How Medical Software Leads Innovation in Healthcare
New technology isn’t always well received. Even the telephone was greeted with skepticism and some fear. Sometimes the reception is well deserved—we can all admit that the first generation of EMRs was far from perfect.
A somewhat humorous example is my family doctor and cardiologist who retired a few years ago. I always enjoyed entering his office because he never transitioned to medical software—at least not successfully. When I walked in, I was greeted by a receptionist surrounded by three walls of smartly presented, organized patient charts in attractive wall cabinets. The irony was striking: I was in the Silicon Valley, in a new millennia, entering a medical practice without a single computer.
In fact the only electronic devices in the office were a telephone and fax. No computers, so no need for medical software. He had banned them all. In his defense, when medical record software was mandated, he enthusiastically invested $64,000 in a top-rated medical record system sold to him at a medical convention. It was never successfully installed, and six months and at least half his investment later, staffers were pleased as punch to continue pulling 25 to 30 folders each evening for the next day’s appointments.
But technology has improved, especially in the last five years, to the point where physicians do themselves a disservice by not embracing it. For instance, although faxing is still a necessity in the medical world, practices that shift to electronic faxing save hundreds of hours a year over those with manual systems. Those hours can be put to use answering patient questions, filling empty appointment slots, and sending appointment reminders (although those, too, can now be automated).
The breadth of medical software in practices of all sizes is astounding, reaching into all aspects of clinical work, practice management, back-end systems, marketing, and more.
Software for Medical Records – The EMR
As mentioned, EMRs got off to a rocky start. These days, they are proving their worth and then some, making patient records not only more standardized, but more accessible. Physicians have adapted to working with them, and EMR/EHR designers made them more customizable, turning them into a powerhouse only visionaries imagined.
One thing is certain: EMRs proved their worth during the ICD-10 changeover. Even with so many more codes and modifiers, practices with advanced software were able to simply follow the software as it led them through the process of (1) choosing the right code for the diagnosis and (2) coding to the highest level of specificity.
These days, templates in the best EMRs/EHRs are tailored to specialties, and workflows can be customized to the practice and even the individual practitioner. Just as importantly, cloud-based EMRs can connect with a variety of external sources, including labs, imaging centers, and pharmacies.
Software for Medical Practice Management
Doing more with less is the mantra of every practice manager. A tall order, but one made more realistic with sophisticated practice management software. Four critical functions of practice management are more automated than ever, enhancing these areas while giving practice managers more time for hot-button issues like hiring and systems security.
Today’s practice management systems streamline and automate:
- Front-desk workers can quickly search for appointment slots that need filling, schedule resources by “first available,” and set up automated appointment reminders.
- Claims can auto-fill from the EMR, be quickly validated and sent to the clearinghouse, and show up on a dashboard if denied.
- Eligibility checks. Patient can enter their information via a portal prior to their appointment, staff are alerted to must-fill fields they’ve missed, and patient identification and insurance can be easily compared to what you have on file.
- Internal reports help practice managers pinpoint areas for improvement, and today’s software makes creating and running them a breeze. Similarly, data needed for CMS reporting (including MIPS) can be pulled together in minutes rather than the hours required by those using spreadsheets.
Software for Medical Coding
There are two important aspects to coding: speed and accuracy. Both are enhanced with today’s advanced coding software, which leads providers step-by-step through the process of finding the right code. The result is fewer denied claims, increased identification of missed revenue opportunities, and a rise in first-pass submission rates.
Software for Medical Claim Preparation
Up-to-date billing software has built-in “edits”: rules that should be checked before a claim is sent to the payer. Your software should check every claim for compliance with the Correct Coding Initiative (which includes a list a code pairs that are not meant to be on a claim together), Medical Necessity (checks for the units of service that can be reported for a single date), and Gender (e.g., cannot bill for a pregnancy procedure on a male patient).
Software for Prior Authorizations
Shifting prior authorization systems from manual (phone calls and faxes) to electronic is a game-changer for practices of all sizes. According to the American Medical Association, prior authorization is still manual in most practices, creating a barrier to timely, patient-centered care.
Reform initiatives are under way, including a bill that would establish an electronic prior authorization process. In the meantime, software with tight integration between billing and EHR can ease the pain significantly, automating most of the prior authorization process and ensuring requests don’t fall through the cracks.
