“I recently had a number of notes
from a practice where a patient had a simple, straightforward problem, and the note had every negative for every system in the body, including things the patients didn’t have — like vaginal discharge in a man,” she said. “Check boxes can be time-consuming and make it difficult to focus on the prob- lem at hand, so that note reflects only that day’s complaint, instead of data that are not relevant to the visit. There is a huge learning curve for physicians as well as the IT [information technol- ogy] team that is designing and imple- menting the EHRs.” Dr. Ream says the advent of EHRs
presented a great opportunity for phy- sicians, but their implementation was problematic. He says AIMA’s old-fash- ioned approach is usually superior to EHR documentation. “Our records are clearly better than
the majority of electronic health re- cords, but that doesn’t matter,” he said. “[In] ours, it’s easier to find why they were here the last time, when they had different [medical issues]. You can find it nearly instantaneously if you know how our charts are organized.”
OFFICE MANAGEMENT CHALLENGES The mounting administrative re- quirements of running a practice have placed an increasing burden on AIMA office manager Jan Ream. “She’s the IT person; she’s the one
who has to deal with all the vendors. She’s the one who has to call the plumber and the air conditioning guy,” Dr. Hoverman said. “And without some giant administrative sugar daddy in the sky to take care of those things for us, it’s very difficult to survive in this current environment.” Earlier this year, AIMA, a nonpar- ticipating group in Medicare, turned to the Texas Medical Association for help after Ms. Ream noticed a discrep- ancy between AIMA’s fee schedule- based charges and the explanations of benefits she was receiving. TMA discovered that technical errors in a draft of Medicare’s 2015 Physician
ICD-10 HELP FROM TMA
The Oct. 1 ICD-10 implementation deadline is right around the corner. The sooner you learn to code claims and docu- ment services to the full level of specificity, the sooner you can get paid most accurately. Call (800) 523-8776 to learn more. Here’s how TMA is helping:
• Register for TMA’s live seminars: ICD-10 Essentials: two seminars in one day. In Essentials in ICD-10 Coding (tma. tips/ICD10coding), staff can perfect their coding and au- diting skills with hands-on exercises using ICD-10. In Essen- tials in ICD-10 Documentation (tma.tips/ICD10essentials), physicians can find out how to improve their documenta- tion to support increased code specificity. These seminars run through Sept. 16 in cities around the state.
• Specialty-specific, physician-developed three-hour online courses. Choose from 21 medical specialties to learn physi- cian documentation tailored to your specialty. Each self- paced course (
www.aapc.com/icd-10/icd-10-physician- documentation.aspx) shows you critical documentation elements you’ll need to maintain payment under ICD-10 and features the top clinical conditions for each specialty, with emphasis on their associated documentation and coding requirements.
• Register for on-demand recordings of ICD-10 planning and implementation courses. View the on-demand webinar list at tma.tips/TMAICD10webinars.
• Visit TMA’s ICD-10 Resource Center at
www.texmed.org/ ICD10 for tools, information, and links to on-demand webi- nars, including specialty-specific webinars.
September 2015 TEXAS MEDICINE 35
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