Most of you probably have a good amount experience with the perks and pitfalls of EMR. Since charting is a significant part of our clinical practice, most physicians do their due diligence to shop around for the best and most affordable EMR. When it comes to practice management systems however, we tend to invest less time researching and finding the ideal company. For the most part, a practice’s staff and manager are responsible for the PM system’s applications. Since doctors have less direct exposure, we frankly don’t know how to even evaluate a PM system properly.
Since the PM system is what keeps the lights on in your office and ultimately puts food on your table, you should do your best to find the right system for you. Having said that, the world of practice management software is a hyper-competitive market, and most programs will come with all the necessary bells and whistles. In the end, it just comes down to usability, speed, efficiency, and customer service, of which customer service is probably THE number one factor.
Server vs Cloud System
First decision you need to make is whether to adopt a server or cloud based system. The pros and cons will be similar to a server/cloud EMR. Server-based systems tend to be faster. You don’t have to grab data from the internet each time, jumping from webpage to webpage to access your information. You also have no chance of being at the mercy of internet access and speed. If you’re internet goes down or if the PM system servers crash, you’re out of luck. Having said that, with a cloud based system, you have no chance of all your data being destroyed by a fire or vandals. You’re more susceptible to hackers and ransomware attacks, and will incur additional IT costs in maintaining your physical server, backing up data, and purchasing software to ward off cyber crime. In addition to the extra hardware cost, server based systems have a larger upfront cost, but lower monthly support fees. In terms of access, cloud systems will allow you to login from any computer or phone in the world. However, you can also access your server-based system with remote access software. There is a move toward hybrid server-cloud based systems in the industry, but it’s still in its nascent stages. Although the costs will probably be higher, I feel that this model will be ideal.
1. Scheduling System
Pretty much all PM systems will have similar features and customizability. You’ll be able to create your own template with different types of color-coded office visits and time slots. Most will have a demographics section with image upload capabilities. You will be able to directly ping insurance companies to check eligibility, copay, deductibles through your PM system. It’s just a matter of how efficiently everything is organized.
Some companies also have automatic text message appointment reminder/confirmation features, credit card storage and recurrent payment features, ways to flag or quarantine patients with unpaid balances, frequent no-shows, or just plain crazies, etc., and some have scanners that auto-fill information into your system from images.
2. Revenue Cycle Management
You will predominantly rely on your PM system to submit your claims and receive electronic remittance advice. Most will submit through a clearinghouse (ie. Emdeon). For the few paper claims you have to generate, your system should be able to auto-populated all the information that needs to be printed out on a CMS-1500 form. Most systems can check for basic claims errors (missing birthdate, incorrect insurance ID, eligibility at time of service, duplicate claims, etc), but others are even better in that it can warn you about more sophisticated things like global periods, incorrect modifiers, inappropriate ICD-10 codes, etc. When you receive your ERA, the system should be able to automatically post payments, deductibles, disallowances, secondary insurance submissions, etc. Once again, some systems do a better job than others, being more accurate and requiring less manual entry. You’ll also be able to print statements and send bills to patients.
3. Report Generator (Data Mining)
With all the financial and demographic data you accumulate, you will want to be able to generate reports that organize this information in a useful manner for you. You will want to be able to find out how much and how old your account receivables are, which claims are outstanding, which patients owe a balance, which upcoming appointments need prior authorizations, how much revenue you brought in during a given period of time, how many patients and what kind of procedures you performed, which accounts have been sent to collection agency, etc. There are a ridiculous number of reporting features, but I find the ones I mentioned to be the most useful.
All in all, most PM systems will have the majority of the features needed to run an efficient practice. It’s just a matter of the usability, speed, cost, and customer service. Since most PM systems will feel similar, customer service should be one of the most important factors that influence your decision to sign up with a company. How your system interfaces with your EMR is also huge. Because there are so many different companies out there, I would first start out with your EMR company’s recommendations. Contact each of the companies and ask for a demo. You can never grill them enough. Always ask for references, and actually contact them.
Selecting a good PM system up front is crucial. Once your practice matures, the challenges of switching PM systems can be insurmountable. I have learned from brief first hand experience.