Auditors Are Actively Looking For Documentation Shortcuts

Posted on January 9, 2014 by Mike Norworth

Technology can make clinical documentation faster & more efficient. But beware the temptation – even when the means are at hand – to take these time saving ideals too far. There may be consequences.

The Department of Health & Human Services (DHHS) has narrowed their EHR focus over the past few years to specific concepts. First, let’s review a quote from congressional testimony in July, 2011:

“The very aspects of EHRs that make a physician’s job easier—cut-and-paste features and templates—can also be used to fabricate information that results in improper payments and leaves inaccurate, and therefore potentially dangerous, information in the patient record.”

So… who said that and why should you care? That was part of 11 pages of testimony from the Chief Counsel for the Office of the Inspector General (OIG), DHHS. Interestingly, it’s echoed in a newly released OIG report that was the subject of a January 8, 2014 NY Times article.

When I occasionally explain to clients that – for their protection – we won’t provide the means to copy their Encounters (SOAP) between patients, they’re rarely happy. And often, they don’t recognize the danger that lurks just around the corner – a danger we endeavor to protect them from.

Perhaps… if they’d been aware of the above 2011 testimony, they might have second thoughts. When you copy documentation between patients to save time, it’s likely that you’re copying more than you actually need. Then, you go back & fix the new note by deleting or updating irrelevant information. However, multiple studies – and your own experience – should help you reach the conclusion that you’re not perfect in this regard. Mistakes happen, especially when you’re in a hurry and/or multi-tasking. At one time or another, most of us have read back over older prose and found mistakes that escaped our original edits.

The new report released Wednesday simply emphasizes OIG’s focus on “copy & paste” along with its potential for fraud. Good documentation habits can save you from myriad problems – or just one. And this is the type of issue which is unlikely to be noticed unless or until someone else reviews your documentation.

ECLIPSE helps you maintain smart, audit safe habits. If an investigator even brings up the issue as a possibility, you can simply point out that your software specifically disallows it. Yet, ECLIPSE makes it easy to move forward appropriate aspects of a patient’s prior visit on an individual basis. By the way, if you think a narrative based computer program that juggles phrases to make the exact same information look different to auditors is fooling anyone, you’re delusional. Ask anyone who reviews documentation.

And don’t forget… DHHS uses computers too. Just like you. They’re doing their best to expose fraud and protect patients on multiple fronts, as well as help combat potential security issues. And one goal is to step up the volume of reviews:

“We recommended that the Department conduct compliance reviews to ensure that Security Rule controls are in place and operating as intended to protect personal health information”

So, with a higher emphasis on reviews and given the potential downfalls, there are likely myriad ways to speed up your documentation without resorting to copy & paste or as they’ve come to be called: “cloned notes.” ECLIPSE helps you reach performance oriented objectives using government preferred “structured data” while saving you from some of the pitfalls that other documentation software may be exposing you to.

 

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ICD-10: What you need to know now…

Posted on October 28, 2013 by Mike Norworth

So… a guy walks into a lamppost… and it turns out there’s an ICD-10 code to describe his encounter:  W22.02XA! Would you even admit that to the doctor? I did that once as a teen and would never tell a soul. You can read a WSJ article that goes into humorous detail on the subject here.

I decided it was time to discuss ICD-10 after Karen attended a seminar on the subject this past weekend and one of the tidbits they provided seemed incorrect. (It was.) So, what do you (and by “you” I mean small business health care providers) absolutely need to know about ICD-10? Here are the basics:

For claim submission

  • Any services dated on or after October 1st, 2015 must be submitted with ICD-10 codes.
  • Any services dated before October 1st – even if you submit the claim after October 1st – must use ICD-9 codes. 
  • You absolutely cannot use both types of ICD code on a single claim – so make sure you handle September 30th the same way you’d handle December 31st – everything gets billed.
  • Though this change is mandated by HIPAA, some non-HIPAA covered entities like Workers’ Compensation agencies have made it clear that they won’t  (or don’t intend to) be ready by 10/1/2015. Check either directly or through your state association to learn whether you’re affected as we get closer to the deadline.

