Insurance Payers Caustic Demeanor Towards EMR

I recently got an email from someone who told of a practice manager that was concerned with the insurance companies demeanor when it came to EMR. Here’s a short description of their concern:

He [A practice manager] mentioned he’s noticed and heard from many physician colleagues that the insurance payers really seem to be getting more of a caustic demeanor and approach with their subscribers. In particular, they don’t seem to care that an EMR is being used. If anything, they seem to challenge the notes saying the physicians are just using a template and not doing what they say. My caller wanted to know if we were seeing more of this. I think some payers are changing demeanor in preparation for upcoming cuts due to health reform.

This type of reaction is something to definitely be concerned about. Back in Feburary of this year I posted about the difference in an EMR that does Documentation by Exception versus Documentation by Veracity. In that post, Matt Chase from Medtuity does a great job describing the difference in documentation methods.

It’s really kind of interesting to see that the insurance companies becoming caustic towards this template based EMR notes that basically post a bunch of junk in the note that may or may not have been done. I don’t know a single doctor who likes those types of notes. In fact, most people hate them. Well, I guess I have seen many doctors who liked this type of note because it allowed them to bill the insurance companies at a higher level than they were documenting previously.

As I write that last line, I guess it’s no wonder that the insurance companies are kicking against this type of documentation. Especially since they’re always looking for ways to save money. Although this spells trouble for many of the large EMR vendors that are designed to document using this type of method.

I guess we can give credit to the insurance payers for something if they can help to end the long, useless, hard to read, templated based notes that are just designed for reimbursement and not better patient care.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

4 Comments

  • “…they don’t seem to care that an EMR is being used. If anything, they seem to challenge the notes saying the physicians are just using a template and not doing what they say.”
    ___

    Back when I worked for HealthInsight during the DOQ-IT era, one of the main EMR selling points was “better coding/better reimbursements,” to which I’d thought “yeah, how long will it be before the bloom comes off that rose?”

  • It is legally risky to document a task that was not performed. In fact, it is fraud. It is also easy to discover in court.

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