Inside Insights On Evaluating Office Software
Choosing the best software program for your practice is not easy. There are many good practice management software programs (PMS) on the market. They vary widely in their features, costs, ease of use and learning curve. While these differentiating factors are commonly known, you may want to consider other aspects of these programs — aspects that are less commonly known or thought of — in order to obtain a software package that provides the best fit for you and your practice. For instance, most of us will think of the need to enter the insurance company’s name, address, phone number, etc. into the system. However, you should also see if the software program allows you to enter the deductibles, co-pay, referrals (both required and obtained referrals) and pre-certifications. The ability to enter notes is also useful. For example, you might be able to enter a note about a past due account and a patient’s promise to pay. This can be very helpful when that patient calls your office and asks to make an appointment. The minute your staff enters his or her name into the computer, the software should offer some sort of red flag as a reminder that the patient still owes for his or her last visit. If your staff can also input the allowable fees for each of your CPT codes for each insurance company, you can better ensure you are getting paid what you are entitled to get paid. In short, you need to know what capabilities these software programs have and how they can significantly improve the efficiency of your practice. Without further delay, here is a breakdown of key capabilities you should look for in a practice management software package. Assessing The Flexibility Of The System Many of the software programs are broken down into modules. One may consider a fully integrated package or look at certain modules as optional. You should be able to integrate any module into your main system so any information your staff inputs in one module will populate the remainder of the system. You don’t want to have to enter the same data more than once into the program. Your staff should also be able to easily move from one module (such as the scheduling software) into other modules such as billing and collection without having to close out a particular page. Try posting an appointment, canceling an appointment and changing an appointment. See how easy it is to do this. Can the program red flag problems with the patient such as a past due account or the need for a new referral when the patient tries to make an appointment? Does it provide a simple recall system? Show Me The Money Is there a way to automatically load the most recent CPT, ICD-9 and RVUs and HCPS codes. Electronic claims are gradually becoming more and more of a necessity. Electronic claims are cost-effective, efficient and enable you to submit claims more quickly. Make sure any system you are looking at facilitates the transmission of electronic claims. Many systems have the software built-in and have a contract with a preferred clearinghouse. Some systems also have the ability to scrub the claims to ensure they are “clean” before submission. In other words, some systems can catch errors like having the wrong policy number or the wrong claims center address, etc. Also keep in mind that some carriers turn around electronic claims much faster. Keep in mind that ease of use is a key issue when evaluating a system’s ability to transmit electronic claims. Is it easy enough so you can file at least once a day? Keep in mind that some systems are so easy you can file after each patient whereas other systems can be time-consuming (having to close down the rest of the system, have everyone log off, etc.) to the point where some offices file as rarely as once a week. I would also recommend a program that allows you to have multiple fee schedules in case you want to utilize them now or later in your billing. What about payments and collections? Are payments simple to post on a line item basis? Just as electronic claims submission was not heavily utilized just a few years ago, most offices do not accept electronic payments from payers yet. However, this may be the norm in the near future. Will the system flag a discrepancy between what was paid and the contracted fee allowable? What About Generating Reports? When evaluating software programs, you may want to see what kind of reports you can generate with a particular software package. You should be able to generate broad reports such as gross collections and more specific reports such as insurance receipts for given dates. Other reports that may be of interest to you may include A/R analysis by provider, billing reports, new patients by provider, reimbursement schedules by insurance company, batch insurance claims for given dates, etc. Again, this is just a sample of the reports that can be generated with these software programs. In addition to the different benefits above, a full needs assessment involves assessing your current system’s strengths and weaknesses. If you are implementing a practice management software system for the first time, ask colleagues about their software systems. Hold meetings with your staff as they will be working with this software program very closely. Ask them what they would like to see in the new program that can help facilitate improved efficiency. For example, one commonly requested software feature from office staff is the ability to compare reimbursement amounts from the insurance companies versus the allowable