ICD-9 vs. ICD-10

  • ICD-10 codes are much more specific, and there are many, many more of them. So, if you manage to walk into a wall instead of a lamppost, yes, there’s a code for that: W22.01XA.
  • You generally won’t find a 1:1 correspondence between ICD-9 & ICD-10 codes. There are websites where you can look up both codes and descriptions. And there are some that attempt to provide a crosswalk from ICD-9 to ICD-10 – but I would use those (here’s an example) as a tool to help locate more precise codes.
  • Laterality (side of the body affected) has been added to relevant ICD-10 codes. So, the code you use may inherently define left or right.
  • Another difference relates to episode of care. Whereas an ICD-9 code remains the same over multiple doctor visits, ICD-10 codes may change if it’s an injury or there’s an external cause. For example, a patient with a sprained ankle may return for re-evaluation to ensure the injury is healing properly. In the lamppost example above, the ICD-10 code would likely change to W22.02XD. The “A” (W22.02XA) stands for “initial” encounter (but “acute phase of injury” would be an appropriate way to think of it). The “D” stands for “subsequent” encounter. In 2015, “A” was clarified with regard to chiropractic care to refer to “acute,” and may to be used for all/multiple visits.
  • Injuries are now grouped by anatomical site rather than injury type.

ECLIPSE

Dr. Karen Walters, DC, FACC discusses everything you need to know about ICD-10 in a 60 minute video that you can watch here.

“I just want to let you know how much I appreciate the ease of transition to ICD-10 with ECLIPSE. The “ICD-9 to ICD-10 comparable” option while entering diagnoses into a patient’s file is seamless. While most other offices are stressing, we will be able to continue along, “business as usual” come October 1st. Thank you.”  — Dr. Michael Goldstein, D.C.

ECLIPSE is ready for ICD-10 now. ICD-9 & ICD-10 codes can be displayed together or separately by selecting an appropriate index. (There are separate indexes for ICD-9, ICD-10 and a crosswalk from ICD-9 to ICD-10.) We have prepared categorized ICD-10 databases for import – which include ICD-9 comparable codes where appropriate – and/or you can enter ICD-10 codes directly. These ICD-10 codes can be imported directly to your existing ICD databases and are available in the same two flavors we have always provided: everything or chiropractic specific. The chiropractic table has been carefully categorized by our team of D.C.’s to make it even easier to quickly locate the code you need. ECLIPSE users can review their 1/16/2014 & 7/16/2014 README entries for more thorough information.

This blog entry has been edited to reflect Congressional delay of ICD-10 from 10/1/2014 to 10/1/2015.

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Who sees 10,000 patients per month with ECLIPSE?

Posted on October 9, 2013 by Mike Norworth

The internet is filled with testimonials that rave about the “best chiropractic software.” Doctors tell you how much they love certain features and perhaps how busy they are… but rarely define what “busy” means to them, or how they’ve actually integrated the software into their offices.

That’s why it was refreshing to see an independent case study that detailed how one busy clinic integrated ECLIPSE into their environment. The 12 location Tuck Chiropractic Clinic has integrated S.O.A.P., scheduling, billing, document management, alerts and other features into their existing setup – replacing multiple programs from multiple vendors in the process. You can peek into this busy 17 physician clinic by reading that case study here on the Software Advice website.

After reviewing the study, consider how ECLIPSE fares in independent surveys and ask competitors why their prices are so high, even when they can’t offer the type of after-the-sale support provided to ECLIPSE users on a daily basis.

 

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Evaluating Chiropractic Software: Practice Management Expertise

Posted on August 11, 2013 by Karen Walters, D.C.

In 2012 & 2013, ECLIPSE once again topped independent surveys by multiple state chiropractic associations. You can read about one of those surveys here. The other was conducted by the North Carolina Chiropractic Association (NCCA) earlier this year. According to the survey, ECLIPSE was the top system preferred (of 21 systems listed). And, according to the NCCA, “ECLIPSE was strongly recommended by 71% of the people surveyed.” (That percentage includes the entire survey group – not just ECLIPSE users. And, for the record, we’re not based in those states.)

