Tips and Advice

Medibill’s Kareo Tips

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Quick Guide to Kareo EHR

By Greg Murphy – Medibill

Kareo E.H.R. vs. “Regular” Kareo PM (Practice Management)

Kareo has recently upgraded their free Electronic Health Records application (E.H.R.) so if you haven’t logged-in and looked at it for a while please do so- I know you will be pleasantly surprised by its smoother-flowing and more intuitive interface.

As you may know, Kareo’s E.H.R. is separate from Kareo’s Practice Management & Billing Platform, which this guide will often refer to it as “PM.”  The E.H.R. is completely optional, although Minnesota law mandates that all Providers in Minnesota, regardless of their specialty, use some “qualified” E.H.R. system by January 1st, 2015.  There are aspects of this E.H.R. which integrate well with Medibill’s account on the Kareo PM-side, providing some compelling reasons to use it- not the least of which is that it is entirely free!  This is a significant fact when you compare it to other E.H.R. systems available, some costing many hundreds of dollars per month!

Kareo’s E.H.R., unlike the PM-side of Kareo, is accessed through any Internet browser from any kind of computer (Windows or Mac.)  Also, Kareo’s E.H.R. has a “companion” iPad application which provides a subset of key functionality that can really streamline your daily workflow: check your Appointment Calendar, review Notes, enter new Notes, and create and submit Superbills / Chargeslips.

 

Kareo EHR iPad app

http://www.kareo.com/ehr/demo/featured-demos/ehr-ipad-app/

 

Kareo EHR Login Page

When you are ready to begin, you access the E.H.R through this link (please be sure to bookmark this page.)

https://ehr.kareo.com/EhrWebApp/login.html

Your Same Username and Password

Login using the same username and password as your “regular” Kareo application.

 

Charting Vs. Billing

It is important to remember that the E.H.R.  is designed to be a completely “stand-alone” application; it is a free service that does not require the PM-side to work. The E.H.R and the PM applications “synchronize” a few elements between each other, especially your Patient Demographics and Appointments.  Importantly, “Documents” are not synchronized!  Both modules have the ability to Upload documents, but these are two completely separate records.  The best way to think of the two applications is that the E.H.R. is for Charting and the PM is for Billing.

The E.H.R Can Send Charges to the PM!

The E.H.R. has the ability to send “Superbills” (a single-entry “chargeslip,”) to the PM-side, but this is a “one-way” communication, i.e. charges or claims created in the PM are not reflected in the E.H.R.  Also, the E.H.R. is not designed to function as a billing platform, only the PM is.  You cannot find claim history or run financial reports in the E.H.R., nor are dollar amounts or Fee Schedules applied to Superbills/charges created in the E.H.R.

 

HOME

Hover over “Menu” on the left side of the landing page & click the various tabs of Patients, Calendar, Tasks, Billing, Documents and Reports; explore the various displays and functionalities of the different sections.

For instance, when you click on Patients, the list of your current patients displays.  These patients are created by Medibill on the PM-side of your account and this list is constantly “synchronized” with that on the E.H.R.

 

PATIENTS

Avoiding Duplicate Patients & Synchronization Errors: Coordinating “New Patients”

*IMPORTANT*   Please do not click +New Patient (to Add a New Patient to your roster)!  We can review how to better coordinate the ability to create a New Patient, but at this time we need you to rely exclusively on the patient list that Medibill creates on the PM.  At this time there is not a way to “turn-off” the ability for virtually any user to create a New Patient on the E.H.R., and the problem lies in synchronizing the section of the Patient Demographics that deals with each individual patient’s insurance information.  Charges, as we will further discuss below, can be “sent-over” to the PM from the E.H.R., but the insurance information that resides on the PM is the one that is utilized in the creation and submission of an actual claim; this means we at Medibill have to maintain each patient’s “active profile” and this needs to be done, as well as for purposes of synchronization, on the PM-side by Medibill.   You can certainly call me and we can go over this in greater detail, but please for now just continue to use & kFax-up your existing New Patient Setup / Intake form.  These k-faxed document(s) also help establish the original baseline for each patient.  Also, the PM-side is a good place to Scan and / or Upload other patient records of releases and other authorizations, etc. which are important to keep and track but are not directly required for billing claims.

