The Encounter vs. The Audit

For most D.C.’s, audits tend to be both rare and frightening. When a large insurance company contacted Dr. H at his Kentucky clinic, requested myriad patient records, and asked for reimbursement of substantial fees, I have no doubt he was ready to panic.

Following his audit, both the auditor and insurance company representative jointly called him. According to Dr. H:

• They reversed all monetary requests.
• They complimented him on his thorough SOAP. In fact they said his notes were “a pleasure to read.”
• They further noted that whatever product he was using “set a new bar” when it came to documentation.

Wow! Dr. H later pointed out in his email to us:

“Although I do try to keep thorough notes, the encounter program reminds you of details and makes translation into a formal soap note extremely brief & user friendly.”

Before we continue, let’s consider a detail that may have escaped your scrutiny. Many doctors who use SOAP software have been through audits… and their documentation has substantiated the charges. But how many audit stories have you heard where the professionals involved said the documentation was simply the best they’ve ever seen? Or offered an unsolicited opinion about the doctor’s software? (And remember, these are professionals who scour documentation day in & day out, looking for both mistakes and fraud.)

I’d bet never.

Until the mid-1990’s, requests for documentation by an insurance company or outside auditor generally meant copies of the doctor’s “travel cards.” These cards allowed the doctor to quickly note the facts – just the facts – of each visit. And then demand grew for a new concept – electronic notes. But electronic notes got off to a different start than the travel card concept and typically resembled a narrative. As we entered a new century, travel cards gave way to lengthy, computer generated SOAP notes for each visit. Of course, those of us who reviewed our colleagues’ notes for various insurers during this period thought the source was obvious. So, companies that developed clinical documentation software created a new holy grail… randomization. Of course, anyone who does IME reviews can distinguish “canned notes” without much practice. But, by 2010, a request for documentation resulted in a lengthy series of visit-by-visit narratives. And doctors now looked for these workarounds as features! The goals: Press the fewest buttons; generate the most text; make each note look different so it appears “authentic.”

The Encounter was designed to conform to concepts as mandated in the American Recovery & Reinvestment Act (ARRA) of 2009, which places repeated emphasis on storing electronic health records as “structured data.” Structured data refers to a simple & direct association between a type of data – such as a patient’s last name, and the field in which it is stored. Internationally, governments are trying to move everyone away from verbose narratives towards concepts such as SNOMED & LOINC because studies show that this affects physician ability to get to “what they need” from a chart (crucial info may be missed or is hard to find).

We built our nationwide reputation with our billing & scheduling software. And though this is our third generation SOAP (and we were the first to automatically co-generate SOAP and bills) some D.C.’s may assume that – when it comes to clinical documentation – our strengths lie elsewhere. Or that ECLIPSE isn’t expensive enough to do the myriad things it does so well.

You can attend seminars where the lecturer got a free car to recommend the software he touts (Oh yes! True story) or watch glowing video testimonials for over-hyped products, but ECLIPSE is still the only software in the chiropractic marketplace that repeatedly tops independent polls… and now you know the auditors are impressed too. Of course, it’s still up to you to actually document each visit. And with that in mind, here are just a few quotes from doctors who use the Encounter:

“The Encounter – which is a completely new design – allows me to handle my notes in seconds… a feat rare among friends & colleagues with various SOAP systems.”
— Dr. RS, New Jersey 

“I feel it’s by far the best software on the market. We have implemented it into a very busy office and its not just the speed in which you can enter a note but the quality of note along with its integration with the rest of the software. I have demo’ed everything and really wanted to say thank you for Encounter.”
Dr. JP, New Jersey

“Thank you. Also just playing around found the PLAN and ADL’s to add into the exam that is great so far I love it. Just to let you know my other office (which I don’t own or have any decision making) just bought **** to integrate with *****. IT was over $12,000 and I like the Eclipse notes better. Thanks again.”
— Dr. MB, Wisconsin

“PLEASE let your long time subscribers know that you already have EHR on your system BECAUSE when I was looking I saw that you put ***** on your affiliates pages and I bought their system. I am VERY UPSET that I have been working with them for over 10 months and still do not have a workable system. I then found out that I had EHR all along on your Eclipse System (I’ve been using your software since 1999) I found your EHR to be much easier, intuitive and infinitely cheaper.”
— Dr. KJ, Oregon

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