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?