So, how does this happen? One factor that few doctors recognize is unparalleled practice management expertise, which we seem to provide as a natural part of “technical support” to clients on a routine basis.  Everyone tends to forget that when you buy software, there’s so much more to it than pre-sales hype and testimonials.  So here are just a few actual examples of the type of scenarios our HELP Desk handles daily.  Please note the variety:

Case #1: Using CMT Codes 98940, 98941 & 98942

This past January, a doctor called our HELP Desk, upset because all his ChiroCare claims were being rejected. He indicated that he was “losing thousands of dollars every week.” He further noted that he is the “chief insurance person for…” a large, well-known Midwest-based practice management firm.  At our request, he provided his clinical documentation. It was immediately apparent that he was improperly documenting & coding his visits. We subsequently confirmed this directly with ChiroCare and provided him with our findings and a solution within two days. We not only explained exactly what he was doing wrong, we explained how to do it right. And this is a doctor who gets paid as an “expert” to provide practice management advice on this specific subject to our colleagues.

This past week, a doctor in MO requested help interpreting his Medicare appeal & denial. He apparently doesn’t have many Medicare patients and was unfamiliar with how to document the 98941 code submitted on his claims. We explained how to document & use CMT (his diagnoses documented 1 region — lumbar) along with Medicare P.A.R.T. We also gave the doctor some relevant links to read on the ACA website.

Case #2 Chiropractic / Physical Therapy Services

An RN called from a client office, gravely concerned that her office would be audited for “committing fraud.” She further noted that she had worked for Medicare’s investigational division, had issued audits as part of her job, and had testified in court.  This all came out while she argued her position – which was that a key provider degree type used in her office needed to be added to ECLIPSE for claim submission. We simply provided the CMS ANSI documentation to the effect that she was mistaken and helped her get her claims out in a timely manner.

Case #3: HIPAA Violation

A doctor called the HELP Desk after a patient had been accidentally deleted from the computer system. It seemed to be a simple problem. And he didn’t realize that he could have set user permissions to avoid it. But it turned out to be a bevy of HIPAA violations. Staff had sat a patient (let’s call him John) in front of one of their computer workstations. And the current user was logged in and apparently had permission to do anything. John, who has Trisomy 21, promptly deleted another patient. And the office was blissfully unaware of the potential violations. Just a decade ago, practice management consultants across the USA were basing many of their seminars on HIPAA. We advised this doctor about proper office procedures, HIPAA requirements, creation of a HIPAA Compliance Manual & appointment of a HIPAA Compliance Officer.

Case #4 OSWESTRY

This past week, it became apparent during a conversation that a doctor was unfamiliar with the OSWESTRY formula. We explained the formula and how the scoring of an OSWESTRY form works in detail. (OSWESTRY forms in ECLIPSE are scored automatically.)

Case #5 What does the HELP Desk know, anyway?

Years ago, a doctor in Binghamton, NY called the HELP Desk with questions about Medicare changes in that part of NY. The HELP Desk Director called Mike for a quick explanation (the changes were brand new) and relayed them to the doctor. Hours later, Mike got another call from the #2 at Markson Management Systems (MMS) with the same question. (At that time MMS was one of the largest chiropractic specific practice management firms nationwide.) Curious, Mike asked why. As it turns out, the doctor didn’t believe the “computer guys” and sought an answer from the consultants she paid thousands of dollars to annually for advice. To this day, she has no clue that both responses ultimately came from the same person!

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Meaningful Use Audits

Posted on March 18, 2013 by Mike Norworth

The rumors began the moment the law (ARRA) was passed in 2009, intensified as testing protocols were created, and continued through the implementation process. Some physicians simply couldn’t get past those rumors, and decided to avoid the cash incentives provided by the Meaningful Use program. An unfortunate choice. However, if you received incentive payments, the audit program is here. And with it, some unexpected confusion.  The audit process is not difficult. The most important items that an auditor may initially request include proof that you owned the certified technology you purchased during the attestation period , a copy of the report you printed from your certified EHR, some screenshots, etc. But those items certainly aren’t confusing, and as an ECLIPSE user, you knew from your HELP to save such reports rather than discard them. So, where does the confusion lie? Just a few short years ago, it’s likely that you attended one or more seminars with regard to maintaining HIPAA compliance within your facility. Perhaps you received C.E. credits. Perhaps your staff attended. You learned some of the protocols you were expected to follow to ensure protection of Patient History Information (PHI). You also learned that this was an ongoing process. It’s likely you appointed a HIPAA Compliance Officer within your practice and created a HIPAA Compliance Manual at that time. Your HIPAA Compliance Manual might have contained wording to the effect of:

Risk Analysis and Management: Little Ferry Chiropractic Center (LFCC) conducts thorough assessments of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic protected health information held in its computer systems on a regular basis. When LFCC’s Compliance Officer believes risks exist, the Compliance Officer addresses each risk and completes a mitigation report. LFCC has implemented security measures to reduce risks and vulnerabilities to a reasonable and appropriate level to comply with the HIPAA Security Rule. These measures are described in detail…

In other words, you’ve been doing risk assessments for years now. During attestation, for item #15, you attested that you have…

conducted a review or security analysis per 45 CFR 164.308(a)(1) and have implemented security updates as necessary, corrected security deficiencies as part of your risk management process.