 

PATIENT FACESHEET

By double-clicking on a Patient’s Name, you are brought to that patient’s “Face Sheet.”  Click on the various relevant sections and fill-in the background info as needed for Medications, Vitals, Labs /Studies, Problems, and History.  You can either click on the section itself, or access it from the menu on the left-side as well.

Please skip over Notes for now and see the Demographics section.

 

PATIENT DEMOGRAPHICS

Although we ask you to not Add a New Patient at this time, you are welcome to click the “Edit” button on the upper-right to change any information, such as address, phone numbers, etc.  *The only section we ask you to NOT EDIT is the Insurance tab- this info we put in over on the PM-side.

*The “Patient Portal” section prompts you to enter the patient’s email address to “invite” him or her to use the Patient Portal capability of Kareo.  We will review that Patient Portal capability at a later date.  However I’d like to point out that the Patient Portal has the ability to accept patient’s credit cards but this is a very expensive transaction, and it is DIFFERENT from the ability to take a credit-card payment on the PM-side, which is priced quite reasonably.  I strongly recommend that you hold-off inviting patients via email to the Patient Portal functionality at this time—but please give me a call when you’re ready and we can address implementing the Patient Portal for your practice.

 

ENCOUNTER  NOTES

Clicking on “Notes” displays all the Encounter Notes you’ve entered for this patient.  You can “single-click” on any given note to review it, or if necessary (i.e. it is still in an “Incomplete” status,) you can click “Sign” to finalize the Note.  Once Signed, a Note is no longer editable.  To make any changes to a Signed Note you will have to create an Addendum.

New Note

You create a New Note by clicking on the “+Note” button(s),.  You can select a variety of different Note types depending on your needs and the type of Encounter you are documenting.  For illustration purposes, we will select “Psych Visit.”

New Psych Visit Note

CC means “Chief Complaint” and is simply a narrative section.  If a section is not needed, you can “remove” it by clicking on the small “gear-settings” icon next to the section name on the left hand side… (see below:)

Template- Subjective Section

Various parts of a Note have the ability to call-up a Template.  For instance, under Subjective, on the right hand-side you will see the word “Template.”

Here, a list of your Active Templates will appear.  (To see a complete list of available Templates, close out of the Note section go to My Settings and select Templates…)

Kareo has compiled a comprehensive list of templates across many specialties.  Obviously many of these will not be relevant to your practice.  To make them Inactive, simply put a check next to the box of the template you do not need and select Make Inactive.)  You may have to log-off and log back in to make changes here effective.  Templates are customizable as well.

 

Back to Encounter Note- Psych Visit:

When you find a “pre-filled” description that suits your needs, click Select, then Close to bring you back to the main space of the Note.  The “text” or copy associated with your selection will automatically be placed in the appropriate section of the Note.  Once you have completed filling in the Note, click “Close” on the bottom-right.  *IMPORTANT*  Once you’ve entered any data at all into a Note and clicked Close IT CANNOT BE DELETED.   When you are finished with a Note, single-click the ‘SIGN’ button and the Note will be finalized.  *There is no prompt that asks “Are you sure?” or anything; clicking “SIGN” means you are done and any changes need be done through an Addendum.

Printing an Encounter Note

Any Note can be printed simply by clicking the “Print” button in the upper-right corner.

Kareo’s E.H.R. will “print” a ‘PDF’ file of the Note, which you will see in the lower-left.  Clicking on this ‘PDF’ file will open the file in a new “Browser-tab” from which you can Print the file with your actual printer, or save it to your hard-drive.  Hitting the Escape key will close the Print dialog window.  Click Back onto the active E.H.R. browser-tab to return to the main E.H.R..

 

CREATING A SUPERBILL

Instead of compiling and kFaxing a “Chargeslip/Log Sheet”  to send your charges to Medibill, you can create and send them to us very simply by clicking on the “Superbill” button at the bottom of any Encounter Note.  Think of the Encounter Note as the actual documentation for the visit and the “Superbill” as the “charge-ticket” needed to get paid for the encounter.

 

Entering Dx (ICD-codes) and Charges (CPT-codes) into a Superbill

When “Superbill” is clicked, the following window appears:

Be sure to click on the “Location” button near the top if you have more than one Service Location from which you see your patients.  Also, for many Providers, there will be no E&M codes (the middle section,) and this can be removed from view by simply clicking “No E&M codes for this bill” at the top of the screen.

