Billing and practice management software and associated services are continuously evolving in an attempt to lift some of the administrative load off busy O&P practices. Providers ask themselves questions such as, Should I outsource billing? or What should I consider when choosing billing and practice management software? These short answers from experts in the field may help map out your next move.
Buying software and implementing are two different projects--how do I get the most from my software?
"While there are several software systems on the market that process claims, purchasing hardware and software to perform this function is only half the battle," says Annette Dolza, customer liaison for Complete Professional Office Services, Fenton, Michigan, providers of Virtual Office' services. "The new computer system must be implemented, office staff trained, and operations converted."
What should I look for when choosing to outsource my billing?
A "virtual office" integrates claims billing, electronic processing, and bookkeeping, Dolza explains. "Virtual Office staff are highly trained specialists who remain abreast of new and changing insurance regulations, HIPAA compliance, and patient privacy issues," she says, pointing out that the Virtual Office keeps computer systems updated, submits claims electronically, follows up on submitted claims, and integrates payments into the bookkeeping records. "Virtual Offices represent the potential for cost savings, improved office efficiency, maximized cash flow, and minimized practice risks," she adds.
"Billing is a profession just like O&P," says Patrick "Pat" Shannon, CHBME, CEO of Cashflow Billing Solutions Inc., Omaha and Lincoln, Nebraska, a billing service that focuses on the O&P industry. Shannon points out that there is an association--the Healthcare Billing & Management Association (HBMA)-- that regulates, credentials, and certifies professional billers, and which has educational requirements, including continuing education. He urges companies who are considering outsourcing their billing to look for the CHBME (Certified Healthcare Billing & Management Executive) credential awarded by HBMA.
A professional certified billing service will have a working compliance plan in place and will be able to provide a summary of its plan, Shannon adds. "It will be able to provide you a certificate of HIPAA training and appropriate Business Associate agreements to protect your company under the HIPAA Privacy Regulations."
In deciding on a billing software or billing service, O&P firms "should look for a company which has a strong and secure background with a proven track record" states Lisa Lake-Salmon, executive vice president of Acc-Q-Data Inc., Boca Raton, Florida. Take the time to contact current users of systems or services in which you are interested. Ask what they like and what they have had challenges with. Ms. Lake-Salmon notes that Acc-Q-Data has been serving the O&P industry nationwide for over a decade and time is one good litmus test of quality of services. "Our team of highly trained professionals provides back office services, including billing, collections, and practice management," says Lake-Salmon. She adds "Acc-Q-Data's AMS software also offers cutting-edge technology and exceeds HIPAA compliancy mandates."
What are some key issues to evaluate when considering a billing software package?
Although the list of issues to be considered when purchasing a billing software for your practice is long, a few of the key issues are: HIPAA compliance, integrated appointment scheduling with patient demographic and billing data, consideration of how accounting information is reported (i.e. is this integrated in the software or exported to a separate accounting package), report capabilities, integration of collection processes, and multiple office stability and functionality. Other issues certainly should be addressed when approaching such an important decision for a practice.
Terry Long, president, Futura International Inc., Clearwater, Florida, states, "With HIPAA compliance and capabilities like PHI control, appointment scheduling, electronic and paper claims submission, wireless capabilities, and complete patient chart tools, Futura software is designed to streamline office operations, as well as separate and secure patient data." Futura's O.P.S. (Orthotic Prosthetic Software) is specific to the O&P market and its H.O.M.E. (Home Office Management Expert) product is specific to the DME market, says Long.
Long adds that Futura provides potential customers with a "grace period" in which they can use the software, thus enabling its entire office staff to evaluate their needs as well as how Futura fulfills those needs.
Medflex software is O&P-specific, notes John Mason, president, Medflex Corporation, Lafayette, Indiana. The software includes automatic patient follow-up based on L-Codes; variable O&P charge tickets based on visit type; assignment of technician, modifier, and practitioner to a job; multiple methods of job costing and job tracing; and special hooks in the scheduling to manage offsite clinics.
"The best way for practitioners to evaluate software is to get a complete demonstration interactively given over the Internet, so that all their questions can be answered," says Mason. "They should also check with people who run the software they are interested in."
According to Mason, practitioners should ask: "How can your software allow me to market better, deal with my patients more effectively, improve my collections and lower my write-offs, and lower my accounting bills? How can your software help me manage my HMO contracts in terms of measurement, tracking, and quoting, and help me manage the productivity of my staff? How does the software expand as offices are added? How does it run using the Internet for multiple offices?"
Billing Software: Exciting Future Ahead
Some exciting developments are on the horizon for billing software and services.
AMS software, designed by Acc-Q-Data, allows providers complete control, security, and access to their customer data from any device that supports a web browser, according to Lisa Lake-Salmon. AMS can be configured as an Internet and/or an office-based application, she notes. Online benefits verification is the latest addition to AMS.
"AMS is developing exciting new innovations such as encrypted e-mail, smartcard biometric authentication, and portability to PDAs and cellular devices," says Lake-Salmon.
Futura is planning several innovations, including opening a training center in July, expanding the sophistication of its PDA interfaces, and providing a tight integration with both QuickBooks and Crystal Reports, according to President Terry Long. Futura will be offering a choice of SQL Server, Oracle 9, or DB/2. "We are very committed to expanding the sophistication of our PDA interfaces as well as improving our standard product line, and our brand new, specially designed training center will offer our clients the chance to come to our offices for a preview of all of our products and services. We will also be offering workshops such as QuickBooks, Crystal Reports, DBA (database administration) and more."
"When we first started with the industry, we saw networking switch from Corvus to Novell and now to Microsoft," says Medflex President John Mason. "Technology keeps advancing and changing. We have added more features to our software that would not have been possible in the past. For instance, MedFlex has had full document scanning for years. Down the road, it will be possible to attach movies right in the patient's database. Currently movie captures are huge and can fill even a large server. Later this will be easy to do as drives increase 100-fold in capacity in the next five years. This movie aspect is about the only thing that is not contained in a MedFlex virtual chart currently."
Mason also sees future expansion in the use of tablet PCs: "PDAs are actually pretty limited devices for eliminating the paper in the workflow. Tablet PCs, however, have the capacity and intelligence to allow for paperless charge tickets and wireless interaction with the database in real time. We will be using that technology in future versions of MedFlex."
MedFlex is currently in the process of being completely switched over to a SQL-based product, says Mason. This will allow for different programming tools to interact with the core data in the MedFlex database and allow for implementation of web-based patient scheduling, in which patients can make tentative appointments themselves, instead of calling the practitioner's office.
"Cell phone-based Internet capabilities and the ability to use your single cell phone account on multiple cell-enabled devices will allow for later tablet PCs to be live on the Internet anywhere at any time," Mason adds. "This will allow for real-time scheduling to interact with the central database or any other MedFlex function."--Miki Fairley
Watch for future updates on billing and practice management software and services.
