What will you do without a superbill? What will you do?

Some coders I know are a little scared of the changes that electronic medical
records are bound to bring to their jobs. But there’s no reason to be scared,
because EMR also brings new opportunities to advance your coding career — if you
know the ropes.

When I learned that the American Academy of Professional Coders was hosting a
workshop in my area called ‘EMRs: What You Need To Know Now,’ I hightailed it on
over there. During the session, I learned how to shop for and select an EMR
system, how to work with IT-types to make it work for my practice, and I got a
glimpse of how EMR will change our medical coding jobs.

Right now, many coders focus on “rescue and recovery,” explained instructor
Shery Smith, CPC, CPC-H, CPC-I, CEMC, CCS, CCS-P, who’s also on the coding staff
of a large teaching institution that is using EMR already. “Rescue and recovery
coding” or “back end coding” involves tracking denials, finding the coding
problems that sparked them in the first place, and appealing the claim.

But with EMR implementation, more coders will become “front end coders.” That
is, they will apply their coding and regulatory knowledge at the front end to
make sure the EMR system is tailored correctly for their practice or department.
If you excel at educating clinicians on coding techniques, you’ll be in high
demand when you organization implements EMR, Smith says.

EMR will put a lot more of the coding in physicians’ hands, once your coding
staff has worked with your IT staff to tailor the system and incorporate the
correct prompts. “The new focus for coders will be coding educator and auditor,”
says Smith. And coders that are knowledgeable enough and comfortable enough to
audit and educate physicians are a “rare breed” in some places.

Meet the ‘Extroverted Librarian’ Coder: Savvy researchers who are good with
data, but can also communicate well with clinicians, IT types and other team
members will be in high demand, predicts Kaiser Permanente, Colorado’s James M.
Taylor, MD, CPC, who wrote the curriculum for the AAPC’s workshop.

In this kind of role, you might do a ten-record snapshot audit for each provider
every month and meet with them for individual education sessions. Or, you might
be available for their questions or what Smith calls “ad hoc education
sessions.” You’d have to be committed to staying abreast of updates that affect
your providers, and may be called upon to do “coding spotlights” at clinician
meetings.

Not the extroverted type? Don’t worry, says Smith. There are some back-end
coding issues that are best left to coders so as not to distract physicians from
patient care. For example, most organizations will probably have coders keep up
with changing carrier rules and haggle with carriers when denials do come up. If
you’re the type of coder who likes to sit in the back office and “just code,”
there will probably be a role for you — even in the brave new era of EMR.

Available on CD: From Paper to Digital — What Coders Need to Know Now.

Does it feel like it's raining paper in your office? Consider EMRs.

Is your practice looking at EMRs? Here’s what you need to know about the transition.

Question: My practice is running out of space for storing our paper records. How long do we actually need to keep them? We’re also moving to electronic records and are not sure if there are different record retentions rules for paper versus electronic records. Can you explain record retention rules?

Answer: Storing billing and medical records — whether paper or electronic —  safely and for the legallyappropriate length of time is important for two reasons. Past records ensure your practice has all necessary information in the event of a lawsuit or payer issue, and past records provide historical information to help with current patient care.

The general rule is that you should retain all medical and billing records for about seven years because that is how long the audit process can be in some instances. Many experts suggest mirroring your record retention policy with whatever the statute of limitations is for suing on a contract is in your state.

Watch out: Here’s when you need to hold on to paper, even after you have EMRs …

Caveat: Even though you’ll have easily accessible electronic records, you should still hold on to a copy of all paper records for the appropriate amount of time as indicated by your state’s statutes. If you keep all paper records, you may opt to keep copies in a separate storage facility if you don’t have a lot of space in your office. As a bonus, many record-storage facilities will make microfiche copies of your records and store those off-premises to ensure you have copies in two separate, safe locations in case of disasters such as fire or flood.

Minor differences: State rules vary as to how long you should keep a minor’s records. You may have to keep a minor patient’s records until he reaches legal age.

With the ease and accessibility of electronic record keeping, your practice should convert your paper storage to electronic copies. And because CD ROMs require such little storage space, you may want to keep your electronic records indefinitely.

Electronic tips: Maintaining continual backup of your computer files will ensure a smooth transfer of this information into record storage —  and, even more important, it will guard against data loss due to computer problems. Just as you should keep a separate copy of your billing records off-site, you should keep computer backup off-site as well. Keeping daily backup of your computer files in your information technology office won’t be enough if a disaster afflicts your whole building.

Consult an expert: To make sure your record retention policy is in line with state rules and hasn’t overlooked any necessary components, consider having an attorney or billing consultant review your plan.

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Change never stops in health care reimbursement, so you have to stay sharp. Get CPC-certified today.

If you think your learning curve will flatten a bit once you get some coding experience under your belt, think again.

Thirty-year coding veteran Tina Landskroener is going back to school to take on new health information technology challenges that are cropping up at her business office manager job with Blessing Physician Services in Quincy, IL. She is a business office manager who also manages the medical records staff, as well as compliance and risk management projects.

And, she’s become so involved in EMR changes at Blessing that she’s going back to school to get her Master’s in Health Informatics.

Where she’s come from: Like many coders I’ve met, Landskroener knows how to embrace change and get credentialed along the way. She began her career as a Certified Medical Assistant, earned her CPC and CCS-P, and became active in the Healthcare Compliance Association.

Landskroener has been in business for herself as a consultant, and has even taught billing and coding to students vo-tech students. “My experience as a teacher prepared me for management,” she says.

Career tip: Master the next regulatory or technical challenge and teach others how to cope. “Four years before HIPAA went into effect, I learned it,” Landskroener recalls. She then became the go-to person for HIPAA compliance at her organization. (She was the one who got to teach the physicians all about the new regs.)

Why HIT? More HIT knowledge makes sense, Landskroener says, because she faces more and more challenges where HIT is a big factor — RAC audits, quality measurement, and some major health information requirements coming out of the stimulus bill, to name a few.

What sealed the deal: Transitioning her physicians from an old electronic medical records system to a new one fired up Landskroener’s interest in HIT. “It’s an even greater challenge than moving from paper to EMR,” she says.

Stay tuned. We’ll be checking in with Landskroener to see what’s she’s learning, and she promises to let us know when the feds figure out what ARRA means by “meaningful user.”

What’s your next step? Our 3-day training camps prepare you for the CPC®, CPC-H® or specialty coding certification.