Insurance Payers Caustic Demeanor Towards EMR

Posted on November 1, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently got an email from someone who told of a practice manager that was concerned with the insurance companies demeanor when it came to EMR. Here’s a short description of their concern:

He [A practice manager] mentioned he’s noticed and heard from many physician colleagues that the insurance payers really seem to be getting more of a caustic demeanor and approach with their subscribers. In particular, they don’t seem to care that an EMR is being used. If anything, they seem to challenge the notes saying the physicians are just using a template and not doing what they say. My caller wanted to know if we were seeing more of this. I think some payers are changing demeanor in preparation for upcoming cuts due to health reform.

This type of reaction is something to definitely be concerned about. Back in Feburary of this year I posted about the difference in an EMR that does Documentation by Exception versus Documentation by Veracity. In that post, Matt Chase from Medtuity does a great job describing the difference in documentation methods.

It’s really kind of interesting to see that the insurance companies becoming caustic towards this template based EMR notes that basically post a bunch of junk in the note that may or may not have been done. I don’t know a single doctor who likes those types of notes. In fact, most people hate them. Well, I guess I have seen many doctors who liked this type of note because it allowed them to bill the insurance companies at a higher level than they were documenting previously.

As I write that last line, I guess it’s no wonder that the insurance companies are kicking against this type of documentation. Especially since they’re always looking for ways to save money. Although this spells trouble for many of the large EMR vendors that are designed to document using this type of method.

I guess we can give credit to the insurance payers for something if they can help to end the long, useless, hard to read, templated based notes that are just designed for reimbursement and not better patient care.