Software for Electronic Faxing
Faxing documents should be as easy and secure as emailing them. Secure medical electronic faxing modules let clinicians and admins open a new fax document from within their communication system, choose a document to fax, add comments to it, enter a fax number (or type the provider’s name if he/she is in the system), select a cover letter, and hit send.
Ideally, the system will let users map outgoing faxes to a patient, save those faxes in the patient document manager, and file inbound faxes directly in the patient’s record.
Software for Patient Communications
Portals can create enormous benefits for medical practices—and most patients love them. However, there are a few necessary components. First, the portal must be completely integrated with your other systems. Second, it must contain valuable tools for patients. Third, it must allow secure, HIPAA-compliant messaging.
With those criteria met, your patients can schedule appointments, get referrals, pay a balance, view lab results, request prescription refills, update their insurance information, ask treatment questions, and download forms to fill out prior to a visit. Some practices take their portals a step further by integrating a reading library where patients can view articles on common conditions and wellness strategies. Properly integrated with your other systems, the library module can notify clinicians about which articles patients have accessed, allowing them to see if an appointment is in order and complete the circle of care.
Software for Telehealth
The pandemic played a huge role in the recent rise in telehealth visits, but experts say interest in telehealth services is more than a pandemic trend. Today’s telehealth modules offer a wide range of services, including documented phone consultation, secure video chat, documenting on any device, and secure two-way chat between clinicians and patients. Importantly, those messages can be imported into the patient’s electronic record.
Software for Physician Credentialing
Credentialing is considered a necessary evil by many practitioners, and it’s certainly time consuming. But it also promotes better patient care by providing standards for medical providers and preventing patient-scheduling snafus.
Here are four best practices practice managers should consider adopting:
- Build time into the process because each payer’s timeline for processing applications is different.
- Double check that none of the information on the application is incomplete or outdated.
- Make a habit of updating and attesting using the Coalition for Affordable Quality Healthcare (CAQH)’s credentialing program.
- Get to know your state laws to ensure you’re following appropriate state standards.
Software can help streamline the credentialing process by allowing practice managers to outsource all or part of the credentialing process while remaining up to date on the status of each application.
Mobile Apps For Doctors on the Go
The world has gone mobile, and healthcare is following suit. Patient-focused apps let providers send notifications about appointments and lab results and securely text with patients. Patients can make appointments, view electronic statements, make payments, receive appointment reminders, and check in for office appointments on their phone. In addition to convenience, these apps boost patient engagement, which can positively affect health outcomes.
Mobile charge capture and billing apps are also gaining popularity, letting providers capture charges and even complete documentation from their phones. Some apps include secure messaging, quality metrics reporting, and patient-handoff communication tools.
Regardless of the type of app being used, the key is integration. The more tightly integrated the app is with your front-end and back-end systems, the more useful it will be to providers and patients.
Software for Medical Marketing
Portals are the best avenue to engaged patients, and engaged patients make good advocates for your practice (and are likely to have better health outcomes). Once you have a portal, consider offering in-office portal enrollment and an easy process for changing/reissuing passwords to encourage use.
A consistent online presence (website, social media, online reviews) is critical to growing your practice. Consider hiring an expert to evaluate your online status, investing in a reputation management tool, and/or making laptops available to patients so they can post while their experience is still fresh in their mind.
Advanced practice management software makes it easy to build up your email database and automate the email process. You can start by sending holiday greetings and work your way up to segmenting your patients by medical needs or age to send targeted reminders about vaccines or screenings.
Digital Connection Software
The software that’s holding your patient records, helping to run your front desk and back office, and keeping your books in the black should be able to connect to a variety of clinical and non-clinical systems. Look for the ability to integrate with labs, imaging centers, pharmacies, hospitals, long-term care facilities, payers, and clearinghouses.
These days, most healthcare software vendors use Health Level Seven (HL7) to make connections with other systems. HL7 specifies a number of flexible standards, guidelines, and methodologies by which various healthcare systems can communicate with each other. HL7 standards are produced by Health Level Seven International, a not-for-profit, ANSI-accredited standards developing organization.
Software Facilitates Numerous Key Administrative Processes
There are four lenses through which providers and practice managers can look at any piece of medical software.
- Successful billing starts with robust coding and documentation, followed by fast digital communication between billers and providers, a strong connection with claims scrubbing and your clearinghouse, and a dashboard that shows the status of each claim.
