mental health billing fraud

A suburban Chicago doctor was indicted last month, accused of filing nearly $1 million in fraudulent health insurance claims. From 2008 to 2013, the doctor allegedly used some patients’ names without their knowledge and submitted claims for scans that were never performed, the Chicago Sun-Times reported. In one case, the doctor allegedly fabricated a seven-page medical record for a follow-up exam during an office visit in which the doctor only refilled a prescription.

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Telehealth–the remote diagnosis and treatment of patients through telecommunications technology–can offer important benefits to both providers and patients. Some research, for example, suggests that the practice helps eliminate stigma and, therefore, make it more comfortable for clients to seek services. Of course, it can also substantially improve access to care, especially in remote areas.

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When clients visit any healthcare provider, they must complete multiple forms, usually stacked on a clipboard. The task of filling out those sheets is often even more challenging and time-consuming for visits to mental health and substance abuse treatment centers because they ask for more extensive information. And staff have to enter all that information by hand into an electronic system. It’s a time drain for all involved.

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ClinicTracker announces a game-changing innovation to help providers manage overwhelming agency routines and workflows.

Administrators and providers of mental health agencies lose sleep worrying that the next day will bring an unannounced visit from regulators checking for noncompliance and fraud. Failing such a visit can be profoundly disruptive, expensive, and embarrassing.

choosing a mental health ehr for large agencies

Since 2008, the number of office-based physicians using EHRs has more than doubled, from 42% to 87%. Even as healthcare workers grow increasingly accustomed to technology guiding their workflows, practices that provide mental health or substance abuse services still face unique challenges in finding EHRs that offer features designed for their complex billing arrangements and reporting requirements.

Performance Measurement

ClinicTracker, the EHR of choice for mental health and substance abuse agencies, introduces an exciting new practice management tool called Performance Measurement Reports. Administrators no longer must remember to check on the health of their operations, as the software automatically emails reports that indicate whether pre-selected parameters fall within or outside established comfort zones. It’s a way for managers to enhance accountability, maximize business performance, improve financial control, and maintain compliance with regulatory requirements. Automated emails serve as a built-in warning system that alerts the administrator when metrics they are tracking go above or below acceptable limits. Of course, administrators can also access those same reports on demand and based on data in real time.

telehealth service

ClinicTracker announces their new Telehealth Service that gives providers a convenient method for interacting with patients remotely using an internet-connected desktop, laptop, or other mobile device equipped with a webcam. ClinicTracker makes it simple to set up appointments, conduct sessions, access recordings, and keep records – all within ClinicTracker’s user-friendly environment.

MACRAtelehealth

The latest development in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) includes good news for healthcare practices that offer telehealth – the use of telecommunications technology to provide health services. When the Centers for Medicare and Medicaid Services (CMS) issued its 1,653-page final rule on Nov. 2, its list of ways healthcare practices can be reimbursed for leveraging information technology now includes new payment options for telehealth.

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Kno2®, the company that provides Interoperability as a Service™ (IaaS) to everyone in healthcare and ClinicTracker, a mental health and substance abuse electronic health record (EHR), today announced a partnership agreement. Kno2's IaaS provides an immediate path to interoperability, enabling the electronic exchange of patient information between ClinicTracker's behavioral health agencies and other healthcare providers throughout the continuum.

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If you live in a part of the world that experiences cold weather, it’s time to winterize your home. Close all the windows tightly, wrap pipes with insulation, add weather-stripping or caulk to doors. As our frugal elders would say, “There’s no sense spending good money to heat the outdoors.”

A similar concern applies to behavioral healthcare agencies; if you work hard to run an effective and efficient practice, you don’t want to lose profits by leaking money. The complex billing requirements of mental health and substance abuse agencies create many opportunities for even the best-intentioned practices to spring leaks that cost you productivity and profits.

Thursday, 12 October 2017 15:57

5 Ways To Streamline Your Behavioral Health Billing

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If time is money, you must make every process related to managing revenue as efficient as possible, from the moment you set appointments until payments arrive. Effective revenue management means you get paid as much and as quickly as possible. Because mental health and substance abuse agencies face unusually complex billing and reporting requirements, streamlining operations is especially important.

