Last month, the U.S. Senate did not pass House Resolution 6331, which would prevent scheduled 10.6 percent reductions in Medicare payments. Although there is a good chance that the bill, with some potential modifications, will be put in front of Congress again in the next couple of weeks, physicians are currently trying to find the best way to deal with this significant drop in reimbursement. For some, this means closing their doors temporarily; for others, it means refusing to accept patients with Medicare plans for all but emergency cases. The problem is compounded for those that do not have an efficient medical practice management and billing system, because their reimbursement cycles are even longer. Medicare pays paper claims no sooner than 29 days after receipt, but electronic claims as little as 14 days after receipt. Additionally, medical billing software such as NueMD allows users to file claims cleanly the first time, meaning rejection rates from Medicare and other payers drop to between zero and three percent. Having that extra money coming in promptly might prove vital for practices that would be impacted by the reduced Medicare reimbursement rates.

Despite the continued wrangling over whether utilizing telehealth methods affects standards of care, there is currently a convergence of perfect conditions for the rise of remote health care options. Technological capabilities are rapidly increasing while the cost of high-tech solutions is decreasing, which also affects the adoption rate of electronic medical records and practice management software by providers. The increasing use of application service providers (ASPs) in this field means that physicians can securely access patients’ records from anywhere in the world, and video conferencing options provide a human touch to a remote physician - patient encounter. Added to technological factors, the U.S. is facing a shortage of nurses, leaving some rural areas particularly understaffed; plus high gas prices are prompting many to seek remote alternatives for services or tasks they would usually conduct face to face.

Telehealth solutions are not just limited to linking patients to providers. Some of the most valuable ways to utilize this technology is to provide a link between medics; for example, between hospitals and consulting surgeons who are not on-site, or paramedics and ER doctors. An indication of how mainstream remote health care services are becoming is Aetna and Cigna’s recent decision to offer reimbursement for teleconsults. It seems that geography or an inability to travel may soon no longer be a barrier to receiving the same range of health care services as everyone else.

Most people that have objections to Internet-based software applications usually cite a lack of security as the reason. Particularly when it comes to applications that deal with protected health information (PHI), even some technology-savvy professionals feel safer if they have the server on-site under their control, with data only being transmitted on an internal network.

This feeling of security is, for the most part, illusory. Client servers located in offices or institutions rarely have the same level of security that ASPs are able to afford their servers due to economies of scale. Plus, having your server on-site means that you are responsible for maintaining it. Not only does this require extra resources, but it can be problematic if there’s a disaster – your on-site server is vulnerable to floods, tornadoes and fires in a way that good ASP servers are not, because they are usually situated at several diverse locations with data replicated across them. If a disaster befalls one of them, the other ones are still safe and so is your data.

Additionally, having to make your own data backups provides another opportunity for a security breach, as the University of Utah Hospitals & Clinics found out recently, when the backup tapes with medical billing information for 2.2 million patients went missing from a courier’s car. They could have taken a leaf out of the book of the university’s student health center, which unlike the hospitals and clinics division uses Nuesoft Xpress, an ASP model medical management and billing system, meaning their data remains secure and HIPAA compliant without university staff worrying about maintenance, backups or disasters.

Check out the new edition of the NuesoftXpress e-Nues.  The spring edition includes an interesting article on smoke-free college campuses, and whether banning smoking in residence halls has any impact on student smoking.

The article also provides advice for administrators who are considering making their campus smoke free, such as…

• Involve smokers in the decision making process.
• Provide areas for smoking, otherwise those that cannot give it up will smoke in non-smoking areas.
• Plan for smokers in inclement weather, otherwise you will have them in doorways and under balconies when it rains. 

The Health Information Portability and Accountability Act (HIPAA) of 1996 requires a unique National Provider Identifier (NPI) for each physician, supplier or other provider of health care services. To comply with this Federal mandate, all claims must be filed with NPI numbers beginning May 23, 2008.

Nuesoft Technologies has placed edits in the system to prevent claims without NPI numbers from being transmitted. In order to comply with the new standards, we are asking our clients to do the following:

1. Have NPI numbers on all claims submitted – claims will be rejected if the NPI number is missing.
2. Send only a few claims for each payer on May 23, 2008 to ensure your claim is accepted.
3. Report any payer-specific issues to NueMD Support immediately.

If your practice does not already have an NPI, you will need to get one as soon as possible. 

Failure to obtain an NPI will adversely affect your ability to successfully file claims.

To learn more, or to apply for your NPI.

How often do you hear the statement, ”I am worried that our office is not as efficient as it could be”? In today’s troubled economy more than ever, keeping track of the true cost of business can directly lead to the ultimate success or failure of a practice.  Whether a new provider is setting up his/her first practice or a seasoned physician is reviewing data for benchmarking purposes, the financial health of their business will ultimately depend on the margin between cost and revenue.

