[Stephen Feikls]

Hi Jamie,

We’re in Erie, and deal with this A LOT with Highmark. CMS has a rule that “anesthesia by operating surgeon is not separately payable”. AAOMS has a document essentially speaking out against this rule for the OMS profession, but the paper doesn’t really change CMS guidelines (that Highmark likes to blindly follow). Feel free to email me directly at steve@erieoralsurgery.com and we can chat.

Steve

[Stephen Feikls]

(Also posted in SOMSA’s WinOMS thread)

Hi All,

I wanted to post an update as to where we are in the implementation process. We have completed a majority of the training sessions thus far, and things are going fairly well. We’ve been no stranger to the occasional “meltdown”, but the biggest thing we are keeping in mind is that we are the only OMS practice using AdvancedMD at the current moment, which means that we have to keep focused on what WE need and not get caught up in a lot of the system extras that don’t really apply to us.

I’m developing all sorts of note templates, the patient portal is mostly set up, and now we are developing an operational flow.

One thing that is a little clunky is the digital signing of consent forms — it involves using two different AdvancedMD apps, but I think this is something that they may be able to address in future updates.

For those interested, I will keep posting updates as we continue to refine our process. I’m also happy to discuss our journey individually, too. Just send me an email at steve@erieoralsurgery.com

I can say this, though — clinically, this is an entirely different ballgame compared to WinOMS (and I mean that in a GOOD way)! Total game changer for us!

Steve

[Stephen Feikls]

Hi All,

I wanted to post an update as to where we are in the implementation process. We have completed a majority of the training sessions thus far, and things are going fairly well. We’ve been no stranger to the occasional “meltdown”, but the biggest thing we are keeping in mind is that we are the only OMS practice using AdvancedMD at the current moment, which means that we have to keep focused on what WE need and not get caught up in a lot of the system extras that don’t really apply to us.

I’m developing all sorts of note templates, the patient portal is mostly set up, and now we are developing an operational flow.

One thing that is a little clunky is the digital signing of consent forms — it involves using two different AdvancedMD apps, but I think this is something that they may be able to address in future updates.

For those interested, I will keep posting updates as we continue to refine our process. I’m also happy to discuss our journey individually, too. Just send me an email at steve@erieoralsurgery.com

I can say this, though — clinically, this is an entirely different ballgame compared to WinOMS (and I mean that in a GOOD way)! Total game changer for us!

Steve

[Stephen Feikls]

99072, but most carriers consider this inclusive of the encounter being billed.

[Stephen Feikls]

You are correct. Both Cerner and Epic, typically, don’t work with small independent practices. If I remember correctly, Epic would only work with us if we had at least 100,000 patient encounters per year.

We looked into some EHR/PM vendors that catered to the smaller sector, and landed on AdvancedMD.

Just like Cerner, AdvancedMD does not presently have the ability to generate an ADA claim form. It also does not have an anesthesia module like WinOMS has. However, they do have the ability to record all anesthesia vitals etc., as they have a few ambulatory surgery centers as clients, so I’m working with them to develop and refine an anesthesia record that will better suit our needs.

As far as the dental billing is concerned, I totally get that is a huge barrier to switching. For us, the unfortunate drawbacks of WinOMS have made the issue of not currently creating an ADA claim form an acceptable negative. I’ve come up with a workaround for the time being, but the overall functionality of AdvancedMD is so far beyond what WinOMS/OMSVision/DSN offers, that it helps make up for the glaring issue of dental billing..I hope.

Steve

[Stephen Feikls]

Update 1

We signed a 12 month contract with AdvancedMD late last week, and so the first step was that we were assigned an implementation consultant. In addition, I was contacted by their sister company, Global Payments Integrated/Tsys. AdvancedMD’s online patient portal offers bill pay that automatically posts directly to the respective patient’s account. GPI/Tsys was able to offer us a lower percentage on merchant services compared to our current credit card processing vendor, First Data, in addition to the integration into the PM side of AdvancedMD. So right now, I am in the process of switching merchant vendors and awaiting our login credentials for AdvancedMD.

I also had to provide a list of our in-network medical carriers so that EDI could be established. Luckily (I think), WinOMS and AdvancedMD both use Change Healthcare as the claims clearinghouse, so hopefully the changeover will be simple.

We just got assigned an implementation consultant, Jane. I anticipate having a brief introductory phone chat with her either tomorrow or Monday.

As things continue to unfold, I will post updates.

Steve

[Stephen Feikls]

You may want to look at 21215 (52 modifier if you aren’t harvesting an autograft).

[Stephen Feikls]

The hospital we take trauma call at uses Cerner, and we badly wanted Cerner (and even Epic), but neither company would work with a private practice of three physicians. I began searching for reputable medical grade EHR’s, since WinOMS really doesn’t meet our needs in that department. I will say this — currently AdvancedMD, like Cerner, does not offer dental billing. I don’t mean to sound disparaging toward Carestream, but our feeling toward them is so strong that we’ve resigned ourselves to a practice management/EHR solution that doesn’t even have dental billing. I have requested that they add an ADA claim form to their software, but as you can imagine,it is something easily said but more difficult to do. Perhaps with more interest, it will become reality.

If at any point you have a curiosity for AdvancedMD, our rep is Steve Gilham: steve.gilham@advancedmd.com

I will gladly keep everyone posted on my process. Would you like me to keep it in this thread, or start a separate thread?

[Stephen Feikls]

I definitely will keep you updated. I fully expect a lot of growing pains in the beginning (heck, we’ve been with WinOMS for almost 30 years), but we felt as though the time as come to move on, sadly.

[Stephen Feikls]

We bill out for J1100 (IV Decadron) and J2405 (IV Zofran), and certain carriers require the NDC codes be on the claim. Highmark, for example, does not require NDC codes for “common” drugs like Decadron and Zofran, while United Healthcare does require it. Since there is no way for WinOMS to put the proper NDC code format on the claim form (paper or digital), I typically enter those claims manually on UHC’s Link interface. On Link, there is an NDC option for lines of service (J codes) requiring it.

[Stephen Feikls]

We use Cerner at the hospital every day, and it is leaps and bounds ahead of WinOMS’ EMR. We are in the process of potentially implementing it, but I am definitely curious about this company looking to enter into the market.

From what I see on LinkedIn, for example, Carestream is very active on the device market. Perhaps they are just going to exit the software market?

[Stephen Feikls]

Have you noticed any other bugs or issues in 9.6 (currently running 9.5)?

[Stephen Feikls]

We use them and they’re awesome. We don’t use all of the services they office (just yet), but their texting confirmations work without any issues. If a patient responds to an appointment confirmation text, WinOMS even marks the appointment as confirmed. I definitely recommend them!

[Stephen Feikls]

Depending on the degree of repair (if any), you could use 40810 through 40816. Since a mucocele typically occurs around the minor salivary glands in the vestibular mucosa (and not on the external lip around the vermillion border, for example), 40810-40816, in my mind, is preferred over 11440/11441/11442 etc.

Either way, definitely cross check the operative report with the CPT description to make sure everything jives together.

I hope that helps!

Steve

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