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Monthly Archives January 2011

Boehner: “Let’s Start With a Clean Sheet of Paper”

BOEHNER: Why cant we agree on those insurance reforms that weve talked about? Why cant we come to an agreement on purchasing across state lines? Why cant we do something about the biggest cost driver which is medical malpractice and the defensive medicine that doctors practice? Lets start with a clean sheet of paper and we can actually get somewhere, and we can get it into law here in the next several months.

Duration : 0:0:24

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Start Your Own Medical Billing Business Always wanted to start your own medical billing business but didn’t know how? This book will help you with all the questions you will encounter in starting a medical billing business. Written by a mother and daughter who started a medical billing business in 1994 and still currently run it with several employees. Learn how they did it, what you will need to know, and how to start.

Duration : 0:7:27

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Family Practice – Practice Fusion EHR Case Study

Lynn McCallum, MD is a family practice physician in Redding, California – a small town in Northern California. She became a Practice Fusion user in February 2009. In this video, Dr. McCallum talks about her process of selecting and implementing Practice Fusion’s free, web-based electronic health record system.

Duration : 0:2:9

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Penile Implant Surgery with Dr. Andrew Kramer

In this eight-minute video, Dr. Andrew Kramer, assistant professor of surgery at the University of Maryland School of Medicine and urologist at the University of Maryland Medical Center, provides an overview of his practice in sexual medicine and prosthetic urology. Dr. Kramer discusses the types of patients he treats as well as the treatment options he offers to his patients.

One particular treatment option Dr. Kramer offers his patients is the penile implant. Here, Dr. Kramer talks about how the implant procedure is performed, the components of the procedure as well as the misconceptions surrounding the implant device. He mentions how his team is able to treat even the most complex patient cases and offer some of the best outcomes associated with this operation.

Related Links:

Dr. Andrew Kramer

UM Division of Urology

Video: Erectile Dysfunction

Overview: Minimally Invasive Penile Implant

Penile Implant Patient Success Story

Distributed by Tubemogul.

Duration : 0:7:59

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Medical School Equipment Helps Train Future Doctors

Applying for medical school is often the most difficult process for any future medical student. You need to start almost a year and a half early in order to ask for recommendations, take the MCAT exams and prepare your personal statements. It is a struggle to get accepted no matter where you apply because the field is so competitive. For the rest of us, this selective process is great because we only want the best people and most intelligent people to become our doctors and health care givers.

However, this process does the future medical community no good unless these potential doctors have the right instructors, materials, and tools from which and with which to learn. Medical equipment is an incredibly important teaching tool and it helps the doctors of tomorrow better prepare for the real world of medicine.

Medical school is where students learn about the most recent medical techniques and theories. New technology is developed almost everyday and it is difficult to stay abreast of all this new information. The great progress made by technology has made medicine much safer. Doctors can now use imagining machines, such as magnetic resonance imaging (MRI) and ultrasounds, to find tumors and other abnormalities. These machines eliminate the need for many invasive exploratory surgeries. The problem is much easier to spot and diagnose while looking at an image then by hoping to find something by making an incision.

Many medical schools rely on the charity of other hospitals and clinics to stock up on medical school equipment. Some hospitals that are closing or getting in a shipment of new machines will donate their used and refurbished equipment to medical schools so that medical students can get the maximum amount of practice using the equipment they will need every day in their jobs. It is one thing to learn the theories on how to use a machine and another thing to learn hands-on with the machine itself. The more familiar future doctors are with these machines, the better they will do when they start their residencies.

If you are someone who would like to sell a few pieces of used medical equipment, consider donating them to the nearest medical school. Helping the future physicians learn how to be the best doctors they can be is very important!

Jane Worthington

Dental Practice Management Consultant on the Three Secrets in Achieving Your Goals

What are the three secrets in achieving your goals, be it your goals in life or in your dental practice? In this article, dental practice management consultant Ed O’ Keefe will share to you the three, real secrets in achieving your goals in life and in your practice. The dental practice management consultant will give you an in-depth look at these secrets. With these, the dental practice management consultant will show you how to set up your goals and how you will be able to achieve them. And this is something they focus specifically at their dental practice website!

