Freedom to Be a Doctor

By Dr. James Winnickwinnick, Stockton, CA

There’s no denying that the movement from paper charting toward electronic health records is well underway. While many factors have contributed to EHR adoption, I noticed two distinct attitudes toward this movement from my colleagues:

  • They were active adopters of an EHR because they prided themselves on having the latest technology, and they realized the increased efficiencies that EHRs provide over paper; or
  • They adopted an EHR reluctantly—kicking and screaming—because government regulations threatened to pinch their bottom lines if they didn’t.

Whatever your attitude toward EHRs, the outcome is the same: you’re now charting with a computer.

I admit, early EHRs rubbed me the wrong way. They seemed to disrupt the doctor-patient relationship. I was bothered more by my own experiences as a patient rather than as a doctor. More times than I would like, I had the pleasure of talking to my doctor’s back as he asked me questions over his shoulder, locked to his keyboard and typing my responses. It seemed to me that experiences like that are impersonal, and I swore I would never replicate that experience in my practice. Looking a patient in the eye, listening, conversing and showing that I genuinely care about why they’re sitting in my examination chair are important to me. Jotting notes in a paper chart on a clipboard has allowed me to maintain that relationship. So, how does a doctor maintain that close doctor-patient interaction amid increasing pressure to adopt an EHR?

Well, some doctors still take written notes during the patient visit. They then enter their notes into the computer, or delegate this task to a staff member, after the patient visit. Some doctors have employed scribes. Both of these techniques allow the doctor to maintain the personal patient interaction. But, both methods cost the practice additional time and money.

Another solution is using a tablet, such as an iPad. They’re light and mobile like a paper chart on a clipboard, and yet they’re also powerful and intuitive. EHR companies have recognized these advantages as well, and are now offering native tablet apps for their latest generation products. For a doctor, tablets break the chains that tied us to the keyboard and pulled us away from our patients.

My practice adopted Eyefinity EHR on the iPad. Because of its light and mobile nature, I can use my iPad for charting exactly how I used to with paper charts. I’m able to face the patient, converse with them, and simply swipe my finger to enter findings as I go. The app can record normal findings for numerous procedures at once, so I don’t spend time documenting “clear” for each individual structure I examine. New adaptive learning technology within Eyefinity EHR actually changes and builds my drop-down menus to match my most commonly used plans and treatments. When I’m done with my examination, my output notes are clear and complete, and my staff can actually read them! If I haven’t completed and documented enough elements of the examination to justify the billing code that I want for the visit, the program tells me what I’ve forgotten. My material orders, medical prescriptions, and billing codes are all sent to the next user with the touch of a button. And, the following year, all of this information is brought forward to the next visit—without looking for a chart!

Before tablet-based EHRs were available, I always said that nothing could beat the speed and efficiency of a doctor documenting with paper. Eyefinity EHR on the iPad has changed my opinion. Being able to maintain the freedom to move around my exam room and office like I would with a paper chart and being present with my patients, all while gaining all of the advantages of an EHR system, has revolutionized the way I practice. I believe it’s the very best way to deliver superior service to my patients and grow my practice.


Down to the Wire: Testing Insurance Claims with ICD-10 Codes before October 1

oct1The transition to ICD-10 is now just weeks away. Hopefully, you have already upgraded your practice management and electronic health records systems. If you’re an OfficeMate/ExamWRITER user, you need to be running version 12; if you haven’t downloaded it yet, you can do so now on MyInstallCenter.  If you’re an Eyefinity Practice Management, Eyefinity EHR, or AcuityLogic user, you’re good to go—there aren’t any upgrades that you need to complete!

Once you’re using updated software, nearly everyone from CMS to the AOA is encouraging you to work with your insurance clearinghouse or insurance carriers and send them test insurance claims with ICD-10 codes. Submitting test insurance claims that contain ICD-10 codes will give you practice in using ICD-10 codes; help you work out any transition quirks with your clearinghouse or carriers before the deadline; and, hopefully, instill confidence in your office’s ability to submit insurance claims and get paid after October 1.

Your insurance clearinghouse or insurance carriers should have provided you with ICD-10 testing information; if they haven’t, contact them.

Remember that if you are using OfficeMate/ExamWRITER 12, you can change the ICD-10 start date for individual insurance carriers, making it easy for you to send test data with ICD-10 codes to carriers. For additional help in preparing for and testing before October 1, review the OfficeMate/ExamWRITER ICD-10 Readiness Checklist and view the step-by-step instructions in the Eyefinity Support Community. If you’re using Eyefinity EHR, Eyefinity Practice Management, or AcuityLogic, review the material in the Eyefinity ICD-10 Resource Center for information on sending test data with ICD-10 codes to carriers.

Test now. The transition to ICD-10 is right around the corner.

Internet Explorer 7 Users: Upgrade Your Web Browser Today!

Did you know that older versions of Internet Explorer are no longer supported by Microsoft? That means those browsers aren’t receiving critical security patches.

Our top priority at Eyefinity is protecting the security of your patients while striving to keep up-to-date with the latest technology. To keep up with security standards, we will no longer be supporting Internet Explorer 7 on Protect your practice from security threats by updating your browser if you are still using this version of Internet Explorer.

Keeping your browser up-to-date has many additional benefits beyond Newer browsers take advantage of advancements in technology to run smoothly at a faster speeds. Many modern websites won’t work correctly in older browsers, leaving you unable to access all the benefits and functionality. Take advantage of the benefits that a modern browser can provide. Protect your practice and your patients by ensuring that you are using a modern browser version.

