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| by Manny Oliverez, CPC |
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A few years ago, if you came into our office you would have seen boxes of old patient charts, Explanation of Benefits (EOBs), charge slips, and accounting records crammed in every corner of the billing office, manager’s office, and hallways. This does not even take into account the stacks of boxes at the storage unit and in the basements. Our problem was the same as many medical offices face: what to do with the ever growing amount of documents that are required to be stored for seven to ten years? The solution turned out to be simple, cost effective, and increased our staff’s productivity: scan everything.
If your practice is like ours, it goes back a few years and there are lots of old charts from patients that have moved or have not been seen in over three years. Usually these charts are stacked up in boxes throughout the office. Depending on how long you have been in practice, you could have hundreds to thousands of these charts taking up space. What if you need to find one of these charts? That would be hard and time consuming. Our practice decided to do something about this problem, so we scanned all of our old charts.
I remember looking at all those many boxes of patient charts and thinking, What have I gotten myself into? It seemed like an insurmountable task. Where do we start? We decided to start fresh by scanning the charts of any patients that were leaving the practice from this day forward. Our regular procedure was to copy the chart for the patient and then store the original. Well, instead of copying the chart, we now scanned it and printed a copy for the patient. We had to copy it anyway; the action of scanning is the same as copying, so by doing this we were essentially not doing any extra work. Now with no effort we have a scanned copy of the chart. If we ever have to make another copy, we now just click and print. After the chart was scanned, it was then shredded.
But what about all those other charts in the stacks of storage boxes? We considered those a low priority; so over the next two years, in small one-box-at-a-time chunks, we scanned them into the computer system little by little. Now there are no old physical charts. They have all been shredded and are in electronic form, easy to access from any computer in the practice. All old patient charts are at our fingertips, stored on computer. If a previous patient calls for a copy of their chart, we just call it up on the screen and print them a copy. Better yet, we burn a CD with the chart on it. CDs are actually cheaper than printing a chart, and they are also much less expensive to mail than a 200-page copy of a chart. We also scan the chart notes we receive from the patients’ previous physician so they don’t take up space in the patient chart. Our practice is still about a year or two away from Electronic Medical Records (EMRs), so for now we still use paper charts.
We saw the biggest benefit of scanning and good records management in the billing department. Previously after we processed the EOBs from the insurance companies, we would store them in boxes by date. Well, it did not take long to fill the office with tons of boxes full of EOBs. We couldn’t take them to off-site storage, because we routinely had to access the documents when we did follow-up and collections. When we needed a document, we had to look through the boxes. Of course, the box we needed always seemed to be at the bottom of a stack of very heavy boxes. It could take from five to twenty minutes to find an EOB. And what if a box we needed was moved to off-site storage? It could be days before we made the trip. With the EOBs scanned, our billers can now pull up the document they need when they are on the phone with the patient or insurance company. What used to take up to 20 minutes or longer to find a document, now takes seconds. Those billers now spend more time getting money from the insurance companies and getting our physicians the reimbursement they have earned.
The original charge slips that have the procedure and diagnosis codes from the provider, which we use to bill insurance, are also scanned. If we need to refer back to them---which we do when we need to check to see if something was billed properly, they are available at our fingertips. Our charge slip doubles as our payment receipt and is signed by the patient and the receptionist. I cannot tell you how many times we have had to pull up the scanned copy to prove to a patient that they did not pay their copay on a particular date and that they signed indicating that they did not pay. Again, we can pull that document up on the computer when the patient is on the phone. This lets us give better customer service for our patients and increases the staff’s productivity.
Finding any scanned document is simple. The patient charts are scanned alphabetically by patient name. The EOBs and charge slips are scanned into the computer by date of service so they are easy and quick to find. All the original documents are destroyed. We also archive other financial, payroll, accounting, and administrative documents for management. However, we attach password security for those sensitive documents. Don’t forget to backup your documents daily. I cannot stress how important it is to backup your data. But we will save that for a future article. Your computer support people should be able to help with your security requirements and back-up solutions.
You may think scanning documents can be expensive and complicated, but it really is not. We started with off-the-shelf scanning software called PaperPort, which we purchased for about $99, and a Fujitsu Scanner for $999. Any scanner that has a document feeder and can scan front and back of a document will work. Usually the more pages a scanner can process per minute, the more expensive it is; but don’t scrimp here. Time is money; so the faster it scans, the better. You will pay for it one way or another by paying more to the person scanning, since it takes them longer to scan. The computer used to store your documents should have plenty of hard drive space. I would go with a 1 Terabyte hard drive. But to start out, you may be able to use one of your existing computers. It will take a while to fill it up with documents. As the years go by you can continue to grow your system. From our humble beginnings we now have four regular scanners, two high-speed scanners, a data server, and powerful new database storage software. Today everything is scanned.
Document scanning is a great step toward having a fully digital office and the right solution for proper records management. It is so affordable and easy to setup that even a small practice can start scanning and reaping the benefits within days. By scanning your old patient charts and billing records you will help manage your office’s paper and make your staff more productive, ultimately saving and making you money. Plus, you can get the boxes out of the office, get back the storage room, and give the doctors back their basements.
I recently had someone come into our office and ask where all the file cabinets and storage boxes were. I just smiled, pointed to our 18-inch-tall computer in the corner, and said “In there.”
Manny Oliverez is the Director of Operations for Capture Billing & Consulting, Inc., a leader in outsourced medical billing, and Business Consultant for Farrell Pediatrics, LLC. If you have any question about records management, medical billing, or practice management, call 703-327-1800 or e-mail Manny@CaptureBilling.com.
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