Now that we’ve established that you’ve been doing this all along…  let’s visit some of the protocols you’ve certainly implemented & checked in your office:

  •  It’s likely that you purchased, maintain a subscription to, and routinely check software from companies like Symantec to prevent malware (e.g. viruses) from entering your system.
  • You routinely remind employees not to leave Post-It notes on a computer monitor with user names & passwords. And your HIPAA Compliance Officer checks this from time to time.
  • If there’s a door between your waiting room and front desk, you’ve ensured that door is always locked from the waiting room side. If your front desk and charts are accessible from the waiting room, you’ve established a procedure that ensures all employees log out when they leave the desk and/or a protocol that ensures the front desk is always attended by at least one staff member.
  • Within your software you’ve assigned appropriate permissions based on job title to limit access to PHI as appropriate.
  • Perhaps you’ve called the HELP Desk to discuss potential security vulnerabilities and how to address them.
  • You’ve ensured appropriate Windows  permissions on your computers or network to limit access.
  • You password protected your routers if you have a network. And if you have a wireless network in your office, you’ve also setup appropriate encryption protocols so your data can’t be intercepted.
  • You’ve established backup procedures in the event of a hardware failure or natural disaster.
  • If you routinely email PHI, you password protect & encrypt attachments prior to sending.

This is just a short list of many items routinely implemented & addressed in your practice as part of HIPAA compliance. During the audit process, if you’re asked to provide proof of your security risk assessment, simply provide appropriate pages from your HIPAA manual, along with the steps that are part of your daily/weekly/monthly routine (and were likely repeated at the time of attestation). You should have a signed, dated copy that corresponds to your attestation period.

Here are some related links:

And some samples:

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The Encounter vs. The Audit

Posted on June 14, 2012 by Karen Walters, D.C.

For most D.C.’s, audits tend to be both rare and frightening. When a large insurance company contacted Dr. H at his Kentucky clinic, requested myriad patient records, and asked for reimbursement of substantial fees, I have no doubt he was ready to panic.

Following his audit, both the auditor and insurance company representative jointly called him. According to Dr. H:

  • They reversed all monetary requests.
  • They complimented him on his thorough SOAP. In fact they said his notes were “a pleasure to read.”
  • They further noted that whatever product he was using “set a new bar” when it came to documentation.

Wow! Dr. H later pointed out in his email to us:

“Although I do try to keep thorough notes, the encounter program reminds you of details and makes translation into a formal soap note extremely brief & user friendly.”

Before we continue, let’s consider a detail that may have escaped your scrutiny. Many doctors who use SOAP software have been through audits… and their documentation has substantiated the charges. But how many audit stories have you heard where the professionals involved said the documentation was simply the best they’ve ever seen? Or offered an unsolicited opinion about the doctor’s software? (And remember, these are professionals who scour documentation day in & day out, looking for both mistakes and fraud.)

I’d bet never.

Until the mid-1990’s, requests for documentation by an insurance company or outside auditor generally meant copies of the doctor’s “travel cards.” These cards allowed the doctor to quickly note the facts – just the facts – of each visit. And then demand grew for a new concept – electronic notes. But electronic notes got off to a different start than the travel card concept and typically resembled a narrative. As we entered a new century, travel cards gave way to lengthy, computer generated SOAP notes for each visit. Of course, those of us who reviewed our colleagues’ notes for various insurers during this period thought the source was obvious. So, companies that developed clinical documentation software created a new holy grail… randomization. Of course, anyone who does IME reviews can distinguish “canned notes” without much practice. But, by 2010, a request for documentation resulted in a lengthy series of visit-by-visit narratives. And doctors now looked for these workarounds as features! The goals: Press the fewest buttons; generate the most text; make each note look different so it appears “authentic.”

