Features That Will Save You Time And Might Improve Your Bottom Line

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Practice Management Systems

• Features That Will Save You TimeAnd Might
  Improve Your Bottom Line
• Steven D. Atwood, M.D., FACP
• satwood_at_pol.net
• www.adultmedicine.com/presentations/practice-manag
  ement-systems.ppt

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Key Points for Today

• What you need to know, not nice to know
• What might separate the winners from the losers
• Specific examples of how your PMS can actually
  help you do your job or help
• save time
• improve efficiency
• increase patient satisfaction
• improve your bottom line

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Key Sections for the Physician

• Scheduling / registration
• Billing / accounting
• Serving the patient
• Which program
• Where to get suggestions and specs

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Lets Get To It
Scheduling

• Everyone Must Be Able to Schedule
• nurse when telling coag results
• doc when telling patient to drop in
• See Schedule at Every Station and From Home
• 30 Second Rule Book Appointment in Seconds
• patient name, doc, reason, when, done
• trim names selection to those that are relevant

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See Schedule
Easy to Add or Change
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Know key data beforethe time is reserved
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How much time, which room
Robust detail
Bundled procedures
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Are You Behind?When Can You Get
Back to the Hospital?
Helps to track when patients

• Arrive
• Roomed
• Exit
• No Show

Show the data by using symbol, color, highlights
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Seen and left
You are seeing now
X No Show
e.g. 9am and you are behind
Arrived
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Practice Management Systems
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One Write, No Duplication

• Cut Paste
• Drag Drop
• Notes Everywhere e.g. individual claims,
  individual codes such as with
  prolonged detention

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Cut and Paste or Drag and Drop to any
spot that week or in future months
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Practice Management Systems
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Notes, Notes, Notes Everywhere

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Practice Management Systems
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Archive the Inactive Data

• No scrolling through 30 people with similar
  names
• Index patients by doctor or site then use
  the list associated with this site etc.

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Archive or leave out the data you dont need
gtgtleave out patients not seen in 10 years
gtgtjust your sites patients--not entire system
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Practice Management Systems
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Summary--Scheduling

• Book an appointment in seconds
• Anyone at any workstation can book the
  appointment
• When locating the patient on your list, the list
  should be trimmed to just your active
  patientsnot every patient who was ever entered
  into the database

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Summary--Scheduling

• Scheduler can easily see all the key data as the
  appt. is made and as you are working through the
  days schedule
• Cut Paste, Drag and Drop, one write system
• Notes everywhere, appointments, insurance, bills

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Billing

• Fee structure every insurance company PAID
  vs. EXPECTED

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Billing

• Past we used numerous fee schedules
  generally a Medicare max allowed fee schedule
  and a fee schedule for the rest of your
  practice

• Now generally all accounts assigned but
  everyone has a different payment schedule e.g.
  1.6 x Medicare rate, no coverage for carve outs
  another is 0.8 x Medicare rates

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Billing

• Paid vs. Expected - your computer should show
  you the expected payment as you enter
  payments

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Billing

• Paid vs. expected--see as you enter

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Billing

• charge vs. paid for each insurance company

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Billing

• Export almost any field for report of data
  analysis Best of Breed, not locked in

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QUERIES

• PMS is basically linked databases
• the setup is proprietary coding and formatting
• you are locked in
• when you buy it you might be married for life
  because you might not be able to get your data
  out if you switch to another program

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QUERIESPMS Design Linked Databases
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QUERIES
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QUERIES

• Now STANDARDS Provide the Connectivity
  Between Programs
• Not Locked In, so Programs Compete on
  Performance
• Best of Breed may be easier to determine
• Export every field will help all this

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Billing

• Modular not All-in-One
  Off-the-Shell Software

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Off the Shelf Software vs.
All-in-One Package

• Software doing majority of operations for
  a large corporation may have dozens of pull
  down menus and take 3 days of training
  before you can use
• e.g. IDX or similar software for large
  health systems

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Off The Shelf Software vs.
All-In-One Package

• Separate Programs or Discrete Modules
  helps 1.) Training 2.) Security
  3.) Upgrades
  4.) Can Reduce Down Time
• Quicken 79 --bank activity and office expenses
• QuickPay 50 or QuickBooks 179 -- payroll
• HotFax --can fax any file as if you were
  printing it

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Billing and Practice Management Software