charge. Seven Phases Of Choosing New Software • Proceed with pre-implementation planning. Select an optimal timeframe for the project. If you are replacing an existing software system, there is less need to rush. If you are implementing a new system, you definitely want to plan ahead. Will you have a completely paperless office? Are you hiring more staff and/or expanding to new locations? Do you see the software as a permanent addition to the practice or are you planning to merge with another practice that already has a software system in place? Keep in mind that combining systems can complicate a merger process. • Start to collect the names of software companies and systems. In addition to quizzing your colleagues, seek out the advice of reliable healthcare consultants as well as the input of your office manager. Surfing the net can also be helpful. If you have the time and are a member of the Medical Group Management Association (MGMA), you can attend one of the association’s shows. The exhibit hall is full of vendors who are more than willing to spend time with you. On a smaller scale, the state and local podiatry association seminars will usually have one or more of the more popular software companies exhibiting. • Request a proposal. Often, it seems like podiatrists approach the process as if the software companies are doing us a favor by allowing us to buy from them. Then we wind up adjusting our expectations to what they can deliver. Alternatively, I would suggest developing a list of software finalists and submitting your request for a proposal that fits your needs. Always be sure that you have a reasonable deadline for a response and then select the candidates based on their proposals. Be prepared to ask more questions. You need to gauge their reputation and their capabilities as well as the costs of implementation, training and maintenance/service. In order to gauge the reputation of a given software company, you should find out how long the company has been in business, how many customers they have and if the company has provided software for other podiatrists. If they have provided service to other DPMs, it would be wise to call them to get a feel for how much they like or dislike the software system. When zeroing in on the company’s capabilities, you want to ask about installation, whether the company provides all the required software, whether the company services the hardware, etc. If there is a compatibility problem between parts of the company’s software program and parts of another system that you have, will the company provide service in this situation? Does the company provide training? How long does the training take and how much does it cost? Will the company provide training for new employees that may be hired after the software has been implemented? • Proceed to negotiate the agreement. Once you have selected a software company, negotiate the contract. Some companies may have a standard contract but you may have more flexibility with others. Determine what kind of software license you will have, who will have access to the software and where the software may be used. For example, you may be granted a corporate license that allows you to operate a software program throughout multiple office sites or a site license, which only allows you to operate the system at a specific area. Be sure to remember other agreements such as maintenance, support and update costs, warranties, express warranties and guarantees of performance. Do not pay the entire cost of the software until you have accepted the software. What You Should Know About Testing, Implementing And Maintaining The System • Establish a plan and timeline for implementation. Have pre-installation meetings with the software vendor and your staff in order to establish timelines and ensure that everyone is on the same page in regard to expectations. Determine how the current patient records will be converted over to the new system. Select hardware if the software vendor does not provide that service. Delegate specific job tasks with the software to key people on your staff. If you are doing a multi-system purchase, set up a schedule for phasing in the installation of the systems. Address any procedural and/or policy changes that need to be made with the arrival of the new software system. • Proceed through the installation process. As noted, one must have a written installation plan. One must address the following in relatively sequential order: hardware and telecommunications; software; conversion to the new system; setting up maintenance files; training; troubleshooting and follow-up. • Maintain the software system. You have made the investment and implemented the new system. Now you must have an ongoing maintenance plan in place. Designate someone who will be responsible for troubleshooting, training, backing-up and closing the month. Ensure that your system is secure. The back-up battery, surge protector and server should be located in a secure place. Your designated systems manager should perform periodic purges on the system in order to ensure the system operates at peak performance. Also make sure this person reminds the system vendor about updates. Dr. Metzger is the founder and principal of Innovative Healthcare Resources, which provides practice management information, consultation and locum tenens to the podiatric community. For more info, you can contact Dr. Metzger at (800) 495-8959 or via e-mail at firstname.lastname@example.org. You may also check out www.innovativehealthcareresources.com.