Don't let auto-generated data lead to 'inadvertent' EHR fraud

Physicians still don't fully understand that the way they use their electronic health records could cause them to look like they're billing improperly, ultimately landing them in legal hot water, according to a recent American Medical News article. 

More specifically, the article, cites a report from the American Health Information Management Association that warns that EHR systems are vulnerable to being used in a way that can be misconstrued as misrepresentation or deception. Unintentional or not, the consequences associated with such deception remain the same.  

Three problem areas of particular concern, according to amednews, include:

  • Authorship integrity: Often an EHR system doesn't indicate who entered what data when, or the physician pulls up information from an earlier visit during a subsequent one, causing the practice to bill twice for the same services;  
  • Auditing integrity: Many EHRs don't keep the original records when they're amended, for example, to add a lab report. The EHR needs to not only track who accessed what records when, but also any changes, amendments and additions made; 
  • Documentation integrity: Too much data is auto-generated, causing inaccurate coding and payment.  

Many of these problems are caused by physicians turning off the audit function of their EHRs, which increases billing issues and violates the Health Insurance Portability and Accountability Act (HIPAA), amednews reports. Use of a "certified" EHR to comply with the Meaningful Use requirements is giving physicians a false sense of security in their systems.

Physicians are advised to take such risks more seriously, especially considering the recent focus on corralling fraud of the Department of Health & Human Services' Office of Inspector General.

To learn more:
- read the full amednews article

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