The first section, ICD code(s), is where you put the Dx code(s) that you are treating at this visit.  Click on the Browse button in this section and start typing the first few numbers of the ICD code, then click Search.  A list of ICD codes matching your search-string appears; select the appropriate one- and- IMPORTANT! click on the “Add to Favorites” checkbox in the lower-left corner…

This will add the selected Dx code to your list of favorites which appears when you first click the Browse button.  This way you can create a list of frequently-used Dx codes so that you don’t have to search for commonly-used ones all the time.  Clicking the “Done” button from this screen will then put that Dx code into the selection-area- and then you click “Add to List” to place it into the active section.  (If you want to Delete a code that you’ve already ‘Added to the List,’ simply click the “X” on the right-side of the line corresponding to the code you want to delete from the Superbill.)

CPT codes (the actual service(s) you provide at the encounter, (for example 90837: “Psychotherapy, 60 min. with patient and/or family member”) are browsed, searched for, added to favorites and Add to List in pretty much the exact same way as the ICD codes.  When you have finished with the Superbill, I recommend that you leave the “Set Status” as ‘Work in Progress’ or change it to ‘Ready to Review’ and then click the Save button.

Modifiers

Put in appropriate modifers, if known.  (Be sure to also indicate “Units” if not= 1.)

 

BILLING

Now, click Billing from the Menu choices on the left-side drop down menu.  Find the Superbill(s) you are working on- you can click the Expand button on the far right to see more detail.  When you are satisfied and the Superbill is ready to send over to us at Medibill, check the little box(es) on the left side next to the Superbill(s) that are ready to send, then, finally, change the status on the lower-left side to “Ready to Submit” and click “Save.”  You’re done!

Making a Superbill’s Status as “Ready to Submit” and clicking Save means it’s SUBMITTED.

That charge has now been automatically sent over to us on the Practice Management side where we will review and modify it as needed, select the correct Insurance Case for that claim, add modifiers, batch numbers, DOS End-Dates, and run it through our claim-scrubbing algorithm.   (Remember, “Ready to Submit” is a “one-way” communication: Superbills are only sent over to the PM and their status will forever remain here on the E.H.R. as “Ready to Submit” (or, in some cases, as “Pending.”)  But no information about that claim is ever communicated back from the PM-side to the E.H.R.)

You can Sort your Superbills according to the Column headers if you’d like by simply clicking on that column header, e.g., to sort by Patient, or DOS, or Status, Dx, etc.

 

CALENDAR

Making Appointments in the Calendar is pretty self-explanatory.  Double-click in the time-slot where you want to make a New Appointment (or click +Appointment in the upper-right corner.)  Start typing the first few letters of the patient’s name and the system will find those that match and simply pick the one you want.  Fill-in the rest of the details as needed; the “Type” is taken from the PM-side’s “Appointment Reason” list.  Once you have created the Appointment, you may hold you right-mouse button down on it and move it around to change the appointment’s time if desired.  Please be sure to review how the appointment’s you create in the E.H.R. are synchronizing with the Calendar on the PM.  I would strongly recommend that you consistently use either the Calendar on the E.H.R. or the one on the PM and stick with that to avoid synchronizing errors.  There is an app for the iPhone that allows you to View Only your appointments.  Also please note that, at least at this time, you can only View Appointments in your Calendar on the iPad app as well- you cannot create new appointments nor edit existing ones.

 

TASKS

You can use the Tasks section on the E.H.R. for a number of functions, including ordering Labs/Studies and for secure inter-office communication however, please do not use this feature to try to communicate with Medibill!  Standard email, phone and your kFax are still the best ways to correspond with Medbill.

 

DOCUMENTS: “Upload your own files and attach them to patient and practice records”

Kareo’s E.H.R., much like the PM, allows you to add your own documents and attach them to a patient’s chart.  This is handy when you’d like to use your own forms or reports for more detail to the narratives you created on the E.H.R. Encounter Notes.  (It would be advisable to include a comment within your E.H.R. Encounter Note that says “see attached Document xxx, for more detail” or something to that affect, simply to indicate that (a) separate document(s) exist(s) in addition to the Note inside the E.H.R. that comprises the charting for this DOS.)  To Add a Document, simply click the “+Upload” button near the upper-right corner of the Documents page.