- Revenue Cycle Management. Cashflow is more complex in healthcare than any other sector. Fortunately, today’s advanced RCM software keeps everything flowing by letting practice managers easily track important metrics like first-pass rates, days in AR, percentage of claims in AR for more than 120 days, net rate of collection, and average reimbursement per encounter. With the right software, practice managers can function more like CFOs than accountants, identifying and quickly remediating bottlenecks and other issues.
- Security and HIPAA Compliance. Patient health record security should be at the top of the list for practice managers. That means careful consideration of physical security (e.g., laptops that leave the office) and education for everyone on staff (including clinicians) about the dangers of phishing emails. It also means using software vendors that understand and comply with all HIPAA regulations. Any technology vendor that stores, transmits, or processes your protected health information should sign a business associate agreement with you attesting to their HIPAA adherence. Finally, make sure all of your office functions are completely secure, including email, digital files, instant messages, dashboards, and calendars.
- Business Operations. The more data you have about your daily, monthly, and yearly operations, the more you can do to improve it. Practice managers typically have their fingers on the pulse of their practice and know what areas need attention. But it’s critical to gather baseline data before you start an improvement initiative so you’ll be able to clearly show the results. Strong practice management software that’s fully integrated into your other systems is essential to this endeavor.
Which leads to our final thought about medical software: interoperability. If one thing has become clear in the last decade of ever-more-sophisticated software, it’s the importance of integration. Anyone who has tried and failed to communicate about a patient or a claim will tell you that it doesn’t matter how many bells and whistles a software program has if it can’t communicate with your other systems.
Aside from slow-moving government programs aimed at improving healthcare interoperability, the responsibility for software integration falls squarely on the shoulders of those purchasing it. Choose a cloud-based system that includes all the functionality you need, then check and double check that it can connect to all the systems you use on both the clinical and the administrative/finance side.
With all the software choices out there running for medical practice at top efficiency, who’s to say which software program is the best? After rigorously reviewing many medical office applications, we’ve taken all considerations and boiled them down to the must-know, top medical software of 2023. Compare and review the advantages and disadvantages of highly specialized features you’ll want to consider for your medical office or healthcare business.
Understanding Medical Office Software Needs
PracticeSuite isn’t just an patient scheduling, billing program, or EMR software. It is a web-based medical practice management platform that combines many applications to provide a seamless, integrated whole-practice management software solution. Typical medical billing applications or stand-alone EHR software applications (electronic health records) include sub-sets of the software capabilities needed to run a medical office. But this platform takes those features and raises the bar to include a host of other must-have capabilities for the today’s modern health care practice.
Create superbills for each of your patients, create insurance claims and reports for every visit, keep a detailed schedule, and more. The front office features integrate seamlessly with the electronic medical records, patient portal, billing and collection modules to form a complete whole practice office solution.
End-to-end software that supports 61 clinical specialties and 150 billing specialties, so you can benefit from the software no matter what type of medicine you practice. The revenue cycle management system can help you manage claims and recover missing revenue and better manage your cash flow. Create a Sandbox Account!
Many Applications – One Office Solution
We know all medical offices need a way to engage patients and that’s why we offer patient portal and medial CRM tools for patient outreach. From rural medical offices to the highly specialized urban care centers, efficient practices keep organized and their economic engines running through appointment scheduling tools. Once patients are seen, medical billing software applications kick-in to process payments and then collections applications help make sure they are reimbursed correctly.
In addition to being comprehensive and complete in its platform feature list, it is also the most affordable system in our review of 2023’s best medical software. It’s best for small offices to mid-sized groups of 11–75 doctors and uniquely designed to support medical billing companies who assist practices with outsourced third-party medical billing services.
Northside Family Care practice Manager Kelly Clark says, “we all agree this is the best software we have used to date.”
Determine What Applications are Necessary In Your Office Setting
We estimate that today’s modern medical practice will interact with at least 5 different medical office software applications every day. Here are the two most common application types:
Medical Practice Management Software: the tools medical billing staff, front-office staff, and the administrative staff use to schedule appointments, organize patient visits, workflow, and the revenue cycle of the business.
Electronic Health Record – EHR: the tools doctors, nurses, therapists, therapists, and medical records staff use to document patient care, manage quality metrics, and keep on top of all the clinical laboratory, pharmacy, and treatment orders across their patient population.