ClinicTracker Small Practice Bundle

ClinicTracker introduces a Small Practice Bundle that fully addresses the needs small practices have for an EHR and Practice Management system. By including expert Billing Services, it even solves the thorny problem of managing the revenue stream. Providers can focus on patient care instead of handling insurance claim rejections and other billing headaches.

Change Healthcare Partnership

ClinicTracker, a mental health and substance abuse EHR, has collaborated with Change Healthcare, one of the largest, independent healthcare technology companies in the United States. The ClinicTracker lab integration allows agencies open access to more than 600 labs across the country. It will facilitate smoother interactions between providers and labs when processing lab orders, viewing automated results, and creating reports within ClinicTracker.

Tuesday, 12 September 2017 13:23

Effects of Coordinated Care on Mental Health EHRs

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The promises of coordinated care are simple: better quality of care, improved patient outcomes and cost savings. In the words of the U.S. Department of Health & Human Services (HHS), coordinated care “involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care.”

EClinicalWorks Meaningful Use Lawsuit

In a momentous legal settlement, eClinicalWorks (eCW) was fined for lying to customers about its electronic health record software being Meaningful Use certified. Investigators also found that eCW was unlawfully paying influential customers a total of $392,000 in kickbacks for recommending their products to prospective customers. Even more accusations were uncovered when Brendan Delaney, a new customer in the process of implementing their EHR, indicated several software issues that put patient safety at risk. Among other things, eCW failed to sufficiently test their software and correct urgent software bugs before release.

EHR Productivity Features

Even without the uncertainty about the future of the country’s healthcare delivery system, behavioral health and substance abuse providers face significant challenges. Demand for services is up, thanks to the devastating opioid addiction epidemic and rising suicide rates. At the same time, the population of practicing psychiatrists declined by 10 percent between 2003 and 2013, and 55 percent of U.S. counties have no psychiatrists at all.

Top Mental Health EHR Features

Many electronic health record systems tout a vast array of features – automatic call reminders, billing, scheduling, form generators, paperwork templates, scanning, and just about anything that addresses customers’ needs. Our system, ClinicTracker, offers so many features that we’ve often shied away from listing them all, fearing that we might overwhelm prospective users. Simplicity has a certain initial appeal, even though complex capabilities inevitably prove essential for tailoring an EHR to an agency’s specific requirements.

Friday, 07 July 2017 13:37

What To Expect From Your EHR Vendor

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Selecting an EHR VendorBefore 2000, nine out of 10 U.S. doctors updated their patients’ records by hand and maintained paper files with demographics and treatment notes. In the last decade, though, physicians – motivated by mandates and hoping to improve patient outcomes and their bottom line – have increasingly embraced EHRs. As of 2015, 87% of office-based physicians had adopted some form of EHR; that’s up from 42% in 2008. By this March, 67% of all providers (office-based or otherwise) reported using an EHR. Responding to the growing need, at least 1,100 vendors offer an EHR.

ClinicTracker Medical Billing Service

ClinicTracker’s Billing Service emerged from the frustration many agencies experienced trying to find a high quality medical billing service dedicated to managing the complex billing requirements of mental health and substance abuse agencies. Most of these organizations have found that general medical billing services simply are unprepared to manage revenue in the world of behavioral health. For example, most services do not have the capacity to automate billing overrides specific to mental health claims or process institutional claims (paper UB-04 or electronic 837I). ClinicTracker handles those requirements and more.

Budgeting for an EHRUnless you have endless resources, it makes sense to do some homework before committing to a major purchase. Whether looking for a house, a vehicle, or a new sound system, savvy shoppers read up on preferred features, performance records, and prices. The same goes for healthcare agencies selecting an EHR. Behavioral healthcare and substance abuse practices, which typically entail complex billing and reporting procedures, require features that suit their unique needs. These tips will help you budget and prepare for this important transition.

