EMRs & Fraud

January 1, 2007

I am wondering about the hoopla I am hearing about “canned” documentation not being up to par and how carriers might deny service documented on EMRs as not medically necessary.What have you heard?

Question: I am wondering about the hoopla I am hearing about “canned” documentation not being up to par and how carriers might deny service documented on EMRs as not medically necessary.

What have you heard?

Answer: That is what I'm hearing, too.

Creating canned documentation - in which you can’t tell one patient from another - is clearly good for neither patient care nor documentation.

On the other hand, the only reason payers care is because so many practices are charging higher E&Ms thanks to their EMRs.

The bottom line: You should be able to purchase an EMR that produces accurate (not canned) documentation. If that documentation is complete and it supports a higher code, then you should bill for it and appeal it if denied.

It’s a matter of creating good notes, not a matter of all EMRs being insufficient.