VSP steps into the classrooms at CSU Sacramento

VSP_Class2Last month, VSP was given the opportunity to participate in Sac State’s Academic Talent Search program with a week of optometry focused instruction. The class, titled “The Human Eye: Surgeries, Sight, and Spectacles,” allowed 6th-9th grade students with special interest in optometry to experience a hands-on introduction to the industry.

Dr. Jim Winnick developed and taught the class, with assistance from Rhonda Wilson of the Industry Outreach team. The instruction was designed to give students an inside look into the eyes and show how medicine, vision, engineering, and eyewear are connected.

“Teaching is the ultimate form of knowledge sharing. I’ve always enjoyed helping people better understand the visual system and the eye care profession,” said Dr. Winnick. “Teaching these young students was a bonus, as they seemed very engaged and interested in what they learned. My hope is that we left a positive impression with them as they continue their schooling and plan out their career paths.” Over the five-day class, Dr. Winnick and Rhonda welcomed several guest speakers from VSP Global, VSP Optics Group, The Shop, and VSP Mobile Eyes who provided an overview of the program and gave tours on board the mobile clinic.

Students who successfully completed the course requirements – participated in class, turned in homework assignments, passed the final exam and earned an “A” or “B” grade – received one unit of high school credit. What a great way to expose students to the optometry profession!

CMS and AMA Helping Doctors Get Ready for ICD-10

Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) teamed up to help doctors ease into the transition for ICD-10 on October 1, 2015.

Here’s a quick overview of the Guidance regarding ICD-10 flexibilities. The Guidance is for all services paid under the Medicare Fee-for-Service Part B physician fee schedule.

  • Claim Denials. For 12 months, Medicare claims will not be denied solely based on the specificity of diagnosis codes, as long as they are from the appropriate family of ICD-10 codes.
  • Quality-Reporting Penalties. CMS will not impose penalties for the Physician Quality Reporting System, value-based payment modifier, or meaningful use based on the specificity of diagnosis codes, as long as they use a code from the correct ICD-10 family of codes.
  • Payment Disruptions. CMS can authorize advance payments, if Medicare contractors are unable to process claims as a result of problems with ICD-10. To apply for advance payment, the doctor is required to submit the request to their appropriate Medicare Administrative Contractor (MAC).

Visit to learn more about the CMS/AMA joint announcement and the Guidance, including these FAQs.


Prepare Now for ICD-10’s Uptick in Claim Denials

By A.J. Johnson, General Manager of Analytics Solutions, TriZetto Provider Solutions

Operational costs for providers continue to rise while reimbursement rates decline. The transition to ICD-10 is expected to compound this problem with denial rates projected to rise anywhere from 100 to 200 percent.1

Providers can offset these financial challenges by identifying, appealing, and tracking claims that were denied incorrectly. This can seem like an overwhelming task, so focus on harvesting your “lowest hanging fruit” to see a better return on your time investment. Here are two ways to identify which denials will yield the highest return when appealed.

  1. Focus on denials with the highest probability of getting paid. These are denials that you can most easily address, such as denials where information was missing from a field or where coding or data was incorrect due to human error. You can quickly fix this information and resubmit the claim for reimbursement.
  2. Other denials may be out of your control, such as denials due to a service that was never documented or benefit eligibility issues. You won’t be able to convince the payer to pay for undocumented services or change their fee schedule contract, so these denials are not worth your time to appeal. However, to help stop this type of denial from occurring in the future, you should go back and review your eligibility verification process to ensure it is working correctly.

Of all the efforts you put toward ensuring your organization is financially successful, managing denials may be the most critical step – TriZetto Provider Solutions’ commitment to aiding smooth transitions to ICD-10 is reflected in our service contracting. We offer Eyefinity customers access to several tools for analyzing current revenue cycles, collecting outstanding reimbursements, and planning for challenges you may face as a result of ICD-10.

Visit to find out how TriZetto Provider Solutions can help you start preparing today.

1 Work group for Electronic Data Interchange, White Paper: ICD-10 Critical Metrics, October 5, 2012


Upcoming Meaningful Use Hardship Exception Deadline

Summer’s here, and the July 4 holiday weekend is around the corner. Before packing your bags or lighting up the grill, take a moment to review the meaningful use hardship exception guidelines. The deadline to apply for a hardship exception and avoid a 2016 payment adjustment is July 1 at 11:59 pm ET.

You do not need to file a hardship exception if any one of these scenarios applies to you:

  • You successfully demonstrated meaningful use in 2014;
  • You’re a hospital-based provider; or
  • You’re a new eligible professional who didn’t file Medicare or Medicaid claims in 2014.

You can only file for a hardship and avoid the payment adjustment if you weren’t able to achieve and report meaningful use due to circumstances outside of your control. For example, if you used a vendor prior to coming to Eyefinity who was not able to get their EHR software certified in time, you might qualify for a hardship.

The timeline for hardship exceptions and payment adjustments can be confusing since the payment adjustments occur two years after the participation year.

If you failed to participate in this calendar year… File for a hardship exception by this date… To avoid a payment adjustment in this year…
2014 July 1, 2015 2016
2015 July 1, 2016 2017
2016 June 30, 2017 2018

To help you determine if a hardship exception is right for you, use the Hardship Exception Tool. For more information about filing a hardship exception, refer to CMS’ Payment Adjustments and Hardship Exceptions page.


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