Here’s what he’s going to share to you about these three secrets…

The first secret is how you see yourself. It has something to do in the way that you perceive yourself. You see yourself in a certain way, then you act accordingly. That’s called your identity. You’re a successful person therefore in everything you do you strive to be successful at. It’s like you’re in the middle of the road, you just kind of try to get by on. If you somehow, came up with a limiting belief that says something like:“I’m stupid, I don’t learn things quickly!”. Well, I can prove to you in a matter of 30 seconds that you’re smarter than you’ve ever imagined, by the fact that you can learn things at rapid speeds! And you say, “I don’t understand that!”. Personally, I get so hurt when I see kids who like who believe that kind of thing. It’s not that others are smart and you’re stupid because you don’t learn quickly like them, but it’s because people just learn differently. And while our school systems are shifting a little bit, the reality is when most of us went to school it was just one dimensional. Sit in a classroom and listen. Well, if you’re strength is not in listening, but you like to be hands-on, or you like to be watching and be hands-on at the same time, well you did not succeed in that environment. It made you crazy, in fact you might have started touching people around you, right? Like you grab some stuff over here and grab some stuff over there, and they called you a bad kid. But no, you were not a bad kid… you were just a highly kinesthetic kid, which means you need to be holding on to things. And somewhere along the line, I figured out that all that “crap” about being stupid or whatever is just not true… and that I can learn anything! Now, you can start saying in your head “I can learn anything quickly and easily! I can learn anything quickly and easily!”. Here’s the thing, if there’s someone who thinks that they’re dumb, or someone who thinks they can’t get it, and when someone’s teaching them something they start talking to themselves, saying, “ I don’t know if I’m going to be able to get this….”. Well, as you tie that conversation, guess what happened? Thirty seconds of the description of what’s going on just went by! So you’re not stupid, you just missed half the conversation! That’s all that’s happened. So as a dental practice management consultant, I tell people that when you’re trying to communicate to people, 90% of the battle is just all about shutting up and listening. How can I know what it is you want if I can’t hear you and understand you, right? So it’s just how we see ourselves.

The second secret is what you asked for. Now, here’s a good news and a bad news. Whatever you asked for, whether you say it in a positive or the negative way, is what you will get! So for example, if you say something like “You know what, I really want to attract joy and happiness in my life…” And you just ask God for that and you just keep praying on that, and you live your life based on that, then you’ll find that you’ll get more of that in your life! For example in dating… you say to yourself: “Well, I hope I don’t meet another girl like the last one I dated, she was just a jerk…”, or “Will the world not send me someone like her?”. Then the world will not know the difference between the two. Now, your focus is on seeing and meeting the “girl of your dreams” coming to your life…. and that’s all you’re going to get! In your dental practice, at times you find yourself in a struggle with money. And you wish you wouldn’t struggle with money anymore. As a dental practice management consultant, I tell my clients that money is attracted to money, because people who have money like money! That’s the idea of money. If, for example, you’re one of those people who say, ” I am always tight with my money, I count every single penny….”. What I advise you to do is go give a hundred dollars to somebody who needs it. And when you do, you just sent a message to the world that you believe in abundance and you believe that everything can come into your life! I’ll tell you a story, there was a family that was in need, then our company wrote a check for a big dollar amount to them, and we just let it go. Talking to a few people, they say like “Are you sure?”, and I said “It’s there, and there’s more coming!”. And I swear to you, I can’t even say that this is reality because I have no scientific proof, but all I know is that every month after that, month after month, we just got better and better! Like crazy things started to happen; I think by the next day we had a record day in the office! And it’s because it’s just a relationship. So, like when I win money, I just go, “Oh, cool!”, because that’s what supposed to happen! It’s because I like money, therefore it likes me. And we’re going to have a nice relationship together! And if you’re like afraid of it, then it’s going to be afraid of you! See the point?

The third secret is what you believe you deserve. And this kind of sum things up! We’ve talked about how we see ourselves; whatever we ask for, whatever we think about most expands; and whether it’s negative or positive, you’re going to get it either way, because the world doesn’t know the difference… so whatever you believe in you deserve it! Like for example, when people buy my dinner, I say “Thank you!”. And it’s because I’m sending them a message that this is fine, that this is a good world! And so what I like to challenge you is start believing you deserve everything you get in life. Instead of saying “no, I don’t deserve these..”, you say “Yes, I have these because I deserve these!”. As a dental practice management consultant, I tell my clients this: with every level you go up, you have to consistently challenge your belief systems! So, if you have goals, constantly challenge yourself. For me, before, what did was write in a piece of paper, “I’ll earn $20,000 a month..” and it was quite a challenge.. and I asked myself “How am I going to do it?”. Believe me, it took me two years to figure that out! And what I started doing is improving my relationship with money. The thing is that if you have a hard time with that goal the first time you write it, you got to write that goal out everyday! And when I achieved my goal of making $20,000 a month, I then went writing down “I want to go for $40,000 a month…” But there is a different feeling in my body, so then I said, “Screw it!”. Why not make it a hundred thousand a month! Well, since I’m at it, might as well keep going! I’ll make $1 million a month! I’ll make $10 million a month! I’ll make a $100 million a month! So, constantly challenge your belief systems and improve your goals!

