How an EMR Helps Pathology Billing and Management

By Darren Whittemore, DO, Dermatopathology at PathologyWatch

If there’s one thing that is constant in healthcare today, it’s change. In our post-pandemic healthcare environment, remote care is essential, and pathology billing and management rely on digital tools for better accessibility and efficiency. But how do EMRs help pathology billing and management?

More than 89 percent of all hospitals have adopted the use of an EMR system or the more overarching electronic health record (EHR) system, which aggregates multiple EMRs to create a more comprehensive collection of patient care. But what do they do exactly? EMRs have many benefits for patients, pathology practices, and medical billing services to ensure departments work together and operate efficiently, even if they are remote. Here are a few of the more common benefits.

How an EMR helps Pathology Practice Management

Experts estimate that most healthcare providers spend around 14.4 hours each week finalizing prior authorizations alone. That doesn’t take into account the delays created by relying on outdated information or data input errors by your office staff. And at what cost? This is valuable time taken away from your patients. 

The incorporation of an EMR system can provide a reduced margin of error in overall patient care due to incomplete or missing records. In fact, as many as 75 percent of providers credit improved patient care to an EHR system, with 88 percent reporting clinical benefits for their practice. EMRs also minimize the need for on-site storage of physical patient records. Because records are stored virtually, not only are they more easily accessible, offices also no longer need to store a backlog in filing cabinets or boxes, which can cost more than $2,000 a year to maintain.

EMRs can create a singular system for charting, including physician notes, pathologist findings, whole-slide images, also known as interoperability, which allows for different systems to share the same patient information between them. While this may not be the case in regards to hospital-based pathology practices—as they are more likely to use the same EMR system as other practices in the hospital—interfacing EMR systems from other practices can require additional technical support in order to achieve interoperability. The benefits of doing so include clearer communication between practices and more accurate diagnostics, resulting in an overall improvement in patient care.

How an EMR helps Pathology Billing

Did you know that insurance claim denials increased by 23 percent in 2020? With governmental changes in healthcare delivery, prior authorizations for medications, coding, and a shift in payer/provider billing models, the administrative burden to sort through these changes to submit valid claims falls on the provider.

A more effective and efficient billing system relies on sharing and processing information quickly. It’s what motivated payers to push for digitizing patient data in the first place, and it has transformed patient care into a coordinated and easily shareable system–on the condition that healthcare providers have the most current billing information. 

According to InstaMed’s Tenth Annual Trends in Healthcare Payments Report, many providers are struggling to keep up with increases in patient collections, with 87 percent of them still leveraging paper and manual processes. Like any other medical service, pathology has its own unique set of requirements when it comes to billing. Those requirements can become even more complex for hospital-based pathology services, as regulations and payer requirements are not only frequently being updated, but so are hospital compliance and other rules.

Among regulations that have recently been updated are the latest changes made to CPT codes. Because coding is a vital element of billing, it’s important that these updates are understood and implemented to provide an accurate assessment of the medical services provided. Once updated, EMRs can then be securely shared with insurance companies and billing services—like AdvantEdge—thereby reducing errors, mitigating paperwork, and eliminating redundancies.

While technology in the healthcare industry is constantly evolving, EMRs are becoming the new gold standard for patient records. Their applications extend beyond improved patient care and accessibility into enhanced practice management and billing solutions for pathology practices. Contact AdvantEdge today to learn more about customized billing, coding, and practice management solutions.