The Encounter was designed to conform to concepts as mandated in the American Recovery & Reinvestment Act (ARRA) of 2009, which places repeated emphasis on storing electronic health records as “structured data.” Structured data refers to a simple & direct association between a type of data – such as a patient’s last name, and the field in which it is stored. Internationally, governments are trying to move everyone away from verbose narratives towards concepts such as SNOMED & LOINC because studies show that this affects physician ability to get to “what they need” from a chart (crucial info may be missed or is hard to find).

We built our nationwide reputation with our billing & scheduling software. And though this is our third generation SOAP (and we were the first to automatically co-generate SOAP and bills) some D.C.’s may assume that – when it comes to clinical documentation – our strengths lie elsewhere. Or that ECLIPSE isn’t expensive enough to do the myriad things it does so well.

You can attend seminars where the lecturer got a free car to recommend the software he touts (Oh yes! True story) or watch glowing video testimonials for over-hyped products, but ECLIPSE is still the only software in the chiropractic marketplace that repeatedly tops independent polls… and now you know the auditors are impressed too. Of course, it’s still up to you to actually document each visit. And with that in mind, here are just a few quotes from doctors who use the Encounter:

“The Encounter – which is a completely new design – allows me to handle my notes in seconds… a feat rare among friends & colleagues with various SOAP systems.”
— Dr. RS, New Jersey 

“I feel it’s by far the best software on the market. We have implemented it into a very busy office and its not just the speed in which you can enter a note but the quality of note along with its integration with the rest of the software. I have demo’ed everything and really wanted to say thank you for Encounter.”
Dr. JP, New Jersey

“Thank you. Also just playing around found the PLAN and ADL’s to add into the exam that is great so far I love it. Just to let you know my other office (which I don’t own or have any decision making) just bought **** to integrate with *****. IT was over $12,000 and I like the Eclipse notes better. Thanks again.”
— Dr. MB, Wisconsin

“PLEASE let your long time subscribers know that you already have EHR on your system BECAUSE when I was looking I saw that you put ***** on your affiliates pages and I bought their system. I am VERY UPSET that I have been working with them for over 10 months and still do not have a workable system. I then found out that I had EHR all along on your Eclipse System (I’ve been using your software since 1999) I found your EHR to be much easier, intuitive and infinitely cheaper.”
— Dr. KJ, Oregon

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And the survey says…

Posted on March 7, 2012 by Mike Norworth

Once again, D.C.’s in Wisconsin have been surveyed by the Wisconsin Chiropractic Association with regard to the EHR / chiropractic software they use.  And the results might surprise those of you who rely on the hype that abounds in magazine ads and on websites.

Over 100 responses came in for this survey, which includes systems noted at the end of this blog entry. The first thing I noticed was that ECLIPSE users dominated the responses with close to 20% of the total. There was only one response from a Platinum customer. Apparently, chiropractors in WI remain blissfully unaware that Platinum (as decreed on Platinum’s website) is the “#1 chiropractic software worldwide.”

Chiropractors reported costs and rated Support & Ease of Use separately on a 7 point scale where a “7” reflected high praise and a “1” … well, you can guess. It gets interesting when you look at these scores and compare them with how much the doctors paid for each system. (For the record, we’re not based in or near WI and had no ties to or knowledge of this survey.)

Let’s compare a few systems. But first, we’ll ignore costs for the 5 ECLIPSE offices which noted “free upgrade” in the Cost column – the only free upgrades noted in the entire survey – because that would simply skew the results in our favor. So, here’s the table for three systems:

System Average cost Support Ease of Use
Average score Lowest score Average score Lowest score
ACOM/Rapid $14,190 4.75 1 4.5 1
ChiroTouch $11,085 5.08 3 5.16 1
ECLIPSE $2,500 5.53 4 5.53 4
Support was rated on 7 point scale with “1” being “Horrible” and “7” being “Terrific”
 Ease of use was rated on a 7 point scale with “1” being “Difficult” and “7” being “Easy”

I’m sure you’ve noticed that the lowest cost system is also the highest rated?  Also, I only included systems with 9 or more responses. Otherwise, it becomes more difficult to place results in any sort of context. So, with the largest # of reported results, when it came to unhappy chiropractors giving their systems a low score, note that ECLIPSE users were generally a happy group.