Follow the dialog prompts as needed.  *Unlike in Kareo-PM, where you have to be within a Patient’s Record and then Upload a file in order for that file to be “attached” to that particular patient, in the E.H.R,. you attach a document to a particular patient within this +Upload dialog box- select the patient here by simply typing the first few letters of his/her name within the ‘Patient’ section… a list of patients matching that search-string appears.  Select the one you want, add Comments if you’d like, then click “Upload.”

To see an already Uploaded Document, highlight it and choose “View” from the Action column.  This calls-up that document in the same browser-tab that you are currently in.  Hit your Browser’s “Back” button or arrow to return to the E.H.R.  If you want to bring a copy of the file down to your hard-drive, simply click “Download” from the Action column.

 

REPORTS

This capability is to see which users have accessed what (an “audit trail.”)  When you’ve chosen the parameters you want, simply click “Run Report” on the lower-right corner.

 

This concludes my “Quick Guide to Kareo’s E.H.R.”  Please contact me directly if/when you have any questions!

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EHR New Release Notes

May 2014

Improvements to Your Kareo EHR Account

Kareo EHR Adds Expanded Notes and Billing Features

On Wednesday, May 21, your Kareo EHR account was upgraded to the latest version. The new features in this release provide you with expanded Notes capability and allow you to add billing comments to your Superbills. If you are using the integrated Kareo EHR and Practice Management (PM) systems, you can now access and use Custom Procedure Codes and modifiers from Kareo PM. For more information on the specific features, see below.

Expanded Notes Capability

Notes that are created by clinical staff, who have permission to do so, can now be assigned to a provider. This gives your practice the flexibility to have the Note started in advance for the provider, and then assign it to that provider to complete. Once the Note has been assigned, it will show up in the provider’s Tasks List.

(Note: Permission to sign off Notes has NOT changed, this is still restricted to users with provider roles. Once a Note is signed off, the Assigned To field cannot be changed and is read only.)

New Comments Section in the Superbill

Now you have the ability to make special notes/comments on the Superbill for your billing staff. It is a convenient way to communicate important messages internally to support effective billing for your practice. Kareo Practice Management users will see comments as Medical Office Notes in the draft encounter.

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Kareo How-to Articles

Check out the great CNET Reviews about Kareo!

http://download.cnet.com/Kareo/3640-2066_4-11107596.html

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Below are posts regarding tips and best practices using Kareo.

Recently I had to identify payments from Medicare and Medicare supplemental plans, including patient’s deductible and co-pays.  To do this, you need the Excel Add-On for Kareo.  Select Payments as your query, include batch number, post date, default payer scenario, and any other information you may need.  Then, once the data is exported into Excel, sort the info by payer scenario.

Import Patient Demographic From Kareo to Practice Fusion

To import your patients from Kareo into Practice Fusion, follow these steps:

  1. Log into your Kareo account.
  2. Click Reports > Patients > Patient Demographic Export on the top menu.
  3. Click the Excel button at bottom of the screen and save the file to your desktop.
  4. Once the file has been saved, upload it to your Practice Fusion account.

To upload your file into Practice Fusion, follow these steps:

  1. Log into you Practice Fusion account.
  2. Click the Charts tab and then the Import Patients button in the top right  corner.
  3. The new window will prompt you to select the file from your computer for upload.
  4. Once the file is selected, click the Upload  button to submit your file to Practice Fusion.

*Please note: Your patients will not appear right away in your EHR account.
Import FAQs:
Q: Will my patients appear right away in my EHR account after I upload my patient data? A: No. It can take several business days for Practice Fusion to  process your data and insert your patients into your EHR account. You  will be notified once your data is entered completely.
Q: What is the minimum number of patients I can upload? A: We request that your upload file from Kareo contain at least 50 unique patients. Please do not upload test patients.
Q: What if I upload duplicate patients? A: Our technicians will check for duplicate patients and will not  add patients into your practice if they already exist in your EHR  account or in your upload file.
Q: How many times can I import patients into my EHR account? A: There is no limit to the number of times you can import patients  as long as each import contains at least 50 unique patients not already  existing in your EHR account.