EHR questions

[Pruce Dental]

Jordan...

I see that you are working hard on EHR certification and saw that many of the features are going to be placed in an add on for an additional fee. How will you be selling the EHR add on? Will it be sold to those that want it by a one time purchase fee or can be gotten by paying a higher support fee? Also if you don't mind answering what type of fee range would you be asking for the EHR add-on- a few hundred or a few thousand? Personally I like some of the features on the EHR list but I am probably never going to qualify for the 30% Medicaid utilization to see a penny from Uncle Sam...

In the beta 7.9 medical history section under the "problems" there is a choice for "active", "resolved" and "inactive"...What is the difference between "resolved" and "inactive" and when should we use which?

in the 7.9 beta there is "formularies" under the EHR tab. Can you give a quick dummies guide to what a formulary is and how they are used?

[jordansparks]

We currently envision a one-time purchase of about $7000. The certification would last for about 2 years, and then a newer version of the EHR would need to be purchased.

I think inactive would mostly be used. Resolved seems to indicate that they were completely cured of the disease.

Formularies are completely useless, but they are one of the requirements. As you may be aware, insurance companies have drug formularies, but they are certainly not going to share them with you. Regardless, we are required to compare drugs to a formulary list.

[Pruce Dental]

Jordan...

Have you decided which features on the EHR list will be in the regular OD versus the sold version? The price tag for two years is out of my budget since I am not going to qualify for any Obamacare dollars. I am curious as to how many others are going to make the purchase because I don't want to be the only one left out and loose a lot of future functionability with OD if additional features are based off of the EHR add-on.

[jordansparks]

No, you won't be missing any functionality. The only reason for purchasing the EHR for $7000 is so that you can get the $30,000 incentive from the government over the next two years.

[Jorgebon]

I was reading up on the criteria we would have to meet in order to qualify as "meaningful EHR users" and maybe get some of the incentive money. Everything was fine until I got to #8:

(8) Record and chart changes in the following vital signs: (A) Height. (B) Weight. (C) Blood pressure. (D) Calculate and display body mass index (BMI). (E) Plot and display growth charts for children 2–20 years, including BMI.

I guess I'm out. This is one of the "core objectives" that are mandatory. I've never met a dentist that plots growth charts or calculates BMI.
Oh well, I never liked the idea of giving the government so much information anyway.
Jorge Bonilla, DMD

[jordansparks]

Yeah, there's a lot of stuff like that. They lump dental into an ambulatory medical category without any special consideration. And they insist that if you want the government money that you need to jump through their hoops. That's why dental software took so long to start the ehr certification process. We were all hoping the government would treat dental differently. But they are having a hard enough time just organizing the medical ehr specs. They pretty much missed their deadlines, so all of the specs are tentative. One of them it totally flawed and useless. Many of them are not practical, but are instead are proof-of-concept that the software could do xyz some day. The testing company had to fill in the gaps and write proper specs for us to follow. Lots of hoops with dubious practical benefits.

[jordansparks]

Our pricing will actually be by provider rather than by clinic.

[atd]

$7,000 per dentist? That's 1/4 of the incentive payment.

[jordansparks]

That seems about right to me. It seems very much in line with what other software companies are charging. One of the main reasons for the incentive is to motivate software companies to include these features. We have to recoup our development costs somehow. That amount certainly isn't locked in by any means. Feel free to explain why you think it should be less.

[jordansparks]

After further comparisons with what other companies are charging, it looks like our final price will be lower.

[savvy]

Can someone please explain this program as it relates to a dentist. I looked over the .gov link and all I saw were Medicaid and Medicare references.
However, I did just take a great course at the CDA Spring meeting called , "Intro to Medical Ins Billing for the Gen Dentist."
I was surprised to learn that more than 50% of what I do as well as more than 80% of what perio and os do is medical isurance billable.

[bcpayne]

I meet all the criteria for the incentive program, so if I get OD with the EHR what is the exact software version that I have to use?

I see that the current trial download is 11.0.41, is that version certified?

In order to be eligible for the money I have to stick with the certified version right?

Do you know if anyone has successfully implemented and been paid for the EHR by medicaid?

Colorado is one of the last states to get the program up and running so I am just waiting for them, they say winter or spring 2012 to accept applications.

[jordansparks]

Yes, that version is certified. You would need to stick with 11.0.x. But if you won't use it for a few more months, we might have certified a later version by then. Offices don't report back to us whether they got paid or not, so we don't really know. But it seems very straightforward, as long as you meet the criteria.

[atd]

We're waiting on the State of Minnesota also - they say 2nd Quarter 2012, but previously they said 4th Quarter 2011, so who knows. You can still do the first part of the registration process through CMS while you wait for your state.

[jparks]

Is there a report that can be used to determine the 30% criteria?

[jordansparks]

SET @FromDate='2010-01-01' , @ToDate='2010-03-31';
/* Percent of appointments by insurance carrier, add the medicaid percentages for a time period to determine EHR eligibility (this query works for current Open Dental users as well as post conversion and trial conversions: if there was no claim for a particular procedure, assumes if patient has insurance currently that the patient had it at time of appointment): Count and % of appointments (or dates where procedures were completed) by carrier over given period, adds up to more or less than 100% because there can be more than one carrier per patient and because non insurance patients are not on the list (although their appointments are part of the denominator for the % appointments) */
/*Adjust above Dates AS needed*/
SELECT A.CarrierName,COUNT(DISTINCT A.PatNum) AS 'Patients',
COUNT(DISTINCT A.ProcDate,A.PatNum) AS Áppointments, FORMAT((COUNT(DISTINCT A.ProcDate,A.PatNum)/(SELECT COUNT(DISTINCT pl2.ProcDate,pl2.PatNum) FROM procedurelog pl2 WHERE (pl2.ProcDate BETWEEN @FromDate AND @ToDate) AND pl2.ProcStatus=2))*100,1) AS '% of visits'
FROM
/*where claims may or may not exist but insurance currently does*/
(SELECT ca.CarrierName, pl.PatNum, pl.ProcDate
FROM carrier ca
INNER JOIN insplan ip ON ca.CarrierNum=ip.CarrierNum
INNER JOIN inssub isu ON isu.PlanNum=ip.PlanNum
INNER JOIN patplan pp ON pp.InsSubNum=isu.InsSubNum
INNER JOIN procedurelog pl ON pp.PatNum=pl.PatNum
AND (pl.ProcDate BETWEEN @FromDate AND @ToDate)
AND pl.ProcStatus=2
UNION/*where claims exist but insurance plan may no longer be attached to patient, UNION discards duplicates*/
SELECT
ca.CarrierName, pl.PatNum, pl.ProcDate
FROM carrier ca
INNER JOIN insplan ip ON ca.CarrierNum=ip.CarrierNum
INNER JOIN claim cl ON ip.PlanNum=cl.PlanNum
INNER JOIN claimproc cp ON cl.ClaimNum=cp.ClaimNum
INNER JOIN procedurelog pl ON cp.ProcNum=pl.ProcNum
AND (pl.ProcDate BETWEEN @FromDate AND @ToDate)
AND pl.ProcStatus=2)
A
GROUP BY A.CarrierName
ORDER BY A.CarrierName;

[atd]

I want to make a correction to my previous post where I stated:

You can still do the first part of the registration process through CMS while you wait for your state.

I went through all the steps of having each provider grant me authorization to submit the registration on their behalf, but then when I went to register each of them our state was not available from the dropdown menu. Until your state has something in place you cannot register with CMS.