Posts tagged ‘Medical billing’

Introducing the OpNote Consultants – Dr. Seth Goldberg

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

After 27 years as an otolaryngologist/facial plastic surgeon in Rockville, MD, Dr. Seth Goldberg launched a new career as a health care consultant specializing in clinical information technology development, utilization management, continuous quality improvement, and risk management. He conducts accreditation surveys of outpatient medical facilities for the Accreditation Association for Ambulatory Health Care. Dr. Goldberg holds board certifications in Otolaryngology-Head & Neck Surgery, and Facial Plastic and Reconstructive Surgery.

He earned his B.S. degree in Molecular Biophysics and Biochemistry from Yale University, and his M.D. degree from Tufts University School of Medicine. He recently received his Masters of Medical Management degree from Carnegie Mellon University. Washingtonian Magazine and Washington Consumers Checkbook have included him in their list of Top Doctors.

In conjunction with his solo clinical practice, Dr. Goldberg was Chief of Otolaryngology at Holy Cross Hospital in Silver Spring, MD, and Shady Grove Adventist Hospital in Rockville, MD. He also served as a member of the Peer Review Committee of the Montgomery County Medical Society and as a peer review consultant with the Delmarva Foundation, Medical Mutual Liability Society of Maryland and the Medical Chirurgical Society of Maryland.

How did you get your interest in medicine?

I’m at the leading edge of the baby boom generation and my role model was – and we can joke about this – it was the TV show “Marcus Welby, MD.” He was a very respected individual and it was clear, back in the sixties, that physicians were highly respected members of and contributors to the well-being of  society.  So I think that’s what originally piqued my interest.

There were other factors, of course – I excelled at science and math.  I had an inquiring, experimental mind – I worked as a lab assistant for one of my biology teachers in addition to taking Advanced Biology as an elective in high school.  I taught tomato plants to say, “feed me, Seth.”

(Laughs)

Once I got into college, I fast tracked into medicine – that seemed to be the thing to get into at the time.  So I did my pre-med and the process for getting into medical school was actually pretty easy.  I had an interview at Tufts that consisted of the interviewer informing me that they had already decided to admit me.

(Laughs) So then you clearly felt like “I nailed it!”

(Laughs) Basically, yeah – I felt like I had nailed it, right.  Also, at the time, there was this other little thing called the Vietnam War.  I had a high lottery number, or I guess it was actually a low lottery number.  So there was only one other choice and that was be cannon fodder.

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March 17, 2010 at 10:25 am Leave a comment

Dictation is Public Enemy #1

Pete O’Toole

Healthcare is the biggest political issue in the US right now.  It’s a huge financial problem for everyone – individuals, businesses, the government and healthcare providers themselves.  It’s become so overwhelming that it has gridlocked congress.  The word “healthcare” just deflates everyone in the room each time it is uttered.  Despite all the frustration and everyone’s acceptance that “healthcare is broken,” most of us can’t name concrete problems in healthcare.  There is a vague sense that sometimes too many tests are ordered, but when it’s you who may need the tests, it’s not a problem.  Personally, I think that modern medicine is amazing, and nowhere in the world is it taught or practiced better than in the US.

I prefer to look for solutions to this crisis in places that do not take away from patient care.  For me, the first place to look is not in cutting screening for cancers – even if “only” 1 in 1000 people in a certain age range may actually test positive.  I think 1 person in 1000 is actually quite a lot to dismiss.  I realize there are excesses in the administration of healthcare — doctors who might be gaming the system, patients who might be hypochondriacs and lawyers who force doctors to practice overly defensively — and that it needs to be addressed.

The world's most powerful computer at Columbia University's Watson Lab, 1954.

There are many other places we can look to save money in healthcare.  One problem that will probably only get worse is medical transcription.  Decades ago, it made more sense for doctors to speak into a microphone and let a professional typist translate that dictation into a typed sheet of paper, than it did to try to make every doctor a professional typist.  When the first computerized medical records came out in the late 1960s, this practice naturally moved right over to support entry into these systems.  In fact, these systems were little more than glorified word processors, and many of them unfortunately have not progressed much beyond that point.  Early computer applications, although exciting, were hard to use.  Human-computer interaction as a field was barely born and would not influence the industry for a long time.  In the 1960s, this workflow made perfect sense.  Let doctors treat patients and let typists type.

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March 15, 2010 at 5:33 am Leave a comment

Introducing the OpNote Consultants: Dr. Roger N. Chabra

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. Roger Nathan Chabra graduated in 1962 from Christian Medical College of Punjab University in India.  For his post-graduate surgical training, he went to the United Kingdom and became Fellow of the Royal College of Surgeons in Edinburgh in 1969.

