The Future Of CAPD And ICD-10 Processing Software

Hiteks has teamed up with leading EHRs to deliver a suite of real-time Computer-Assisted Physician Documentation (CAPD) software set to open the doors to the highest functioning healthcare billing system in history.

Healthcare is changing. Fee-for-service and value-based care, coupled with the adaptation of new ICD-10 compliance standards, has left insurance companies in a position to deny coverage to those who fail to follow the proper coding system protocol. But because of its complexity and expansiveness, clinicians are overwhelmed, as they struggle to adapt to a system that pools tens of thousands of codes into a single documentation and billing system. The demand for thorough clinical documentation improvement (CDI) software has never been greater. Here’s a brief explanation of how Hiteks is addressing this problem to bring CAPD functionality directly to physicians in their workflow, bypassing many of the queries or inappropriately coded charts.

HCC Risk Adjustment

AdvocateMD powers Epic NoteReader and serves as the flagship solution of Hiteks’ expanding Insight: Real-Time Revenue Rescue suite. Hiteks automatically codes all relevant HCC risk adjustment, MCC, CC, and DRG diagnoses in real-time. It is a software solution that utilizes artificial intelligence to minimize the amount of time spent on documentation by optimizing notes, monitoring quality, and providing immediate (within one second) feedback to providers. Feedback includes specificity of diagnoses, suggested treatments, and what information in the provider’s notes is missing or requires further investigation and/or documentation.

Hiteks allows providers to cover their bases more thoroughly prior to presenting their notes to the billing department. This, in effect, lessens the number of coding queries, which has been an issue that has delayed processing for years. The result of AdvocateMD in the medical workplace will be faster and more accurate compensation to physicians, as well as better and more immediate coverage for care and prescriptions to patients.

Workflow And Case Mix Index Optimization

Hiteks’ CDI software, ConcurDI powering Epic NoteReader CDI, also acts as a centralized source of information and data. This streamlines workflow, allowing for better communication between providers, which leads to higher provider and patient satisfaction. Through a single click providers now have the ability to add documentation into their EHR to optimize Case Mix Index (CMI) and Risk Adjustment Factor (RAF), keeping the CDI, HIM and CFO functions happy.

Hiteks Solutions is a collection of physicians and technology specialists who have a vision of a more cohesive healthcare community. To learn more about Hiteks’ Insight: Real Time Revenue Rescue suite and how it’s changing the way physicians and other healthcare providers think of HCC Risk Adjustment, Case Mix Optimization, CDI, ICD-10 compliance, and Enhanced Surveillance and Quality Monitoring, contact them via email at info@hiteks.com or by phone at 212-920-0929.

Hiteks Delivers VigilantQA With Its Professional Package

Healthcare billing in the United States involves a rigorously complex chain of events. It requires cooperation between a range of individuals and departments. This inherently means that there’s a high margin for error. Moreover, healthcare billing standards remain in constant flux due to an imbalanced political climate. As it stands, if either Medicare or Medicaid notices that one or several physicians have been improperly billing patients or insurance companies, the entire facility for which the physicians work runs the risk of falling victim to potentially detrimental audits, clawbacks and legal action. What starts as a careless mistake often metastasizes into a series of inappropriate measurements and indicators. And this can lead to poor patient satisfaction and reduced revenues.

How Doctors Can Inadvertently Bankrupt Their Employers

During patient examination, a physician must determine the nature and severity of the patient’s visit. The doctor must determine how many of the patient’s systems he or she should check. He or she must base this decision on a series of variables, namely the patient’s medical history, how many visits he or she has had in the past year, and whether he or she is showing any signs of distress in particular regions of the body. How many systems that the doctor examines determines what’s called a level. And it’s this level that determines how much the hospital can bill the patient. Then the billing department sends this bill to an insurance company.

The problem is that the level selection process is tremendously complex. Physicians frequently misjudge how many systems they should check. As a result, they can sometimes spend an inappropriate amount of time on each patient. If a physician makes an incorrect judgment when selecting a patient’s level, he or she may end up spending too much time with the patient, thus charging an insurance company an inaccurate amount of money. This, in turn, can lead to poor patient satisfaction and sometimes more severe consequences.

How Hiteks Plans To Protect Hospitals From Their Employees

With the Hiteks’ VigilantQA Software, we aim to vanquish that margin of error. We want to protect physicians from themselves, and thus protect the hospitals that employ them. Our plan is to do so by eliminating the possibility of improper diagnosis and/or inaccurate level selection. We believe that doctors should have real-time reminders and support that’s consistent with the billing system criteria. We also believe that each and every patient should get the time and attention that he or she deserves. With our VigilantQA Surveillance for Sepsis and other Patient Safety Indicators, equipped with automated diagnosis improvement and CDI software, doctors will know precisely how much time they should be spending with each patient and what to focus on.