Darcy Juarez

Incorrect Medical Coding and Billing Can Result in Thousands of Lost Revenue for Your Practice

Orlando, FL — November 04, 2008 — It is no surprise that medical coders and billers are essential to the success of every practice. A well-prepared coding and billing staff will deliver careful chart examination, accurate code selection, cleaner claims, fewer denials, and enhanced revenue.

Staying on top of coding changes affecting their specialty is crucial to a medical coder and biller. Why? Because even a simple mistake can lead to thousands of dollars in lost revenue.

In preparation for the 519 new, revised and deleted CPT changes expected for 2009, coding and billing professionals across the nation are expected to attend the 2009 Coding Update and Reimbursement Conference on Dec. 4-6, 2008 in Orlando, FL or Feb. 8-10, 2009 in Las Vegas, NV. Attendees at these conferences will be provided with the most up-to-date information for their specialty from nationally-recognized coding, billing and reimbursement leaders.
At the Orlando conference, there will be 12 specialty tracks to choose from, including: Ambulatory Surgery Center, Anesthesia, Clinical Lab, General Surgery, Multi-Specialty, Neurosurgery, Oncology, Ophthalmology, Optometry, Orthopedic, Pain Management and Pathology. Additionally, attendees will be able to jump from one specialty track to another free of charge.

At the Las Vegas conference, there will be 9 specialty tracks to choose from, including: Ambulatory Surgery Center, Family Practice, Internal Medicine, Intervention Radiology, Multi-Specialty, Ob-Gyn, Orthopedic, Pathology, and Pediatrics. Additionally, attendees will be able to jump from one specialty track to another free of charge. Early-Bird registration rates end December 8th.

“These upcoming conferences are particularly important,” said Coding Conferences President Samantha Saldukas. “Staying on top of changes affecting their specialty will help coders and billers to maximize their skill-set, reduce claim denials, and receive the reimbursement they deserve; all while contributing to their practices financial stability in 2009.”

These national coding conferences have been organized by Coding Conferences, LLC and The Coding Institute. Sponsors and exhibitors at the Orlando conference include the American Academy of Professional Coders (AAPC), Ingenix, American Medical Association (AMA), ClaimRemedi, and Coding Cert.

For more information, visit them at or call Coding Conferences at 866-251-3060.

Rohit Kumar

The Physician’s Guide to Electronic Medical Records Software

A challenge awaits the physician who has had enough of the frustrating inefficiencies, financial penalties, and antiquated practices associated with maintaining a paper-based medical office. So the decision is made to digitize the practice. Any initial enthusiasm quickly wanes once an initial search for medical software uncovers hundreds of products and vendors. It doesn’t take long before the 300 or so electronic medical records system screenshots and feature/benefit grids begin to look remarkably similar. The sheer number of vendors occupying the EMR (electronic medical records) market is unmanageable without a basic product assessment/elimination strategy.

For physician practices with limited time and resources, the selection process can appear overwhelming. Fortunately, physicians can begin to narrow down potential systems by eliminating uncertified products, as well as those built upon dated technology architectures.

  • Eliminate products not certified by the CCHIT® (Certification Commission for Healthcare Information Technology).
  • By confining research only to CCHIT-certified EHR (electronic health record) products, a substantial number of systems are quickly eliminated. As of this writing, 53 ambulatory EHR systems have successfully met the 2007 standards, while only 18 have met the more rigorous 2008 criteria. Using CCHIT certification as an initial benchmark is prudent for a variety of reasons: The CCHIT is the leading Healthcare I.T. certification organization, and is publicly endorsed by the American Academy of Family Physicians; the American Academy of Pediatrics; the American College of Cardiology; and the American Medical Association, among others. In addition, a CCHIT Certified designation ensures that a product has met the basic requirements for functionality; interoperability; and security and privacy.

    A 2008 CCHIT certification warrants the product’s utilization of standard formats enabling the exchange information with other systems – known as interoperability. The exchange of patient information on a regional or national level is the underpinning of a more efficient and less costly healthcare system. Future tax incentives and Medicare reimbursements may be tied not only to utilization of digital medical records in general – but specifically benefiting practices with CCHIT-certified EHR systems.

  • Eliminate products that do not operate on a shared database for billing and patient charting.
  • As little as five years ago, “interfaced” practice management/billing and patient charting systems were the norm. Today, “interfaced” systems are technologically inferior to medical software that has been developed from the ground up by a single vendor, on a single platform, and utilizing a single database – described as ‘integrated’ or ‘unified’ electronic medical records and practice management systems.

    Interfaced systems are still sold today, so it is a “buyers beware” market. In the past several years, there have been a number of mergers and acquisitions between vendors having market share in one side or the other (scheduling and billing or charting/EMR) but desired a comprehensive solution to offer physicians. As a result, there are products currently marketed as a “suite,” but were developed by disparate vendors on different platforms, tied together using a separate application. Although generally transparent to the practice, there may be questions of data integrity; patient safety (for example, a patient’s practice management/billing record does not match the clinical record and lab results get overlooked in the mess); and even the vendor’s long-term maintenance of the system.