ClinicTracker EHR is compliant with Wyoming Client Information System regulations"Greater Columbia Behavioral Health (GCBH) is one of several Behavioral Health Organizations (BHOs) in Washington State. GCBH manages a network of Behavioral Health agencies located in Asotin, Benton, Columbia, Franklin, Garfield, Kittitas, Klickitat, Walla Walla, Whitman and Yakima counties. GCBH operates through an Inter-local Agreement with these 10 counties to provide services through contracts with the State of Washington." (www.GCBH.org, 2017)

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ClinicTracker, a robust, future-proof mental health and substance abuse EHR, announced that it is partnering with TSI to provide an automated collections interface for users seeking a more productive collections process.

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No question about it – figuring out how to move old data into a new EHR can be intimidating. For mental health/substance abuse agencies, the change requires handling mountains of records required by insurance companies and regulatory agencies as well as complex reports and billing information. As with any big project, it helps to break the tasks into discrete goals and actions. These steps will help you plan your data migration and make the process go smoothly.

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ClinicTracker, a mental health and substance abuse EHR, has partnered with Paper Alternative Solutions, Inc., a leader in paperless strategies and document management. This collaboration offers ClinicTracker’s new customers a way to convert their old paper records to a format that makes them accessible – without having to input the information manually. Implementing ClinicTracker becomes far easier for agencies when they have an efficient method for handling years’ worth of paper charts stored in file cabinets.

A recent Philadelphia news story reported that six people within a few blocks died as a result of heroin overdoses in the same day. It’s just one of many heartbreaking headlines pointing to the country’s devastating opiod epidemic. The toll has been high. According to the Centers for Disease Control and Prevention, 2015 saw 12,989 heroin-related deaths in the United States.

gI 62619 ClinicTrackerNewVersion(1)

ClinicTracker has completed a full-scale modernization of the platform underlying its unified Electronic Health Record (EHR), practice management, and billing software. This significant technological upgrade makes ClinicTracker even more attractive to those mental health and substance abuse agencies searching for an EHR that is both robust and future-proof.

Affordable Care Act

Because the Affordable Care Act (ACA) lists mental health and substance abuse treatment as one of ten “essential benefits” that all private insurers and Medicaid must cover, more patients have been receiving treatment. Of the 20 million people who gained health insurance coverage under the ACA, an estimated 29 percent have a diagnosable mental illness, substance use disorder, or both. An estimated 2.8 million people with substance use disorders, including 220,000 with opioid disorders, have coverage under the ACA.

Wednesday, 15 February 2017 15:08

The Path to a Successful EHR Implementation

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Implementing a new – or first – EHR into your mental health or substance abuse practice can be intimidating. You already know the main benefits: less paperwork, greater efficiency, and improved productivity. That means your staff saves time, which translates into better patient care and higher profits.

But getting there takes time and planning, especially for behavioral healthcare practices that deal with mountains of paperwork and face complex billing and reporting requirements. There’s no question that setting up an EHR system takes a lot of effort. Here are a few guidelines to make the process less stressful:

trump obama ACA

During the presidential campaign, Donald Trump vowed that on Day One as president he would “repeal and replace” the Affordable Care Act (ACA), which has resulted in an estimated 20 million people gaining health insurance coverage since 2010. After winning the election, Trump backpedaled a bit, suggesting he may retain parts of the ACA. But his pick for secretary of health and human services, Tom Price, strongly opposes the ACA. Meanwhile, Republican lawmakers continue promising to dismantle President Barack Obama’s signature healthcare law, which lists mental health and substance abuse treatment as one of 10 “essential benefits” that all private insurers and Medicaid must cover.

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When the healthcare industry began transmitting claims electronically, Medicare and large insurance payers envisioned clearinghouses as a way to manage the flow of information. Clearinghouses are software-based hubs that allow healthcare practices to transmit protected health information in a secure, efficient manner. Healthcare facilities can consolidate electronic claims and manage them from a single location through an online dashboard. After clearinghouses scrub claims, they transmit electronic claim information securely to the insurance carrier for reimbursement.

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