Check out our blog for the latest news and commentary in the EMR/EHR world.

Archive for April, 2015

ICD-10 Testing: A Guide for Medical Practices

Wednesday, April 29th, 2015

Healthcare organizations have raised many concerns about the transition to ICD-10, which will introduce thousands of new diagnosis codes, citing that a lack of preparation could result in an increase in claim denials. The compliance date, however, is still set for October 1, 2015, and it is unlikely that the deadline will be pushed back yet again. In order to avoid cash flow disruption resulting from claim delays and denials, medical practices must be proactive and take steps to prepare for the compliance date.


ICD-10 testing is by far the most important thing that practices can do to get ready for the switch in code sets. It is not required but will make a huge difference in determining how quickly providers get paid, particularly in situations where the wrong diagnosis code could result in a denial and extra work for billing staff.

Getting Ready for ICD-10 Testing

When it comes to ICD-10 testing, the first step for practices is to contact their software vendors to ensure compliance. Come October 1st, ICD-10-ready practice management software and electronic health record software will be necessary for processing clean claims. Using software that is ready for ICD-10 will also ensure that physicians are able to meet the new standards without any complications or disruption to workflow. 1st Providers Choice’s software solutions are ICD-10-compliant, and we are currently helping healthcare organizations carry out testing.

Providers will also need to coordinate testing efforts with the payers with whom they regularly work. Note that it is not necessary to test with each payer. Practices may choose to focus only on the ones that process the highest volume of claims. To find out how a particular payer is supporting ICD-10 testing, visit their website or contact them directly. Medical practices that use a billing service will need to contact the billing service to find out how they are handling the testing process.

The Centers for Medicare and Medicaid Services is offering two test cycles for ICD-10 testing. The first testing period will be from April 27 to May 1 for those who already registered. The next test cycle will take place from July 20 to July 24. Providers will need to contact their Medicare Administrative Contractor for details about signing up.

Creating Test Claims & Analyzing Results

When thinking about what to test, practices should keep it simple, focusing primarily on the most common diagnosis and procedure codes, as well as those that bring in the most revenue. This will prevent staff from feeling overwhelmed during the testing process. It is also important to throw one or two complex claims in the mix in order to avoid surprises.

Also, when creating test claims, remember to follow each payer’s instructions for doing so. Some may require a specific date to be entered or for specific data to be included in order to easily identify test claims.

Once test results are in, practices will need to check for ICD-10-related errors. If there are errors, staff should work with payers to understand what caused the errors and how they can be avoided. Once those issues are resolved, conduct further testing until all test claims processed are free from errors related to ICD-10.

To learn more about using our fully certified EHR software and ICD-10-compliant practice management system, contact us online or call 480-782-1116.

Health Information Exchange: What You Need to Know

Monday, April 6th, 2015

Despite the healthcare industry’s widespread adoption of electronic health record software and the push for interoperability, patient care is often fragmented. Medical information known to a patient’s primary care provider, for example, may not be known to the specialist treating the individual or to the hospital or urgent care center that the patient visits and vice versa. This lack of knowledge can lead to medical errors, higher care costs and gaps in treatment.

Health information exchange (HIE) addresses this issue by allowing providers to securely share and access critical patient information at the point of care. Rather than requesting medical records by fax or mail, HIEs allow for instant electronic access to patient health data. The data from one system gets stored seamlessly in another and is available for the provider to view at any time. This data may include past medical history, results for lab and imaging tests, current medications and more.


The two types of HIEs most commonly used by providers include:

  • Directed exchanges (support coordinated care): allow providers to send and receive secure information electronically. For example, a primary care physician refers a patient with an abnormal heart murmur to a cardiologist. The physician sends the specialist the patient’s current health issues, medications and diagnostic findings.
  • Query-based exchanges (for unplanned care): allow providers to find or request information on a patient from other providers. For example, a patient arrives at the emergency room and is experiencing seizures. The physician uses the HIE to access information about the patient, including a medical history, current medications, and potential drug allergies.

What Are the Benefits?

Health information exchanges allow providers to easily share patient health records, resulting in better care coordination, lower care costs and improved treatment outcomes. Studies have already shown that the use of HIEs in emergency departments reduces the number of duplicate tests and procedures – and the same is likely to be true for providers in medical practice settings. After all, when a provider has access to a patient’s complete health history, better decisions can be made regarding the patient’s diagnosis, treatment and care plan.

HIEs provide the following benefits for improving quality and safety of patient care:

  • They ensure that all caregivers have access to the same information.
  • They prevent medical errors often caused by a lack of information.
  • They provide clinical decision support tools for more effective treatment.
  • They reduce medication errors and prevent possibly harmful drug interactions.
  • They eliminate redundant or unnecessary testing.
  • They improve health monitoring and reporting.

How to Get Started

Participating in a health information exchange is recommended for medical practices looking to improve care coordination and attest to Meaningful Use. There are many data exchange options available including HIEs supported by EHR vendors, HIEs developed by accountable care organizations, and local and regional exchange networks.

For many practices, working with a certified EHR software vendor is one of the best ways to get started with an HIE. Not all vendors offer the functionality, so you will want to make sure that you work with a vendor like 1st Providers Choice that is fully committed to interoperability. Our EHR software is flexible and fully interoperable with a wide range of software systems. Furthermore, we use advanced technologies and offer comprehensive services to help our clients meet their data sharing needs.

Are you looking to learn more about health information exchange, or ready to get started? Call 480-782-1116 today!