I have a request to fill the fee sheet from the calendar appointment category selection. The idea was that all the categories on the calendar match the fee sheet categories. So, the fee sheet can be auto-filled with that category for billing.
I wanted to get some thoughts on this. I think there is a flaw in doing it this way but can’t really come up with why not. I think this is going to be a coding nightmare. But it can be done. They want to remove some of the human error in coding. I would appreciate any constructive thoughts.
Flaw #1
What’s scheduled is not what happens. The appointment secretary enters a brief exam, but the patient failed to mention the other 9 problems. A brief exam turns into a complex exam.
Flaw #2
Mismatch wil mean a lot of editing of the Fee Sheet for no good reason.
Flaw #3
Doing this consistently will mean a heap of trouble if Medicare/insurer does a chart audit.
If the practice can pare down on the number of CPT/ICD codes used, it should make billing process smoother. To minimize error the physician can code the visit & enter it on the superbill. Most physicians dislike this chore.
I do apologize for posting such an open ended question. I really didn’t know what I was getting into until now. I have more information and thought it would be of use to the OEMR community.
The group that I am working with right now is a behavioral health office. Their practice is different than that of a primary care or any other specialty. I was informed that there is a single CPT4 and a justifier used during a visit and unlike a MD practice the patient tends to have a diagnosis for a long time. So it rarely changes. So automating the fee sheet for them is advantageous to cut down the redundancy of entering information for them.
We have begun the process. The client showed me the software that they were using. The reason for switching to OpenEMR is that they wanted the flexibility the program offers. So one of the changes we made to the program is the calendar catagories also contain the CPT codes in the title. I have coded the add_event.php file to parse this information and add a few more things to it so the entry can be made to the billing table. We are calling it stage one. The next stage is to setup the ICD codes in the patient chart so that the justification can be entered in to the billing table.
The client’s goal is to not need the fee sheet at all for this type of medical practice because it is an unecessary step for them where they would go directly to the billing manager to process the claims batch.
What I was think is that once the process is finished so that OEMR can add behaviour health in a more meaningful way to the list of specialties that the software supports. I was thinking of making this a Global feature that can be turned on and add instructions to the wiki on how to use it.
Well, I have the code worked out so that the calendar category is used for the CPT entry and the diagnosis is entered into the billing table. It produces what is below without any manual entry. Stage two complete and then we move to the modifier issue.
