If your practice is in the market for an Electronic Health Record (EHR), I’m sure system price and financing rank among your top concerns. There are two basic EHR models: on-premise, or client-server, and Software as a Service (SaaS), or web-based. Many practices love the SaaS or web-based software, because it works on a subscription model. Did you know there are many financing programs available that allow you to pay for your on-premise systems monthly, just like the SaaS model?

SaaS gained popularity because it works like any other monthly services, such as your internet, cable TV, or utilities. It does not require a purchase – no large amount of cash up front, so essentially it lowers the barriers of entry for practices who want to get started with EHR. The downfall of SaaS systems is that you never own the product. It is like renting an apartment compared to buying a house.

Buying a house, or an on-premise system, makes more economic sense in the long run. You pay off the system and the software is yours forever. Cash gets you the best deal. Just like buying a house, most practices will probably need financing. Financing is attractive, because it allows you to pay for a system monthly, like a SaaS model. This shifts the burden away from your capital budget, and moves it to your monthly operational budget.

Tax Code 179 offers a unique advantage over SaaS systems. The code allows you to deduct the full amount of capital purchases, up to $500,000, in one year. Assuming you purchase a system for $19,000 and your practice is in the 35% tax bracket, you will save approximately $6,600 in taxes, effectively decreasing the purchase price of your software to $12,000. This is not possible with SaaS, because you do not purchase the software.

GSG Capital, our preferred financing partner, offers many attractive plans. They provide deferred payment plans of three and six months. Deferred payments allow your practice to implement your EHR system and get your patient volumes back to normal before you begin paying for the system. GSG also boasts a “stimulus plan special” with nominal payments for the first year, followed by a 48-month term.

GSG also offers some of the most competitive rates. You have many options for financing, banks, credit unions, or other institutions. We have noticed over the years that GSG consistently offers the lowest interest rates, typically around six percent. Of course, rates are subject to change, and will vary based on your credit and purchase amount.

If you are interested in more information about purchasing EHR systems or financing, please contact us at info@xlemr.com. Feel free to contact Todd Greenberg at GSG capital directly via tgreenberg@gsgcapitalllc.com.

The HITECH Stimulus program is in full swing, and many of you may be shopping for a new or replacement Electronic Health Record (EHR). While implementing EHR is important to the future of your practice, the health of your billing system is even more important. Cash flow is the lifeblood of your practice. Without efficient billing, your revenues will decline, and you will be unable to care for your patients.

EHR systems should exchange data with your billing system in two directions: importing demographic information to the EHR, and pushing charges into the billing system. Re-keying information into your billing system is not only time-consuming, it also leads to data entry errors. As you know, even the smallest error can result in denied claims.

Industry experts agree you should not change or adopt an EHR and switch your billing system at the same time. Slowing down your clinical volumes and your billing at the same time can result in a heavy financial burden. Not only will your billing slow down as the staff learns the new system, you may also have to set up all your insurance profiles again. In addition, you may encounter some delay in working with a new clearinghouse.

Next, you have to decide between a single vendor for EHR and billing or the “best of breed” strategy where EHR and billing come from different vendors. There are benefits and drawbacks to each. Using a single vendor is a popular choice for those who only want to call one number for support.

However, combined EHR and billing systems may still be separate systems joined together under a common graphic user interface (GUI). Combined systems usually start life as either an EHR or billing system, and the other piece is either developed later, or acquired through a merger. If the vendor’s expertise was in EHR, the billing system may not be as good, or vice versa.

“Best of breed” is a good choice if you are happy with your current billing system. There is no reason to change your current system if it works well. More often than not, your new EHR will be able to integrate with your current billing system. Although you will pay a fee for integration, it will usually be more economical than purchasing a new system.

Best of breed is not without its problems. Make sure the maintenance, support, and updates for your billing system are paid in full. Otherwise, your system may not be able to interoperate with the new EHR. Also, be sure to consult your vendor to make sure they will work with another EHR system. In most cases they will, because they want to keep you as a customer.

If you have questions about billing system integration, please feel free to contact us at info@xlemr.com. We look forward to hearing from you.

Eligible Professionals (EPs) who qualified for Meaningful Use in 2011 have until February 29th, 2012 to register and attest. The last possible reporting period for 2011 Medicare program ended on December 31st, 2011. EPs who completed their 90-day period in 2011 should work with their Regional Extension Center (REC) representative to register and attest online as soon as possible.

Incidentally, February 29th is also the last day to submit any unbilled Medicare Part B claims from 2011. Please bare in mind that Medicare Stimulus payments are calculated based on your annual allowable charges submitted to Medicare Part B. EPs must bill a minimum of $24,000 to qualify for the maximum $18,000 payoff for year one.

The HITECH Stimulus program reimburses EPs up to $44,000 under the Medicare or $64,000 under the Medicaid program for implementing certified EHR technology. Medicare requires a 90-day attestation period where each provider meets the meaningful use objectives. Medicaid only requires EPs to “adopt, implement, or upgrade” to certified EHR technology.

If your practice is still shopping for EHR, consider making a purchase decision during the first quarter of 2012. That will give you plenty of time to install and train on the system before beginning your 90-day attestation period. The last reporting period for 2012 begins October 1st, so be sure to start early.

XLEMR is hosting a one-time web presentation about how to achieve stimulus funding under the Medicare program. The presentation is on Tuesday, February 7th at 5:00 PM EST. It is free to all clinical and administrative staff. You can register online at http://www.xlemr.com/webinar.html.