Now, let’s discuss those “free upgrades” that 5 chiropractors noted in the cost column. We believe this survey was about Meaningful Use and the $44,000 most doctors crave. Why was ECLIPSE the only software that doctors didn’t have to pay a premium for – even if they already owned it – in order to qualify for Meaningful Use funds? Other companies in this survey often preface news releases by noting their leadership and citing instances where they’re “giving back” to the profession. This is a perfect example – in an independent survey – of how we give back to the profession every day by intentionally keeping prices low. And of course, though we shy away from words like “leader,” ECLIPSE was certified months in advance of the October 1st, 2011 deadline that allowed ECLIPSE users to receive an $18,000 payment during the first year of the program… a claim that products like ChiroTouch can’t make.

To the best of my knowledge, ECLIPSE is the only system that’s been independently reviewed over a course of decades by multiple generations of chiropractors: in 1988 by NYSCA, and in 2001 and 2011/2012 via WCA surveys. Shouldn’t that tell you virtually everything you need to know before you buy a system?

When ECLIPSE debuted in 1985, Logicomp, Parker (Yes… that Parker) and PDR were the hot systems to buy nationwide. Every chiropractor knew this. And each proclaimed itself to be the best chiropractic software available. One of my professors at NYCC enthusiastically endorsed PDR. The Parker rep even flew his own plane to NJ to provide a product demo. And I’ll bet you’ve never even heard of them… because as big as they were… they’re now all out of business. ECLIPSE has demonstrated that it can stay current in your office for your entire career. How many of your colleagues are still on their first computer system?

Systems mentioned in the survey include: ACOM/Rapid, Chart Talk Chiro Quick Charts, Chiro 8000, ChiroAdvantage, Chironotes Complete, ChiroTouch, Clinic Pro, Compulink, CTR-X, EMR Datacenter,Epic, EZ Bis, EZ Notes, Future Health (E-Connect), Lytec, MacPractice, Medicfusion, Medinotes, My EMR Free, Office Ally, Platinum, Practice Fusion, Practice Studio, Quick Practice, Quixote, Vericle, Virtual Office Suite, and WritePad.
All product names mentioned above are trademarks of their respective owners.
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ECLIPSE, Credit Card Processing and The Cloud

Posted on January 4, 2012 by Mike Norworth

In November 2010, I purchased a case of wine as a gift for the upcoming holidays. Rather than wander into my local liquor store, I ordered from winelibrary.com. The recipient was delighted with the gift. And that was the end of it. Until yesterday.

I received a letter from Wine Library informing me that their servers had been breached and that my personal information…

“including your name, credit card information (including the three or four digit code on the back of the card and the expiration date) and website user account information (including passwords, user names, billing addresses, and shipping addresses) was illegally accessed or taken from our website  by computer hackers sometime between October 20, and November 7, 2011.”

This went on for two pages! Of course, they didn’t even know they’d been breached until customers started contacting them. Anyway, perhaps you’re wondering what this has to do with ECLIPSE?

The above scenario can’t happen to ECLIPSE users. ECLIPSE is PCI compliant and doesn’t store credit card numbers locally on your computer, so patient credit card numbers are theft proof in the event your system is compromised. Thus, when you take advantage of automated, recurring credit card processing with flexible payment plans, you don’t have to worry about what happened to me. Because it can’t happen to your patients.

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What happens when the lights go out?

Posted on December 17, 2011 by Mike Norworth

The email excerpt below was sent to physician clients by a cloud based, ONC-ATCB certified company that recently decided to halt business operations:

“After months of effort in an attempt to survive the ongoing economic crisis, Redpine Healthcare Technologies, Inc. (“Redpine”) has made the difficult decision to discontinue business operations.  Effective immediately, Redpine will no longer be able to provide billing services.  In addition, as of the end of the month, Redpine will no longer be able to provide software for the benefit of its customers.”

First… what happens to your data? According to the email:

“Redpine is beginning the process of compiling all provider data from our internal files and will provide that data to you as soon as possible. We recommend discontinuing the use of Redpine software on any new transactions (we may be able to help you with current transactions and all new transactions will be entered into the new system within a matter of days).  We also recommend that you print all outstanding claims currently in your system. While doing this you will want to select “print soap notes” with HCFA, this will give you a complete patient visit record for all outstanding claims.”