    Unfortunately, uncovering if a system is integrated or interfaced is not always straightforward and may require the buyer to conduct some detective work. The first step is to ask the vendor questions about the product’s history – which company developed it, does it utilize a common database, and is there a single login for billing and charting? Some interfaced systems require users to log in separately to access the practice management/billing and the clinical portions of the software.

    Following the elimination of uncertified products with dated technology, the pool of suitable products begins to shrink and the specific needs of the practice should be defined and considered.

  • Establish a Budget. Medical software systems vary widely in cost. By establishing a flexible budget early in the process, practices can avoid wasted time looking at systems that are too expensive or potentially not robust enough to meet the needs of the practice. Ask questions about ongoing maintenance costs and what the maintenance covers, just as a buyer would ask when making decision to purchase a car.
  • Specialty-Specific Content. Not all EMRs accommodate all specialties – regardless of what the sales rep claims. For example, some leading vendors have well-developed content for family practice; ob/gyn; internal medicine; and ear, nose, and throat; but may not fare as well in specialties such as oncology or chiropractic. By asking the vendor to demonstrate the product’s performance in a specific specialty, the number of potential candidates will decrease.
  • Scalability. Just as not all electronic medical records systems accommodate all specialties, most are geared toward a specific practice size – with features and cost typically reflecting the product’s expansion capacity. In general, if the practice expects to add providers or additional locations over time, it is important to start with a product that is stable and feature-rich enough to handle the workflow of a larger practice – even if the product’s features may not be fully leveraged early in the product’s lifecycle.
  • Finally, it is time to ask questions about the vendor’s service and support – the most ambiguous, but arguably most important aspect in the decision making process. After all, you can purchase an electronic medical records software system with every bell and whistle, but if the implementation is disorganized; the training inadequate; or the post-installation support lacking – productivity will drop; providers and staff will be frustrated; cash flow may be interrupted, or worse.

  • Take stock of in-house I.T. (information technology) resources.
  • Does the practice have a staff I.T. department or a trusted medical office I.T. company? If not, it’s important to ensure that the software vendor offers I.T. services. Improperly installed hardware or inaccessible support personnel can have a detrimental effect on the success of the training and implementation.

    Some smaller practices opt for a web-based installation to decrease the cost of hardware and eliminate the need to maintain servers and other equipment. Web-based installations are known as SaaS (Software as a Service) and are delivered by an ASP (Application Service Provider). The electronic medical record ASP hosts the software in a secured data center, and the end-user (the practice) simply accesses the system using a web browser. All that is required is a high-speed internet connection and a workstation. Access to the data is dependent upon the internet connection, so mission-critical applications are not appropriate in a SaaS environment under most circumstances.

    The alternative to a web-based installation is Client/Server, requiring an onsite server and regular maintenance of the system by the vendor. Both types of installations have advantages and disadvantages, so it is important to discuss installation with potential vendors.

  • Assess technological skills of clinicians and administrative staff. Ensure the vendor’s project planning and implementation staff can aid the practice in choosing who the functional area “champions” will be.
  • Training, EMR implementation, and “go-live” support expenditures account for a substantial portion of the total initial system cost, and careful planning is essential for a smooth implementation. The vendor should provide a project coordinator that will help the practice make critical decisions and schedule the project timeline. Most practices utilize a combination of web-based and on-site training prior to go-live (the days or weeks dedicated to using the new system). In addition, the vendor should provide onsite support for the practice during the go-live. The number of training days, go-live days, and the delivery (web-based or onsite) is determined by the size of the practice and the skill levels of the staff. Follow-up sessions to reinforce original training or introduce advanced concepts is important for continuity.

    To keep costs down, some practices may utilize a heavier web-based training plan for the bulk of the staff with designated superusers who attend advanced training. For practices with less technologically savvy staff, more handholding through onsite training may be the best option. In addition to improperly installed I.T. (hardware, networking, security, workstations), insufficient training or post-implementation technical support are prominent failure points in medical software implementations.

  • Who supports the practice following the go-live? The original training and implementation staff, or a separate call center?
  • Not only does unresponsive medical software technical support frustrate and discourage users, it fosters lost productivity when users struggle with denied claims; unanswered questions; or broken functionality. Still, large vendors often outsource support to overseas call centers – lowering vendor overhead at the expense of high-quality, timely, and knowledgeable support.

    By asking relevant questions, evaluating the needs and culture of the practice, and systematically eliminating unsuitable products and vendors – practices can enjoy the host of current and future financial and patient safety benefits that an electronic health records system provides.

Andrea Schroeder