Though aiming to modernize and streamline healthcare, electronic health records (EHRs) have seen their fair share of negative press over the years. Typically these stories center around issues of EHRs changing or misrepresenting patient documentation, but the problems also extend into the billing side of the equation, where they can cause just as many issues.
According to a recently unearthed complaint from 2012, a series of EHRs from Epic Systems, the country’s second most popular electronic health software company, had been double billing by using both versions of billing criteria that have changed over the years. For example, anesthesia used to be billed in 15-minute units, but starting in 2012, the system evolved to bill for the exact time that a provider spent rendering the procedure. The Epic glitch, however, billed both the exact anesthesia time AND the nearest allotment of base units, causing CMS to reimburse essentially double as much as it should have.
According to RACmonitor, a North Carolina medical professional who used the EHR and noticed the glitch reported it to Epic, but the company reportedly only updated their software to fix the issue for the one North Carolina hospital. Somewhat surprisingly, the United States Department of Justice refused to pursue the matter, and Epic released an official statement claiming that the person who filed the complaint of double billing had a “fundamental misunderstanding of how claims software works.”
Although the full scope of the double billing caused by Epic’s software has not been determined, medical billers everywhere should be on alert to make sure that they do not submit improper claims. Even if your practice does not use an Epic EHR, it is always a good rule of thumb to double check claims before they are submitted. If anything looks off, be sure to contact your practice manager as soon as possible.