There’s hope there… but no guarantees. Notice use of the term “HCFA?” The Health Care Financing Administration changed it name to CMS years ago. Why are they using antiquated terminology? Anyway, I digress. Here are a few points that come to mind:

  • There’s no guarantee that you’ll receive your data in a situation like this. What will you do? Sue a defunct corporation?
  • There was no hint whatsoever that the company would cease operations. Doctors must now scramble to rush new systems into place. If you had control of your data, this wouldn’t be an emergency. You’d be able to look for alternatives in a controlled manner. Better yet, if you were using a program like ECLIPSE, where all the data is exposed via ODBC, you could easily hire a programmer to move some or all of your data to a new environment at your leisure.
  • Timing! Typically, this is the time of year when any outstanding billing needs to be completed before the next calendar year.
  • HIPAA!!! You must have absolute faith that your data will be handled in a HIPAA compliant manner. ‘Cause if it isn’t, it’s your responsibility. A smart move might be to consult an attorney with relevant experience about the possibilities.

And let’s not forget the potential loss of various comments, reminders, and day to day notes with respect to patient care, follow-up, and billing. Also, during any transition to a new system, a variety of patients may “disappear through the cracks.” And they won’t be noticed until too much time has passed to get them back. So… think about the revenue lost to your practice.

According to the same email:

“We have contacted numerous EHR systems and billing services on your behalf and have found a solution that is consistent with the level of service you are accustomed to, all the while offering an expedient transition process that promises to minimize cash flow disruption.”

Perhaps it’s great that they’re attempting to mitigate the problems you’ll face (which may help the principals avoid lawsuits and/or class action litigation). However, this means that you don’t get the opportunity to make the selection yourself. And they didn’t contact us. But again, I digress.

Anyway, trusting your computing solely to the cloud has the advantage of “anywhere/anytime” computing. Does that outweigh problems like this? Put yourself in the shoes of doctors who have to complete their billing before the end of December (the email we received was dated 12/7/2011). And keep in mind that, outrageous claims and promises aside, this can happen to any company.

ECLIPSE provides a local database and internet accessibility simultaneously. Only you or your power company can turn off the lights.

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Size Matters

Posted on December 7, 2011 by Karen Walters, D.C.

Today, we’ve been receiving calls from doctors who are ready to panic. Here’s an excerpt of the email from their software vendor:

“After months of effort in an attempt to survive the ongoing economic crisis, Redpine Healthcare Technologies, Inc. (“Redpine”) has made the difficult decision to discontinue business operations.  Effective immediately, Redpine will no longer be able to provide billing services.  In addition, as of the end of the month, Redpine will no longer be able to provide software for the benefit of its customers.”

Apparently, many doctors purchased this software as a direct result of an endorsement by a reputedly neutral party. Unfortunately, this is far from atypical. For example, in June 2004, the American Chiropractic Association strongly endorsed a system:

“The American Chiropractic Association (ACA) proudly announces its endorsement and exclusive distribution of Chirocere, an innovative, Web-based service designed to revolutionize the management of chiropractic offices. The new Chirocere service not only reduces overhead costs, but also streamlines clinical and administrative operations for practice of all sizes, leaving doctors of chiropractic free to spend more time caring for their patients.”

Sadly, this was also a short-lived venture and the product and company have been gone for years — with your money. However, such endorsements are common. In fact, we’ve been offered numerous endorsements over the years as well… for a fee. When a speaker at a seminar you’ve attended endorses software, odds are high that some form of compensation is involved. We don’t pay for endorsements. Period. Yet, at any given time, the principals of  major state and national associations use ECLIPSE, and a variety of practice management consultants recommend us to their clients.

A Google search related to Redpine indicates that they’ve likely defaulted on at least $350,000 in taxpayer funds that they accepted from Bay County, FL in exchange for relocating to Panama City, FL — where they were expected to create 410 new jobs by 2015 at an average annual salary of $49,000.

If you review the “Size Matters” video on our website, we’ve warned about this for years. Remember, cool websites can’t answer the phone. There’s a reason you should take a company’s track record into consideration before falling for a sales gimmick or pricing that can’t support a company’s long term growth. ECLIPSE has been around now for better than 25 years. And far from becoming stodgy and shopworn, the software continues to incorporate state of the art enhancements, small & large. More to the point, as a company, we don’t owe money to anyone. And our operations aren’t backed by investors. Doctors have gone out of business while they wait for such snafus to get resolved once their billing is affected. Don’t be one of them. Your software is an integral part of your practice.

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