So far I’ve been using OpenEMR for progress notes for appointments and am using my old billing program, but I do want to switch to using OpenEMR for billing in the future. There’s one thing I’m wondering about before starting. Maybe things will look different once I’m using billing but at present it looks to me like billing is tied to typical encounters such as office calls.
I’m wondering if there will be any problem for billing for services which are not connected to typical office calls. The most common situation will be when I read EKG’s at the hospital. I’m only reading the EKG and there is no encounter on the schedule and therefore wonder if that would cause a problem. I’m also wondering how this will effect quality reports. I would have large numbers of people in the system on whom I’d have no data on items such as weight, tobacco use, immunizations, etc. Is there a way to have these patients treated separately so that this won’t be an issue?
Billing is tied to encounters, but you could create a special encounter type so it appears different on the calendar, if you schedule your services. When billing, you select the service and diagnosis codes for the encounter, so they do not have to be office or hospital visit codes. However, I do not know what other requirements are needed for billing these services, possibly referring provider NPI or some other prerequisite. Whether these are handled by the billing process is a question you will need to answer. If possible, create few test bills in OpenEMR and do a line-by-line comparison of the billing output of OpenEMR and your present billing software.
I have been discussing this with a couple of specialist customers and we think that creating an “encounter” type that could be excluded from MU reports is a possible solution.
Tony
All billing entries need to be tied to an encounter number. However all encounters do not have to be tied to the calendar.
The AMC/CQM rules look for patients who have one or more encounters within the evalulation period, so there is not a way currently to exclude your EKG only patients neatly. One option that wouldn’t require code changes though would be to setup a separate login/provider account specifically for EKGs and document/bill them from that user.
Beyond that I suspect that for the large number of EKGs you read it’s going to be a pain to setup their billing/insurance information in OpenEMR.
It is already a pain to enter all these people into any billing system! The question is whether OpenEMR can handle it without causing major problems.
In may current billing program, I have myself entered as two different doctors (with all info the same) to keep these separate for things such as reports of business done and past due balances. (Needless to say, collecting past due balances from patients when I have only read an EKG on them is far different from collecting on established office patients).
If necessary I imagine the patients could be entered on the calendar at arbitrary times in the morning when I’m at the hospital reading EKG’s, and then have the actual office patients in the afternoon.
The quality reports were another issue I was concerned about. Tony, is there currently a way in which encounters such as reading EKG’s can be kept separate from regular patients? Obviously I have no information on quality issues such as whether their pap smears are up to date, and even if I could get this information I don’t want to spend the time entering it. (Actually I probably can get this information thru the hospital’s system, but the real issue is that we shouldn’t have to look this up or enter it.)
I also meant to ask a follow up on the line "All billing entries need to be tied to an encounter number. However all encounters do not have to be tied to the calendar. " How is this done? Again, I have not used this for billing yet, so perhaps it will be obvious when I start billing, but at present I only see how to bill an encounter on the calendar.