Do You Need a Scribe?

Over the past several decades, new and interesting healthcare roles have been created to reflect the changing complexities of our health care system. We have seen the proliferation of hospitalists, surgicalists and laborists (in-hospital obstetrical specialists) on the physician side, and patient navigators, physician extenders and patient ombudsmen in the non-physician side. Now, there is an additional and intriguing job title that may gain some traction even in the high-tech era of the electronic medical record (EMR): the “medical scribe.”

The medical scribe, also known as a “clinical information manager,” “medical scribe specialist” or “ER/ED scribe,” is a trained medical information manager who specializes in charting physician-patient encounters in real time. Although originally spawned as an adjunct in the emergency medicine environment, this clerical resource is seeing wide-spread use in the inpatient and outpatient/ambulatory care settings.

The use of scribes has exploded in direct relationship to the negative consequences of EMR use.

In the inpatient setting, the time that physicians are spending at the patient bedside has been drastically reduced in order to spend more time with EMR data entry. The same applies to the outpatient, ambulatory or office setting where physician face-time with patients has seen an equally significant reduction, by some estimates by as much as 30 percent! Not only is productivity negatively impacted but the time that physicians spend during a patient visit capturing and entering data rather than focusing on the patient can be a major drag on the overall quality of care, patient satisfaction and revenue generation. Here is where the medical scribe may serve a very important role.

The medical scribe is an unlicensed individual hired to enter information into the EMR or chart at the direction of the physician or licensed independent practitioner. Through the use of medical scribes, organizations can improve the overall quality of documentation for both granularity and specificity; which in turn improves billing and revenue generation. In addition, by shifting the vast majority of real-time documentation responsibility to the scribe, physicians are able to see more patients, generate more revenue and better manage their time overall so that at the end of a busy day there is no need to finalize one’s charts or enter additional data in the EMR – increasing regulatory compliance!

The positive effects created by working with a medical scribe are legion:

Quality of Care Increases
Patient Volume Increases
Revenue Increases
Patient Satisfaction Increases
Physician Satisfaction Increases
Regulatory Compliance Increases

As more and more healthcare organizations look to implement medical scribes two methods of implementation are being used. Some healthcare organizations look to engage a medical scribe management company while others choose the homegrown method. Each option brings with it certain advantages and disadvantages.

By partnering with a medical scribe management company a healthcare organization is typically entering into a multi-year agreement where the scribe management company will recruit, hire, train, manage, monitor and deliver a medical scribe program. The fees for this service typically fall into two categories – a one-time implementation fee to get the program up and running (typically between $25,000 – $100,000 depending upon the size and scope of the program) and a per hour fee for each scribe used (typically in the $20 – $26 per hour range). So for each scribe FTE the healthcare facility is paying about $48,000 per year (using $24/hour). A nice premium over the $10 – $14 per hour a typical scribe earns.

And for those organizations who choose the homegrown method the task of recruiting, hiring, training and developing competent resources in sufficient numbers becomes a bit of a challenge.

But now there is a third option.  The American Healthcare Documentation Professionals Group, a Certified Academic Partner of the American College of Medical Scribe Specialists will partner with you to recruit, hire, train and oversee the use of medical scribes at your facility. Whether you need one or 100 scribes our online/on-site medical scribe training program might be just what the doctor ordered!

The benefits of our program include:

  • No upfront implementation cost.
  • No ongoing per/hour per scribe fee.
  • An all-inclusive training fee of less than $2,000 per scribe which covers each scribes tuition, books, materials, membership in the American College of Medical Scribe Specialists and certification exam.
  • Flexibility to “customize” the training program to meet the specific needs of your facility.

Contact us today if you need a medical scribe or 101?

Scribes Actually Saving Hospitals Money!

Scribes are growing assets to the hospitals. Yes, some hospitals have the added the expense of Scribes, but it frees up the physicians’ time from clerical work which thus increases their productivity. The physician’s increase of productivity then brings in more money for the hospitals. Check out this article and share your thoughts!
- See more at: MILFORD DAILY NEWS ARTICLE

Medical Billing and Coding Professions, Which one is best for you?

By: Karen Mooney, MBA, BS, CPC, CPC-I, CMSCS, CHI

There is a large misconception from those that are just entering into the medical administration field.  Many people believe that billers and coders are one in the same.  In reality, there is a big difference on the focus between these two categories.  A medical biller is focused on data entry of claims, claims processing, claims follow up, accounts receivable, patient billing, and collections.  Billers also make very strong registration specialists and front desk staff.  A medical biller is a strong strength when it comes to collecting funds due by the patient at the time of appointments as they know what to look for.  Billers are also great enforcers of referrals and authorizations that may be necessary for payment of services.  One other avenue that could work for a biller would be working in the health information department as billers are trained on HIPAA requirements and the need for completed medical records.