Hiteks’ software comes in three packages, which we distribute all throughout the nation. To learn more about our products, give our office a call today at 212-920-0929.

CDI Software And Defining Medical Necessity

Hiteks’ Insight: Real-Time Revenue Rescue includes clinical documentation improvement software which combines back-end coding logic with front-end physician queries in real-time as the doctors are completing their Notes. Our ConcurDI is Documentation Improvement for the health system which cannot get through all its records through traditional CDI programs. Hiteks Solutions is a 6-year old company with a mission to give patients the quality of treatment they need while ensuring that their physicians receive the compensation they deserve. Our software is being used by hundreds of hospitals and thousands of physicians and nurses throughout the country.

The Best Quality Care In A Problematic Billing System

The United States boasts the highest quality healthcare in the world. We have the best technological resources and the top ranked hospitals and universities with the most progressive and experienced physicians and researchers on the planet. But most average Americans could tell you without batting an eye that our healthcare system is not without its flaws. One of the greatest obstacles we face is in the sheer complexity of defining the cost of medical service and the interactions between insurance, doctors, hospitals and patient financial responsibilities.

The Evolution Of A Complex Value Based Care System

Recent memory shows a spike in costs for healthcare. It is for this reason that physicians have begun to follow a value-based care (VBC) system. But determining the value of care is not as simple as it one may think it should be. While the system largely bases cost and value on patient outcomes, it must also factor in the use of hospital resources, the amount of time the doctor spends with the patient, and the amount of experience the doctor has. One of the most crucial factors that many physicians often overlook is the degree to which further treatment is necessary.

Rising Costs Lead To Rising Pressure On Physicians

With the rising cost of care that is putting pressure on hospitals throughout the country, physicians have a greater responsibility to be increasingly conscious of their use of hospital resources. They must construct a clear treatment plan that strictly utilizes resources that are necessary, based on the patient’s diagnosis, which the physician also has to define. Throughout this process, the physician has to document all of this with enough detail to convince insurance companies that their use of resources and time that the physician spent with the patient was completely necessary. In the event that the physician does not document his or her diagnosis and treatment plan with enough detail, it will usually cost not only the physician, but also the hospital for which he or she is working.

The Solution

Hiteks’ Insight: Real-Time Revenue Rescue will put an end to this problem. Our software automates the documentation process, so that at no point can an insurance company claim that a diagnosis was overly vague, that a treatment plan was poorly defined, or that any hospitalization or treatment was medically unnecessary. With Hiteks’ clinical documentation improvement software, physicians need only follow an easy-to-use and clearly laid out system. Now hospitals and physicians will receive the correct compensation. And patients will be able to count on receiving the best possible treatment for their particular circumstances.

Want to learn more about Hiteks’ Insight: Real-Time Revenue Rescue software? To find out about our AdvocateMD, ConcurDI, and VigilantQA packages, give our office a call at 212-920-0929. You can also reach us online at www.hiteks.com.

What Will Customers Demand From Their Software In 2017?

Over the past decade, we have witnessed the rise of artificial intelligence at an unprecedented rate of technological advancement. No longer is AI a feature of science fiction films. We are now face to face with the task of establishing standards and expectations for the AI technology that already exists. Along with AI’s entrance into the mainstream came the popularization of bot-based technology and adaptive software.

Some of these technologies have simply not yet reached a standard that is ready for mass production. For example, you may recall when Internet trolls corrupted Microsoft’s Tay chatbot with hate speech to the point that its makers had no choice but to remove it 24 hours after launching. Meanwhile, we’ve also seen other new technologies enter the market that are actually reshaping entire industries. For example, workflow management and clinical documentation improvement software (CDI) has transformed the healthcare industry to the point that it could become a standard for all hospitals in coming years.

The challenge, thus, is to determine what features of a new software will be most crucial to establishing longevity in a highly competitive field. What will we as a society demand from our artificial intelligence in the years to come? We submit that these three features will be crucial:

Adaptiveness

Our expectations are going to evolve along with the resources that we have available to us. It will not be long before we begin to expect our software to adapt to complex changes in circumstances, and to provide suggestions and predictions for us. For example, one of the most advantageous features of CDI software in healthcare is its ability to organize a sophisticated collection of patient information and provide a diagnosis, treatment plan, and code for billing, which the software draws from a collection of several thousands of options instantaneously.

