Jonathan Morse, M.D.

OffSiteCare: Have you found HarmoniMD to be an efficient billing vehicle?

We’ve cut the billing time from 20 minutes per patient to less than five. I really appreciate what Nick has done with the HarmoniMD website – it’s now much more practical to do my billing immediately after I see the patient, even if it’s at all hours of the day or night. The process has been streamlined so all we have to enter is a first name and a last name, and a medical record number, and all the other pertinent data is in a dropdown menu format.

Once you use it once or twice, and you get familiar with the system, your data can be entered in under five minutes, the billing is posted to the website, and you are free to move on. You no longer have to enter the demographic data or the insurance data, which is an incredible time-saver, and the diagnosis dialog process has been streamlined as well. It’s easy to edit, which ensure accuracy.

OffSiteCare: How does the Harmoni software stack up against the other billing software you have used?

When I was in Petaluma we used IM Bills, and that was my gold standard because you could literally put in all your billing at about a minute per patient. HarmoniMD is just as good, because once the billing information for a patient has been entered, all you have to do is enter a new date, put in the appropriate billing code, and you’re done in about 30 seconds. It’s amazingly fast and efficient.

The system keeps track of the patients and their electronic medical record numbers, and gets this information from the hospitals automatically, either through their website, their online presence, or through some sort of faxed face sheet. The doctor doesn’t have to deal with any of that – the system tracks the patients by name, date of birth, and medical record number. It’s beautiful – it’s as streamlined and easy to use as IM Bills.

OffSiteCare: How long do you think it will take an MD to come up to speed on using the software?

Realistically, all you need is a 10-20 minute tutorial. Either one-on-one or an online tutorial – that’s all you need. Just show the doctor where to click to add the patient, where to click to put in their diagnoses, and where to click to put in the billing information. The software is so intuitive that many users could figure it out on their own, but the tutorial makes it simple. If you see it once, then you’re done.

OffSiteCare: Do you think there’s a benefit to using HarmoniMD in terms of accuracy?

Absolutely. One of the roadblocks we encounter when doing remote telemedicine consultations is having to rely on the fax machines. In one night you may have three or four patients, with 30-40 pages of faxes per patient. If you do your billing the following day, you’re going to have to go through that data again to do your billing, and remember which diagnoses you put on the chart so that your billing is accurate.

The software makes it easy to enter your start and stop time, which is a required procedure for Medicare reimbursement. As a result, the patient chart and the billing forms are more tightly integrated. It also helps prevent undercoding, or underbilling, because sometimes patient consults take longer than I remember. Medicare payments are based on time as well as intensity. Sometimes I’ll put in an hour and fifty (?) minutes, which is the highest code for a consult, but it won’t have seemed to take that long. This way, I’m fully reimbursed for my time, because I bill at the time of service, not at a later date.

For example, if a patient presents with chest pain, and it takes an hour and half to make the diagnosis, I can justify the use of a certain billing code because I’m billing for the consult when the experience is fresh in my mind.

The increased accuracy would also be of great value if a doctor were to be audited. If someone is doing your billing for you, they have to guess at the times when a patient was seen, and it won’t correspond to the chart as closely as if the doctor inputs the data directly from memory or from the patient’s chart. If you can do your billing yourself, and do it concurrently with your work, it ensures a tighter correlation between patient records and billing statements, and greatly reduces the potential for errors.

Some systems do not require that the physician or billing agent put in the time of day – they may just be using CPD codes and not have a timing requirement. HarmoniMD requires some semblance of accurate timing, and by enabling the physician to efficiently do their own billing, it takes the guesswork out of the process. Billing agents are also typically unaware of the timing requirements for the codes. They might enter 30 minutes for a certain code, and if you’ve entered a CPT code that requires 60 minutes, then an error has been created that could leave a physician vulnerable in the case of an audit.