In 1970, he emigrated to the United States and went through a complete surgical residency program at Boston University Medical Center.  He joined Cape Cod Hospital as Attending General Surgeon in 1974 where he worked until his retirement in 2000.

During his time at Cape Cod Hospital he was on the faculty of Boston University Medical School as Clinical Instructor in Surgery and was involved in training surgical residents and medical students rotating through the hospital, which is an affiliate of the Department of Surgery at Boston University Hospital.

How did you get interested in medicine?

Where I grew up, in India, there’s a lot of influence of the parents.   In a subtle way, they decide what their children are going to be.  So there was this slow…”brainwashing” may be too strong a term.

(Laughs)

But that was going on all the time.  It was almost difficult to escape that concept.  In a country like India, you do not want to disappoint your parents, or make them unhappy because you chose something different than what they wanted.

So the die was cast, as far as I was concerned.

Why did you decide to become a surgeon?

I had surgery at a very young age.  I was in this magnificent hospital and I saw the aura around the surgeon and the nurses.   The reverence and respect they received.

“My god,” I said, “I want to be like them one of these days.”

So that drove me into surgery.  My original field was going to be chest surgery, because I had thoracic surgery done on myself.  That didn’t pan out, so instead I became a general surgeon.

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March 5, 2010 at 4:27 pm 1 comment

Introducing the OpNote Consultants: Dr. John Mattson

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. John Mattson is an orthopedic surgeon who specializes in knee arthroscopy, ligament reconstruction and sports medicine.  Operating out of Berkeley, CA, Dr. Mattson is both a member of the staff of Alta Bates Summit Medical Center as well as working with his own private practice – the Berkeley Orthopaedic Medical Group, Inc.

Dr. Mattson graduated from Northwestern University in Evanston, Illinois and completed his medical and Orthopaedic training at the University of Michigan in Ann Arbor.  Dr. Mattson joined Berkeley Orthopaedics in 1983 and was Chairman of Orthopaedics at the Student Health Service of the University of California at Berkeley from 1990-2004. Dr. Mattson is a member of the clinical faculty at the University of California San Francisco Medical Center.

Dr. Mattson specializes in knee arthroscopy and Anterior Cruciate Ligament Reconstruction. He uses minimally invasive state-of-the-art arthroscopic allografts (donor grafts) for ACL Reconstructions. Dr. Mattson has one of the largest series of soft tissue allograft ACL Reconstructions in Northern California.

How did you get interested in medicine/surgery?  Why orthopedic surgery?

I became interested in a surgical career as both my father and uncle were surgeons and I strove to emulate them.

I was fortunate to be accepted to the University of Michigan medical school where I graduated in 1972. While in medical school, students rotate among various clinical services and are introduced to both the nature of the specialty and to the personalities who were attracted to that particular specialty.

I was immediately drawn to Orthopedic Surgery as I enjoyed both the nature of the specialty and the individuals who were residents. It seemed a comfortable fit.

I’m sure you’ve been approached by other Health IT organizations before.  What about mTuitive – or the OpNote product itself – did you find appealing?  What got you interested in working with us to develop the OpNote?

Number one – I’m sort of a computer nerd and drawn to innovative advances using technology.

(Laughs)

And I like the idea of being able to create an operative report that is complete and comprehensive in a very rapid and efficient way.   I review a number of medical legal reports, both for the medical association and for various attorneys, and have been struck by the disorganization and deficiencies of non-standardized dictations.  Basic information about the procedures done are often missing or incomplete. In working with OpNote, it became apparent that a complete, standardized report could be generated in a rapid and intuitive manner.

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February 23, 2010 at 9:36 am 2 comments

The RAC is Connecting the Dots: Are You Ready?

Did you ever wonder about the insanity of separate billing for the hospital and a hospital-based physician?  The requirement was put in place to simplify Medicare’s accounting system and keep track of which trust fund the payments came from.  Separate billing is demonstrably redundant, wasteful and confusing to patients – and recently CMS announced plans that will likely add insult to injury.

RAC (recovery audit contractors) efforts have been expanded into complex case reviews.  Hospitals in RAC region C (Connolly Healthcare) are starting to compare inpatient DRG assignments to physicians’ reports, especially in the area of surgery.  Although the patient, the procedure and the diagnosis are the same in actuality, there is little coordination of billing and coding between the surgeon and the hospital to ensure that they are billed and coded similarly. Coding and billing are independent processes for each party. This is the weakness that the RAC will be attempting to exploit.

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January 29, 2010 at 12:00 pm Leave a comment


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