Omnichannel Integration

The Internet of Things has raised the stakes for software as a whole. No longer will we consider applications that are incompatible with other technologies acceptable. In order for an automation technology to last, it must integrate with its counterparts, to the point that it centralizes everything into one cohesive, easy-to-use organism. Such is the case for Hiteks’ ConcurDI software, which is being showcased nationally to Clinical Documentation Improvement Specialists. Instead of having several separate apps under the same umbrella, Hiteks’ Insight: Real-Time Revenue Rescue software integrates workflow management, documentation, coding for billing, sepsis surveillance, and more into one central application integrated with the data from the EHR and in some cases, communicating back to the EHR to store the audit of responses solicited from the clinical users.

Exceptional Security Features

Hackers pose more of a threat than ever before. Cybersecurity goes far beyond American political campaigns. Hackers have dipped their hands in literally any industry that stores its information online. Hackers have infiltrated cars, homes, and even hospitals, holding their victims for ransom or worse. This, then increases the need for better security features, because lack thereof will eventually lead to customers taking their business elsewhere because it’s too much of a risk to their assets and privacy.

Hiteks Solutions provides front-end, point-of-care solutions for physicians, nurses and Quality Improvement staff in as many as 15 different states throughout the US. To learn more about how we are influencing the medical industry, give us a call at 212-920-0929 or reach out to us via email at info@hiteks.com.

How Risk Adjustment Software Helps Insurers Adapt To Modern Times

The Affordable Care Act, enacted in January 2014, has changed the face of healthcare in the United States. The bill is best characterized with the three Rs: Reinsurance, Risk corridors, and most importantly, Risk adjustment. Here’s how the risk adjustment program embedded in the Affordable Care Act (ACA) has changed how health insurers conduct business in America.

The Problem That Brought Us Here

The United States is a nation with a capitalist mentality. Historically, we have embedded our values in private enterprise. Government intervention, even for healthcare, is limited to senior citizens. There are many advantages to encouraging competition in the marketplace. But it also entails that the enterprise prioritizes self interest. This can create problems when it comes to health insurance.

For decades, insurers were notorious for denying applicants who had previously suffered illnesses. That included anyone who’d received treatment for conditions that could potentially become expensive for the insurance company in the future. But as a result, people who needed health insurance the most were often denied coverage, simply because they’d had a preexisting condition.

How Risk Adjustment Aims To Fix The Problem

Risk adjustment prohibits insurers from denying applicants the right to insurance due to preexisting conditions. Furthermore, insurers must relocate money that they earn from lower risk clients in order to help fund those with higher risk. This theoretically should eliminate the incentive of denial due to preexisting conditions. Instead, it’s more beneficial for companies to compete based on the quality of their care, and remain open to all applicants. Not just the ones who pose the least financial burden on the companies.

Hierarchical Condition Category (HCC) Risk Adjustment In 2016

The Centers for Medicare and Medicaid Services (CMS) first introduced HCC Risk Adjustment to us back in 1997. But never before has it been so relevant. It is a form of medical coding for billing that helps identify individuals who have chronic or more severe illnesses and conditions. They then assign a score based on the findings, which they determines the cost of care. This is all based on the International Classification of Diseases – 10 (ICD-10) system of codes. A risk adjustment factor score once was the dread of those who were too sick to receive care. Now it’s an opportunity to determine an appropriate plan of action for each patient moving forward.

How HCC Risk Adjustment Software Helps Us Adapt

Hiteks Solutions is a clinical documentation improvement (CDI) software company. We offer mobile device packages to healthcare facilities that allow them to determine an HCC Risk Adjustment score in real time. Our Real-Time CDI technology is appearing all across the nation, allowing insurers and healthcare providers to stay better in touch with patients, coders, documentation specialists.

We are headquartered in New York City but have clients all throughout the nation. Wherever there’s a need for improved documentation practices, we want to be there. For more information on our products, give us a call today at 212-920-0929, or feel free to reach out to us on our contact page.

The Challenges Of Physician Documentation Software (And Why It’s Still Worth It)

Computer Assisted Physician Documentation Software

With the spreading trend of clinical documentation software becoming mandatory in healthcare facilities across the nation, some physicians are fighting back against the cause. As is the case with any transition, there are always a number of bumps along the way. We are in the midst of a culture clash between generations. And in a field as sensitive as medicine, resolving such a clash comes with its fair share of challenges. But when it’s all said and done, the fact of the matter is that technology is an asset that we cannot afford to take advantage of. And with enough effort, we can and should get everyone on the same page. But first, it’s important to recognize why this transition into physician documentation software is so difficult for some doctors.