Relative Value Units (RVU) – a term that is becoming more and more popular amongst physicians - is a coding system allowing a provider to assign a specific cost for their services.  Providers can perform accurate cost analysis by identifying the amount of reimbursement that they are receiving from insurance companies for each procedure and directly comparing this to the cost of performing the procedure, as well as various practice overheads, from office rent to malpractice insurance.  The end result is figures that show how much money is coming in compared to how much is going out.

Some practice management systems (including NueMD®) feature a built-in RVU calculator that can automatically take the RVU data from procedures performed within a specified time frame and prompt you for your cost information to build up an accurate picture of what you might choose to charge per relative value unit. As relative value units continue to be identified by insurance companies as key to reimbursement in this pay for performance market, calculating RVUs will truly assist a provider in creating and maintaining a financially healthy practice.

For more information on how RVUs can be a useful tool in benchmarking, refer to Oranges and Apples: HIM Productivity and Benchmarking by D’Arcy Myjer, PhD, and Dan Butu, CCS, in AHIMA’s FORE library (members only).

If your college or university has started its pandemic planning efforts, you may be interested to know that the Department of Health and Human Services (DHHS) has recently launched a campaign called “Take the Lead”, aimed at raising awareness of the importance of pandemic planning. It provides a tool kit with talking points, factsheets and even posters to help you disseminate the information across your campus community. More help on getting a plan together can be found in this Nuesoft Xpress newsletter article on pandemic planning, featuring tips from Anita Barkin, chair of ACHA’s pandemic planning task force.

Late last year, HL-7’s Electronic Health Record Technical Committee moved the industry one step closer to a Personal Health Record System Functional Model  (PHR-S FM). The model became a draft ANSI standard in Dec. 2007, and the final standard is expected sometime this year. Read the press release from HL-7 about the draft standard here.

PHR-S FM is designed to be technology–neutral. It also promotes interoperability, and so will require best of breed collaboration between vendors. Nuesoft is a member of the American Health Information Management Association, which has been instrumental in moving the PHR functional model and standard forward. In addition, Nuesoft has been forging partnerships and integrations with EHR companies and other vendors that have embraced the future of health care and that are committed to the adoption of industry standards. Take a look at our news releases about our partnerships with electronic medical records vendors, and our news release about our industry-leading interface certification program.

Nuesoft Technologies Inc. today announced the spring 2008 winners of its 15-year Anniversary Scholarship program. Five schools each received an in-kind donation of up to $15,000 of Nuesoft Xpress™ health center management software.   

The spring 2008 grant recipients are: Agnes Scott College, Barry University, Folsom Lake College, St. Norbert College and Winthrop University.   

“We were extremely pleased with the number and quality of applications that we received this spring,” said Nuesoft Technologies President and CEO Massoud Alibakhsh. “The process was very competitive, but after careful deliberation, the review committee selected the schools that had the most demonstrable need for the grants. I think the choice accurately reflects Nuesoft’s commitment to improve resources for the college health community.”  

“This is huge for our health center,” said Eileen Egan-Hineline, director of student health services at Barry University, and one of this spring’s scholarship recipients. “We have tremendous budget constraints and have not been able to stay current with technology. With a product like Nuesoft Xpress, we will be able to electronically schedule appointments and more easily analyze our school’s health care trends.”   

 “We couldn’t be happier,” said Barbara Bloomer, director of health services at St. Norbert College, which also received a grant award. “We’ve been tracking our student immunizations and other services manually, and it has been an extremely arduous and time-consuming process. Nuesoft Xpress will make us so much more efficient.” 

 The spring winners complete the first round of scholarships given out by Nuesoft. Because university budget calendars vary, Nuesoft is awarding grants in two rounds. The next five winners will be announced in the fall, with all applications reviewed by a selection committee comprised of college health professionals. 

 The deadline for the second round of applications is September 5, 2008. Fall winners will be announced on October 3.  For more information and to download the fall 2008 application, visit the Nuesoft Xpress Web site at www.nuesoftxpress.com/scholarship.

The traditional university health center model may not include third party billing as a source of revenue, but times are changing and some institutions are now embracing commercial insurance options as a way of making ends meet and giving more choices to students.

The topic is still hotly debated, but according to testimony provided by a third party billing service vendor to the Department of Education’s Commission on the Future of Higher Education, third party billing could be one way to avoid capitated health fee increases. Some are not convinced by this - ACHA recently commented that the analysis this testimony relied on was flawed - but third party billing, or indeed a combination of third party and a university plan, may warrant further investigation for some schools. If you’re considering addressing rising costs and falling funding in your college health center, this article explores the issue in more depth.