topsE&M Coder for Pocket PC - Historically, most physicians tend to undercode, whether due to fear of an audit or to lack of time to sufficiently document the care given. A "level 2 E&M" visit is based more on deficiencies in documentation than on the merits of the visit. Use of our software allows rapid, extensive documentation of visits, making it possible to properly document your cognitive services in order to justify the correct E&M level. With minimal data input, topsE&M Coder rapidly calculates the correct E&M code, based on 1997 HCFA/CMS guidelines*. The calculator works with all E&M categories, including outpatient, consultations, emergency room, hospital, and nursing home visits. Built-in text illustrates missing documentation required to obtain a higher E&M level. If you are an "under-coder", you will see a full return on your investment in just one day!
Medical Economics magazine has estimated a $40,000 to $50,000 annual loss to physicians who routinely down-coded one E&M level. An EMR that helps with E&M coding enables a provider to code correctly, with full supporting documentation. As an example, Northwest Diagnostic Clinic, the medical practice located in the same facility as e-MDs, completed a reimbursement study following the second quarter of 2000. Actual E&M coding distribution with corresponding reimbursement was compared to the E&M distribution report for Blue Shield of Texas and projected reimbursement. The distribution of E&M codes by users of e-MDs Chart was shifted toward higher-level codes. They also realized increased reimbursement approaching 20% when compared with the expected reimbursement if the clinic followed the standard E&M code distribution. Northwest Diagnostic was able to increase average reimbursement by $9.01 per visit due to the increased documentation efficiency afforded by our EMR. In addition, accurate evaluation and management service (E&M) coding reduces staff time needed for claims correction and post-processing. If you "down-code" E&M levels due to fear of an audit, you may be losing up to $54,000 annually.
ROI from E&M Coding
Average physician appointments per day
25
Total days worked in 12 month period
(5 days/wk x 48 wks)
240
Patient visits per year
(25 visits x 240 days)
6,000
Total ROI per doctor per year
(6,000 visits x $9)
$54,000
This increase in provider efficiency alone more than pays for the costs of implementing an EMR system. The doctors in this study work 4 days per week and have a relatively comfortable patient volume of approximately 20 patients per day, so their actual increase in income was approximately $40,000 each. See our web site for more in-depth information on this study.
About e-MDs
e-MDs is a medical software developer offering e-MDs Solution Series, an integrated line of clinical and financial software modules designed to automate medical practice processes and chart management. With their goal of improving patient care, decreasing physician errors, and increasing practice income, e-MDs has enjoyed one of the most rapid growths in the industry and now has over 1,350 offices nationwide using their products. For more information visit www.e-mds.com.
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