By Alex Tate, Health IT Consultant, CureMD
Twitter: @CureMD
Twitter: @alextate07
How old is your practice management system (PMS)?
If you had to sit there and do some significant thinking, and math, chances are your system is quite old and doesn’t offer any of the robust features newer systems now have that support modern workflows and mandates.
You’re not alone, though. According to a report by practice management systems guide Software Advice, it is estimated that nearly 65% of practices are currently running older systems that are no longer keeping up with health care reform demands.
Not sure if you really need a new practice management system? Here are 10 signs that you do:
Your Old PMS Doesn’t Have an ICD-10 Code Converter
Unless you’ve been living under something very large and heavy the past couple of years, or you’re in complete denial, the ICD-10 transition is less than one month away and it has the potential to wreak havoc on providers’ revenue cycles unless they are completely prepared.
If you want to make sure your claims go through and do not come back denied, you’ll have to ensure they are coded accurately. One way to do this is to make sure your practice management system comes with an ICD-10 Code Converter that easily displays the ICD-10 code equivalents to an existing ICD-9 code. This will save your coders a lot of time (time is money) and help get as many clean claims through as possible.
Your Old PMS Doesn’t Have a Built-In Claims Denial Manager
No matter how much training your staff has received and how prepared you think you are for this ICD-10 conversion, the fact is, you can still expect to see an increase in denied claims; it’s just the nature of the ICD-10 beast.
If your current PMS system does not have a built-in claims denial manager, you should seriously consider purchasing one that does, as this will make your life easier and your bottom line healthier. Newer systems have denial managers that are extremely easy to use. Denied claims can be viewed as often as needed and at any time. Many allow you to view denial details so you can make quick corrections and resubmit quickly.
Your Old PMS Does Not Have Automated Billing or EDI Capabilities
Your Billing is the lifeblood of your practice and you can always use as much help as you can get to ensure every payer pays you. New PMS systems now come with intelligent medical billing features that cover billing, Revenue Cycle Management, collections, electronic claim submission, and remittance.
Nor Does it Allow You to Automate Your Patient Workflow
Being able to control the flow of patients and their digital information is crucial to your practice and you know it’s time to update your PMS if you currently aren’t able to automate this whole process.
Can Your Current PMS Verify Insurance Eligibility?
You and your staff simply don’t have the time (nor should you have to exert the effort) to verify insurance eligibility prior to rendering services. A quality practice management solution will be able to automatically handle this process for you and confirm the patient’s insurance status.
Can Your Reporting be Customized?
Financial reports are critical to the health of your revenue cycle and give you a bird’s eye view of your practice. Your PMS most likely offers these reports currently (we certainly hope!) but are they customizable? A good PMS will offer extensive customization as well as filtering, sorting and scheduling options. And, look for a system that allows on-screen print previews so you can be sure you’re compiling the exact report you need before sending it to the printer.
Do You Have Quick and Easy Access to Your Patients’ Information?
Sometimes you just need to be able to quickly pull up a patient’s pertinent information, like scanned images, photos, and documents in one click.
Also, in today’s world of Meaningful Use and value-based economics, you need access to patient demographic information. This might include things like insurance eligibility, medications lists, appointment and medical history. Does your current PMS offer this?
What About Any Visual Resources?
Talk about a robust feature…
Do you like the idea of managing your patients visually? Modern PMS software manages which patients go to what exam room and when, and then notifies nurses and doctors when that patient is ready for the next step in the workflow.
Does Your Current PMS Streamline Your Billing/Claims Management?
Once you’ve finished your patient consult, the patient continues to move through the workflow and is deposited into the billing and claims management processes. If your current PMS doesn’t pull encounter information into the right template to create a superbill, let alone suggest which ICD codes to use, you will definitely want to start shopping for a new system.
If you have a very small practice you may even want to consider looking for software that offers fully outsourced billing and revenue cycle management solutions, which would eliminate the need for any internal coding or billing specialists, resulting in significant savings.
Is Your PMS Helping You Comply with Meaningful Use?
If you are considering attesting to the Meaningful Use Incentive Program (or perhaps are already)you should know that certain PMS functions, like patient portals, are now requirements of a “complete EHR.” Attestation to MU is fully determined by the software you are using. So, if this list blog post has already alerted you to the fact that your PMS is old and you want to attest to MU, now is the time to update your system.
Just as aging is inevitable in the human body, it’s inevitable in technology as well. As the health care industry becomes even more complex, physicians need all the help they can get to stay competitive and afloat. If your practice management system is doing less for you than more for you, it’s time to start looking into a new one.