post from: ACOM Health Blog

Health insurance fraud is committed when either a patient or provider intentionally conceals or misrepresents information that causes health care benefits to be paid out incorrectly. Health care fraud in the United States costs the system anywhere from $125 billion to $175 billion each year.

Examples of patient fraud include:

• Enrolling or making claims for ineligible members
• Altering or falsifying information on enrollment forms
• Concealing or failing to report pre-existing conditions
• Failing to report primary or secondary medical insurance coverage
• Failing to report claims from a work-related injury

Examples of provider fraud include:

• Submitting claims by false physicians
• Submitting claims for services that were never provided
• Billing for higher levels of service
• Billing for treatments outside the range of the practice
• Billing for services provided while a license is suspended or revoked
• Altering claims

Yet another kind of health insurance fraud takes place against medical practices when insurance companies claim that fraud has been committed for a legitimate claim. Often the provider is forced to settle with the insurance company for a minimal amount of money. In these cases, the provider ends up paying for the majority of the medical care provided by not receiving financial compensation for services they legitimately provided.

Increasingly, health insurance companies are also making claims against physicians in which they maintain that a provider rendered additional, unnecessary services in order to increase the amount of their payment, exploiting a patient’s legitimate condition to the physician’s benefit. In all patient cases, it is of utmost importance that providers document medical necessity for each and every service they provide.

The most important step a medical practice can take to avoid claims of insurance fraud against their physicians is to make clear documentation of every patient service and treatment at the time that the service is rendered. Physician records are the most solid defense and piece of evidence in cases of insurance fraud, since fraud must be proven by intent and intentional misrepresentation.

When a claim lacks physician documentation, it is red-flagged by insurance reviews and an investigation by a claims adjuster begins. It’s hard to document a service after it’s already been provided, and impossible to document it once the patient’s file has been submitted to the insurance company for review. An office should never submit a claim that lacks documentation, as this is setting the physician up for an accusation of fraud. In addition, a medical office should double check each claim before submitting it, to ensure that the service they’re billing for was actually provided.

Since patient records are a doctor’s only real defense in an insurance fraud case, other steps to avoid claims of fraud involve:

• keeping records in order
• making sure that patient records are never lost or misplaced
• clearly documenting all clinical decisions
• documenting medical necessity for every service and treatment provided

Of course, another solid defense mechanism is to purchase malpractice insurance from a reputable, proactive carrier with plenty of experience, and to review and update your malpractice coverage regularly.

Automated electronic record keeping and filing systems are the most efficient way to assist a medical office with record documentation and maintenance. Patient records are archived and automatically filed in the system so they are easily found. Records can be automatically backed up and stored through a secure portal that can be accessed online if something happens to office computer systems. Consider what would happen to paper records in the event of a flood or even if a neighboring office had a fire and the sprinklers in your office came on.

Electronic files and note taking help physicians stay on top of patient documentation right in the exam room, the place where haphazard, incomplete records can often begin. If doctors enter notes and document treatments in the exam room, the work is already done before the patient leaves the office, eliminating the need to create patient records after the fact.

When staff members need to find patient records to submit with insurance claims, these documents will be right at their fingertips in an automated system.

Steps to Prevent and Defend Against Claims of Insurance Fraud is a post from: ACOM Health Blog

Receiving a warm greeting from the receptionist and being thanked for their visit before they leave is definitely a welcome change from the customer service most patients experience in their encounters with the medical establishment. That said, good customer service isn’t as simple as a nice hello/goodbye.

Along with their health, patients’ main concerns are time and money, and when medical offices don’t recognize these patient concerns, dissatisfaction begins to spread throughout the practice. Patients can see that time and money are a primary concern of medical offices, and they will feel more than slighted when these concerns are not reciprocated to them.

1. Keep your staff happy. A happy staff will pass the good rapport on to patients, treating them with the care and kindness they deserve. In turn, patients will be more considerate to you and your staff, and more understanding when problems do arise. Staff members who repeatedly deal with unhappy patients are less likely to enjoy their jobs, and patients are able to see this when they visit your office. Just like illnesses, happiness and satisfaction are catching too.

2. Make sure your patients are happy. Sure, some people are never happy, especially when they’re ill or in pain, but you generally want to keep your practice running at a high level of patient satisfaction. When patients are happy they’ll treat you and your staff with more respect, creating a satisfied environment throughout the office.

Keep in mind that patients who are treated rudely by staff members, repeatedly kept waiting in the lobby or exam room, and/or rushed through their time with the doctor can and will cause them to switch care providers. And the dissatisfaction can begin when they call to schedule an appointment, before they ever enter the office. Some patients will even choose a new care provider solely based on how they were treated on the phone when they called to schedule the initial exam or ask questions.

You’ll often know when patients are unhappy with your office, but measuring their satisfaction can be harder. You can have the receptionist ask patients whether their needs were met at check-out or ask them to fill out a short satisfaction survey before they leave. Be sure that both the physician and receptionist thank patients for their visit, and mail out a thank-you note after the initial visit, thanking the patient for choosing your office.

3. Be punctual and stick to your scheduled appointments. Patients are often asked to arrive early for appointments, only to be kept waiting in the lobby, sometimes for over an hour. Even if patients are taken to the exam room at the time of their scheduled appointment, they may wait there for the doctor, anywhere from ten to thirty minutes or more.

If you expect patients to be on time, they will expect the same from you and your office. Making them wait for you to play catch up sends the message that your time is far more valuable than theirs. Likewise, if your office always sticks to its scheduled appointments, patients will be more likely to understand when they’re late and you have to ask them to reschedule for a different day.

Patient tardiness is one of the main reasons that medical offices get backed up and have overlapping appointments that cause timely patients to wait far too long. You can include a statement on punctuality that patients read and sign along with their health history and confidentiality forms at the first visit, as long as you make clear that this policy is expected to honored by both parties.

4. Streamline patient check in. In a busy office, the time it takes a patient to wait in line at the front desk to check in is where the backup of appointments begins. Try integrating one or more of the following check-in procedures instead, including the ways that patients fill out initial health questionnaires and insurance information:

• Self check-in computers, which can enable them to fill out and sign forms electronically, while it eliminates a great deal of data entry your staff would have to perform (and the errors that come with re-keying data).
• Over the phone – have consider taking down as much of the necessary info as possible when they call to schedule.
• Sending forms through the mail, which patients fill out at home and bring with them to the appointment.

5. Don’t schedule overlapping appointments. Office backup is inevitable and causes patient appointments to overlap anyway, so don’t set yourself up for failure by scheduling appointments this way. When a patient is late, use the time to get caught up on notes and other paperwork. Avoid scheduling new patient appointments back to back; schedule them in between repeat patients instead.

6. Give the patient your undivided attention. Going back and forth between several patients at once wastes time, causing backup and inefficiency. Deal with one patient at a time and finish with that patient before you move on to the next. Try using a laptop or tablet computer to write notes and file charts instead of traditional paper records. Electronic files can be pulled up by the doctor in the exam room (instead of using receptionists’ time), and both the nurse and doctor can record info and type all their notes while in the exam room with the patient.

Six Tips for Better Practice Management is a post from: ACOM Health Blog