Disrupting The Narrative

Including software into the equation of physician patient interactions can feel like an interference, especially at first. There’s a certain rhythm that physicians craft and develop over the many years of their careers. On top of that, they also tend to think about issues in a certain linear, narrative fashion. The doctor asks the patient a series of questions, the answers of which determine what the following questions will be. But when software determines a percentage of those questions automatically, it disrupts the interaction. This, in theory, can be at the expense of the quality of care.

Why To Overcome The Narrative

Firstly, while such a disruption is reasonable in that change is confusing, it’s not a worthy enough complaint to reverse the movement. This is simply a transition that takes some to grow accustomed to. But it’s thanks to changes like these that humans collectively can now live far healthier lives than those of past generations. In the spirit of moving forward, it’s worth the trouble to make the effort to learn and adapt.

Some Worry The Benefits Of Free Text Will Fade

Also, the routine is different writing something down versus typing something in. Doctors tend to organize things in such a way that makes sense to them. By requiring them to use a device that organizes information in such a way that’s different than what they’re used to can cause them to perform their jobs poorly. Because it is outside of their comfort zone. Additionally, free text allows doctors to take note of aspects of the patient that do not fit a category. For example, if a physician determines that a patient is more frail than he or she appears, this is something that requires a side note. These are the kinds of human aspects that may move become less accounted for with the onset of new technological norms.

How Physician Documentation Software Addresses The Human Aspect

Side notes such as the one described above will not fade to the back of the line. On the contrary, that which does not fit a category will be considered extra pertinent information. The greatest challenge is convincing physicians to adopt a new system. That entails convincing them that this system is better than the one that they are used to. But the evidence is there. And with the proper training and education, we can work towards a more succinct future.

Hiteks Solutions offers quality Computer Assisted Physician Documentation (CAPD) software. We operate out of New York City but deliver to clients all throughout the country. For more information on our various packages, give us a call at 212-920-0929.

4 Challenges Of Medical Coding And Why It’s Worth The Effort

Nothing worth doing is ever all that easy. Medical coding, which is the system used for medical and billing purposes in healthcare, is no exception. It’s a challenging career path that demands a tremendous amount of attention to detail. You must have a regimented commitment to mastering the craft. However, if you’re willing to go the length, you’ll find a stable and stimulating job waiting for you on the other side. And now, thanks to modern technologies like Hiteks’ ICD-10 compliant ConcurDI Real-Time Medical Documentation Improvement Software, equipped with Case Mix Index Optimization capacities and a Medical Diagnosis Calculator that can automatically calculate the risk adjustment factor score on a case-by-case basis, coding is easier than ever. There’s never been a better time to be a coder. But before you jump into the deep end, here are a few things you need to know about the job.

Distinguishing grey areas:

One of the trickiest aspects of the job is applying a binary mindset to complex scenarios. Rarely is a patient’s condition as simple as it looks on paper. The coder’s job is to take a vague collection of symptoms, medical history and past treatments. The coder then has to translate that into a concrete collection of codes. Then they send that translation to the billing department for processing. These are the kinds of things that require the presence of a trained professional to apply reason where there is nuance.

Learning the codes:

ICD-10, in the United States, has over 70,000 separate codes. That number will likely increase within the next couple months. Hence why training to become a medical coder takes longer than just a single course. Instead, it’s a two year immersion in medical terminology and the adjacent coding that goes with it. It can be fascinating for those interested in medicine, but it is not an endeavor to be taken lightly.

Immaculate attention to detail:

The hardest phase is the beginning, when you’re still familiarizing yourself with the codes and terminology while also having to think critically so that you can organize them accordingly. It’s enjoyable working to solve the puzzle. The process of combining different information drawn from descriptions and doctors’ notes, ultimately arriving at a final code is stimulating. Just keep in mind that it will be a bit tricky in the beginning.

Keeping up on changes:

Understanding an assortment of codes, conditions, anatomy, and other technical terminology is difficult. The fact that it is in constant evolution adds an additional obstacle. ICD-10 codes are regulated and updated practically every year. That creates a wide margin for human error. This is why the assistance of Hiteks’ Real-Time software can make such a significant difference for all parties involved. With our software, coders will be able to do their jobs more effectively and efficiently. This will cut out the margin for human error and speed up the process.

Coding is for those who have an interest in working in the medical industry and have a knack for detail. It’s a great line of work and it has never been a more accessible career than in 2016. To learn more about how Hiteks is changing how we think of medical coding, give us a call today at 212-920-0929.

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