When a person is considering a coding profession, there is much more challenge in this aspect due to the level of knowledge that is necessary to perform the duties of a coder.  A coder must understand the working knowledge of the ICD-9-CM as well as the CPT coding reference. Coders are responsible for making sure that when coding services and procedures that the diagnosis that has been provided supports the medical necessity for the service before these are forwarded for processing.  Medical Coders hold a very large responsibility in their hands when performing their daily duties and are completely responsible for what they code.  Coders can find work in physician offices, clinics, hospitals with the right background of training.  From there, coders become quality reviewers, advanced educators, auditors, and consultants.

When individuals are researching new careers, the medical profession is a great choice as there is a long line of stability in the medical profession.  With that said, locating the best focused training is very important to a person’s success.  History has proven that the most direct route into medical administration is through the billing side of the profession.  This provides a great passageway into the field and allows many opportunities to a new comer to the medical field. Practices and physicians are more likely to hire individuals that are right out of school for a billing position versus a coding position.  The reason for this is that the coders hold a large responsibility of a physician’s revenue in their day to day process. Physicians are completely aware of this fact and are less apt to hire a person, right out of school without any live experience in the coding realm.

When researching your career path, and you are looking to learn to become a Medical Biller, then you want to focus on a program that will be sure to provide you with the background knowledge of the types of insurances, patient’s responsibilities, what can and cannot be processed from a billing side of the process and still covering an introduction of ICD-9 and CPT coding.  An introduction to ICD-9 and CPT does not make a biller qualified to work as a coder.  If you are looking to become a coder, be sure that the program offers you an entire review of the CPT coding reference. This process should be a minimum of 3 months to accomplish the course you are looking at.  If you decide that a medical biller and coder is the program that you are interested in, the program should be a minimum of 9 months to ensure that you have learned the skills necessary for both specialties. The most direct process is to become a biller and introduce yourself to the profession in the billing community, build experience, continue to code, then work your way into a coding position within the profession.  Ultimately the final decision is yours.  You need to make the best decision for reaching your final goal. Just remember that anything worthwhile is worth working towards.

It Doesn’t Take a Harvard MBA to See The Value Of Today’s Medical Scribes

In a recent article by Patricia Kirk, published on Wednesday, November 13th, 2013 by the enews/management briefing service Dark Daily, the article makes reference to a claim made by EHR vendors who “contend that the need for medical scribes is temporary because eventually EHR use will evolve in ways that will make scribes obsolete.”

I hope not for a number of reasons.

First off, with a well-documented shortage of well-trained physicians I cannot imagine a scenario where we as a country would want to burden our scarce resource of physicians with the responsibility of doing data entry.  As I have said before this would be analogous to having the CEO of Macy’s operate a cash register or having Tom Brady work the concession stand at half-time.  Unless I was doing some type of wacky marketing thing, if I owned stock in Macy’s (which I do not) or the owner of the New England Patriots (which I am not) I would certainly want to make sure I was getting the most value from my investment and having doctors doing data entry is clearly not the solution. I bet getting the most value from an investment is taught on a regular basis at Harvard!

Secondly, and this one might get a chuckle from many readers, if Obamacare truly increases the number of people with health insurance (40M more people) and those newly enrolled seek additional healthcare services what physician is going to have time to provide these additional services and do the increased level of administrative tasks associated here? This is simply a question of supply and demand…another topic I am sure is taught at Harvard.

And finally, one of the biggest reasons it doesn’t take an MBA from Harvard to see the value of today’s medical scribes is simply this…you do not lower the cost of healthcare by replacing a $12 – $20 per hour resource (a medical scribe or a medical transcriptionist) with a $200 – $500 per hour resource (the physician).  That’s madness and begs the question, why aren’t more hospital CEOs, CFOs, CIOs and physicians themselves seeing this?

To effectively lower the cost of healthcare we need to have the right people, with the right tools (technology), in the right roles, doing the most cost effective work possible.  This includes Healthcare Documentation Specialists of all types, including Medical Scribes and Medical Transcriptionists.  This is why it doesn’t take a Harvard MBA to see the value of today’s medical scribes!

Read more: Medical Scribes Move Outside the ER to Help Clinicians in Other Healthcare Settings Make the Switch From Paper Charts to EHRs