HIPAA Compliance - Clinic Pro  Medical/Chiropractic Software
There is strong evidence that many software companies are using HIPAA-compliance as a way to line their own pockets, create an additional revenue stream for themselves. Let's face it. Practice management software has two sources of new sales: the graduating doctors going into practice for themselves and doctors who are dissatisfied with their current software. As a product, practice management software is in the mature phase of the product life cycle. It's hard to generate new sales. After all, there are a limited number of possible consumers. That is true of any 'mature' product. Then along came HIPAA and with it, opportunity. A new way to make money.

Many medical practice management companies accommodated free direct transmission to Medicare and BCBS - until HIPAA struck. Now, these same medical software companies are choosing to force users to send claims through a clearinghouse to become compliant. Who pays? You, the provider. Claims that used to be free are going to going to cost you money while generating a new revenue stream for your medical software company. It doesn't seem fair, does it?

Amednews.com...January 27, 2003

"Under the deals, IDX, Burlington, Vt., and Misys, Raleigh, N.C., which sell physician practice management software, will transmit claims and other transactions from doctors to insurers via a claims clearinghouse owned by WebMD." WebMD who also owns Medical Manager software is forcing its users to go through its own clearinghouse to become compliant. http://www.ama-assn.org/amednews/2003/01/27/bibf0127.htm

With Clinic Pro, you can still send claims FREE; we are HIPAA-compliant and do not need a clearinghouse to achieve it. What makes matters worse - some of the large clearinghouses are experiencing problems in creating 'clean' claims. Read on....

And from another article, Amednews.com...Feb 9, 2004

"Doctors around the country are feeling the pain as WebMD experiences problems transmitting HIPAA-compliant claims to insurers, creating serious cash flow problems. WebMD isn't the only company having that sort of trouble, but it's the biggest, so it's generating the most complaints.

While those offices would have preferred that WebMD make its practice management software HIPAA-ready for electronic transactions, WebMD instead is offering a subscription service because it believes that's the better way for it -- and its customers -- to comply with the federal law.Under the service, physicians and other providers submit noncompliant claims to Envoy, which then converts them into a HIPAA-compliant format and transmits them to insurers. For a fee.

That didn't sit well with four-doctor Middletown (Conn.) Surgical Group, which previously transmitted its claims directly to insurers for free.  But the practice grudgingly signed up to pay $89 monthly per physician after it learned that WebMD would not provide technical support if it chose to submit claims directly to insurers or via another clearinghouse.

"I don't like being strong-armed, which I felt I was," said Marilynn Kurpiewski, practice manager. "But we really had no other option. We all thought, 'Oh, God we've got to get our claims out.' "

http://www.ama-assn.org/amednews/2004/02/09/bisa0209.htm

If you would like to research further:
http://www.informationweek.com/story/showArticle.jhtml?articleID=17501393
http://www.informationweek.com/973/webmd_letter.jhtml

Is this information self-serving? Of course. Clinic Pro Medical/Chiropractic Software has shouldered the burden of HIPAA compliance so you do not have to.  This is what it means to you:

*  Free direct claims to Medicare, BCBS and any carrier that accepts ANSI 837 4010A1 claims. Many insurance carriers are currently investigating ways to reduce their costs by eliminating the intermediary, the clearinghouse. Clinic Pro can transmit to any carrier directly. So, when new carriers accept direct claims, Clinic Pro is ready.

*  Quicker return and greater report accuracy. When you deal directly with the carrier, you receive 997 reports quicker. There is no intermediary to filter information.

*  Automatic payment posting. When billing direct to the carrier, you receive an 835 file. This file contains information about payments and rejections. Because it comes direct from the carrier, you receive the highest accuracy for automatic payment posting.
 


HIPAA Compliance = Free Electronic Claims

Please call us at (866) 333-2776 to discuss electronic HIPAA-compliant claims in your state.

  
In a chiropractic office environment, the use of chiropractic software streamlines the functioning of the office. Chiropractic software should include an appointment scheduler that allows chiropractors to set up visit plans. It should include chiropractic procedure codes for x-rays and adjustments such as 98940 and 98941. It should include an integrated electronic medical record that allows chiropractors to record Medicare mechanism of trauma. Using an EMR to record documentation notes and physical exam findings streamlines the overall functioning of the chiropractic office.
To meet Medicare guidelines for mechanism of trauma, ClinicPro chiropractic software has developed an EMR template that elicits the mechanism of trauma information along with PART information meaning pain, asymmetry, range of motion and tissues/tone changes. This chiropractic specific documentation justifies the use of procedure codes 98940 and 98941. Medicare chiropractic guidelines require a mechanism of trauma to initiate care. ClinicPro chiropractic software provides a documentation necessary to pass a Medicare chiropractic audit.
 To meet Medicare guidelines for mechanism of trauma, ClinicPro chiropractic software has developed an EMR template that elicits the mechanism of trauma information along with PART information meaning pain, asymmetry, range of motion and tissues/tone changes. This chiropractic specific documentation justifies the use of procedure codes 98940 and 98941. Medicare chiropractic guidelines require a mechanism of trauma to initiate care. ClinicPro chiropractic software provides a documentation necessary to pass a Medicare chiropractic audit.