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Practice management software is a vital part of any medical practice’s revenue cycle. Yet, some clinicians are not aware of the capabilities and uses of this essential software or how it is supported by other associated technologies.

Medical practice management software allows healthcare providers to automate many back-office activities. These potentially time-consuming activities include patient management, billing, claims processing and other related operations.

Why the Need for Practice Management Systems?

Practice management (PM) software is usually part of a larger billing system. These systems may also include clearinghouses and electronic health records (EHRs). PMs, Clearinghouses and EHRs/EMRs are IT tools that greatly enhance the abilities of healthcare providers. When these individual pieces of software are combined, providers create a more robust and efficient technology stack.

In general, the overall goal of these technologies include:

  • Help stay in compliance with regulatory mandates.
  • Insurance payer requirements.
  • Minimize the amount of back-office work.
  • Provide early warning signs of potential billing problems.
  • Perform work in real-time and speed up the revenue cycle process.

Using Practice Management Software:

This software is used for a medical practice’s billing and collection functions. Sometimes, practice management solutions are integrated with other software applications, which creates a more complete PM system. When using PM software, healthcare provider offices often need to maintain large amounts of data. These data sets are usually organized into files known as dictionaries which can include payer information, diagnosis & procedure codes as well as other necessary clinician data.

Modern practice management systems also include additional capabilities that are critical for accurate billing and collections. Some of these features include: managing pre-authorizations, claims management and payer reimbursement schedules/fee agreements. Many PMs will also connect to other crucial systems such as a healthcare provider’s electronic health records.

Many practice management systems are now cloud-based. This is a change from older interfaces that were usually installed on a medical office’s computer network. These newer cloud-based systems are a different model from the older client-server interface.

Whether a medical office selects and deploys a cloud-based or client-server model, there are many questions that need to be addressed. Here are a few of the questions that healthcare practices should ask when investigating practice management software companies:

  1. Are there similar medical specialties using this PM system?
  2. Is there sufficient security and data protection?
  3. What are the exact contractual obligations and agreements to use the system?
  4. How extensive are their customer service and tech support options?
  5. Do they provide end-user training and support?

A good practice management system will make any healthcare provider’s back-office run more smoothly. However, clinicians need to invest time and thought into learning the software interfaces and full capabilities.

The Benefits of Electronic Remittance:

Having an employee manually process and post payments is a traditional requirement for many data entry type positions in a medical office or healthcare organization. However, this manual enter of data is an inefficient use of time. When this work is done manually, problems can occur. By the very nature of the task, it is time-consuming and easy for an employee to make a mistake when manually keying in the information.

To make matters worse, when a mistake does occur; valuable time is required in order to locate and correct the mistake. The posting of payments needs to occur in a timely manner with 100 percent accuracy. It is especially difficult for new, inexperienced staff to consistently key in information that is 100 percent correct. A way to avoid these problems is to use well-established revenue cycle management practices. One of these is the use of electronic remittance technology.

The payment posting is more efficient, and error-free, when the process is automated. When using an electronic remittance interface the payments will drop directly into the practice management system. This allows back-office staff to not have to engage in the time-consuming task of manually entering posting payments. The vast majority of insurance payers, including Medicare and Medicaid, offer electronic remittance.

Any payments that do not automatically show up in the practice management system can still be entered manually in order to resolve this problem. It is also important to remember that even though the payment posting process is automated, there are still additional steps. Employees need to verify that all payments are reconciled and accurate. This includes checking to see that the payment levels as well as any contractual adjustments are correct.

About Us:

We provide experienced and friendly healthcare revenue cycle management services. We pride ourselves on our ability to help medical clinicians overcome business obstacles. At ABCS RCM, we have the ability to work with a variety of billing, clearinghouse and EHR systems. This allows us to provide customized, physician-centered services that are flexible & professional.

Reach out to us for more information. Call us directly at 614-890-9822 or email us.

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