With so much talk in recent years about incentive programs and quality-based reimbursement, these two systems have taken the forefront in many discussions. However, other software tools are critically important to running an efficient medical office. Here are few to consider.
Medical CRM: CRM stands for customer relationship management software and is sometimes referred to as patient relationship management software in the medical environment. It gives clinical and administrative staff tools to routinely reach out to patients between patient visits. They use these tools to extend their care beyond the patient visit and keep engaged with the patient until they see them again.
Online Reputation Management: Patient satisfaction is quickly becoming the name of the game for physicians and practices. In fact, it is starting to impact their revenue! These tools give practices and physicians ways to proactively seek patient feedback and manage how that feedback helps showcase the great care they provide.
Did you know that 84% of patients use online reviews to evaluate providers?
Websites and Patient Portals: Online and self-service is the name of the game for today’s consumer-oriented patients. The tools young patients, middle aged patients, retired patients, and even senior patients use to communicate with their doctors.
Waiting Room Kiosks: Managing patient scheduling, check-in and patient flow through the office starts as soon as they walk in the door. Kiosks and mobile devices for patients in the waiting areas jump-start the workflow and keep the patient engaged without having to wait for someone behind the front desk to be available.
When it comes to medical practice management can you think of other office software applications? These solutions are but a handful of all the available applications on a robust office platform. We’ll discuss email, secure file storage, HIPAA compliance, project management tools, and others in a different review.
Understanding Pricing and Commitment Levels Across Options
With the diversity of applications contained within the Medical Office Software category, pricing is quite variable. There are several clarifications you need to make every time to discuss pricing with a medical office supplier.
- Do we pay for the software monthly?
- Is price impacted by the number of people who will use the software?
- Does the price change based on the number of licensed medical staff using the software?
- How does the number of patients impact the price of the software?
- As the software is updated, what additional costs are there to receive the latest enhancements?
- Are there any features that will require more money to turn on?
- Does the price change based on the number of computers/devices we use?
- Are there any additional storage fees for HIPAA compliant storage?
Another important aspect of pricing is how long you will be on the hook for paying for the software. Sometimes there will be a contract that you sign committing yourself to a specific period. Other times, you pre-purchase months or even a year. In those cases, make sure you check the refund policy should you decide the software does not work for you.
Understand the Diversity in Price and Total Cost of Ownership
As far a price ranges and methods, we have seen several prevailing models in our review.
Freebies: Medical offices have access to free software products across all aspects of the practice – web-based medical billing, EHR, appointment scheduling, patient portals, and even websites. Generally, the free software has great capabilities, but also have limitations that can easily be overcome by upgrading to a paid version. Nonetheless, free is good and many organizations do quite well with completely free products.
Price Range: $0
Try For Free: These “Try It” models are different from freebies in that there is usually a time limit to the “free” trial period. Common time frames run from 14 – 30 days after which the account is closed if an upgrade to a paid option is not selected.
Price Range: $0 for A Limited Time!
Monthly Subscription Pricing: This is the most popular model across all practice software pricing models. Medical offices pay a monthly amount based the size of the organization and the capabilities in the subscription.
Medical Practice Software Price Ranges:
- Medical Billing Software $99 – $800+ per provider per month
- Appointment Scheduling Software $20 – $199+ per month with various user counts; often included in other software bundles
- EHR Software $99 – $1,000+ per provider per month
- Patient Portals: $5 – $100+ per month; often included in other software bundles
- CRMs: $19 – $1,000+ per month per user
- Online Reputation: $199 – $500+ per provider per month
Technology Enabled Services Pricing: Another element in the pricing equation is when a company provides third-party or outsourced services for the medical facility and thus, the facility is given access to a portfolio of software tools. In this case, the software usage is “free” but only with a paid services engagement.
Price Ranges for Services: 1.9% – 10% of monthly collections
New School Meets Old School Pricing: There are also pricing models for stand-alone apps across some of the categories that range from one-time purchases on the Apple App Store or Google Play to traditional software purchases where you buy the software with a one-time fee, install it on your computer, and pay for upgrades if and when they become available.
Know The Vendor Landscape
PracticeSuite is proud to be one of the top companies in this area. Below is a list of other companies you may encounter as you evaluate your options. Hear from their users about their experience with the software – what they like, don’t like, had problems with, and received help on.
Vendors listed in alphabetical order
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