• Future Is Modular
• No All-in-One Program Separate Program or
  Module for Each Part e.g. EMR, Billing,
  Schedule, Ordering
• Now STANDARDS Ability to Import and
  Export data can Provide the Connectivity
  Between Programs

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Billing

• Security specific for each section or each staff
  member

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SECURITY

• User ID, Password
• Station ID
• Section Permission e.g. Hospitalize
  Senator, only treating staff have
  access to this patients tests e.g.
  charge and collection for the day not
  accessible by file room staff

Too many programsgive full access to
everythingafter you log on
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Billing

• Print-to-File vs. Programming an Interface
  to transfer data between programs
  Print-to-File rather than a printer
  makes report or papers go to a
  digital file then can save it, send it, print
  it or automatically add the data to a database

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Print to File

• Best thing since sliced bread
• EG. 50 page AR report made in digital form
  then save this file rather than paper
  then send your satellite office(s) this via
  e-mail rather than mailing or faxing
  50 pages
• can use a claim clearinghouse NO
  INTERFACE PROGRAMMING NEEDED your digital
  file fills in their database

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Print to FileData to Clearing House

• e.g. Claims to a clearing house via the www
• Generate HCFA type claims to Print
• then you can Print to File so you can save the
  printout and all its formatting
• Send to your claim clearing house as file upload
• Your clearing house can use this file and the
  print layout to transfer this information to
  their database NO INTERFACE NEEDED-- NO
  MORE TYPING

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PRINT TO FILE
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PRINT TO FILE
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PRINT TO FILEcan look like a HCFA claim with
just your data being displayed


Every letter and number is exactly where it
would be on a claim Thus a computer can
import the data
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Print To File

• Select printer then click print to file option
• Go to DOS prompt (in WindowsgtAccessories)
• Enter the command PRINT and file name e.g.
• Then strike enter and your file prints
  thus you can save anything you want to print

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Print to File printer must be connected by LPT-1
port
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Summary Billing

• Security specific for each section or each staff
  member
• Fee structure every insurance company PAID
  vs. EXPECTED
• Export almost any field for report of data
  analysis not locked in, Best of Breed
• Modular not All-in-One Off-the-Shell
  Software
• Print to File vs. Interface programming

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Physician in Back Office

• Need a full current registration sheet or
  face sheet right at your finger tips
• insurance type may dictate where to go for tests
• insurance type may dictate which hospital to use
• insurance type may only cover certain meds
• may need DOB
• may need SSN
• may need phone numbers for patient
• may need phone numbers for insurance company

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Physician in Back Office

• then as a batch you can
• printfaxreservereformat

• must be able to tag individual data
• progress notes
• claims to send
• schedule spots to reserve
• rooms or equipment to reserve

Same as hold down Control then left click to
select desired data in MS Windows
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FAX

• If you can print it you should also be able
  to fax it

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Send to fax machine rather than printer
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Practice Management Systems
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Orders

• prescriptions goal is to order the
  right med quickly
• formulary
• which med, which dose
• vs. Voice Mail at Pharmacy

FAX a Script--how do you sign
if digital signature not OK
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Forms

• Scan the form
• Insert the file on a page as a background
• Overlay text boxes where the data goes
• Bookmark each box (controlF9)
• Jump box to box / bookmark to bookmark (F11)

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Any word processor hopefully your PMS can
prepare and store any form
Start box 1 F11 to jumpto next field
bookmarks
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Practice Management Systems
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Physician in Back Office

• Email at every work station internal
  network vs. entire web inexpensive

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Summary Physician Seeing Patients

• Face sheet
• Create batch for faxing or printing all at once
• Fax directly without converting to paper
• Outside forms become part of your program
• Internal e-mail system

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Whats Out There
Selecting Your Practice Management System

• How Many Different Programs
• List of Vendors
• Cost
• Features

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PMS Vendors
List on Internet at
www.HIPAA.org/ pmsdirectory
about 110 listed
www.HealthCareInformatics.com/
issues/2002/10_02/spotlight.pdf
www.aafp.org/ PreBuilt/fpnet_techguide.pdf
9 rated
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PMS Vendors
There are over 110 programs perhaps ½
have ASP (web based) option
e.g.
Larger Systems
Smaller Offices

• Medical Manager
• Millbrook
• IDX
• NextGen
• CompuMedic

• Lytec
• Medware
• Medisoft
• E-MD
• FoxMed

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PMS Purchase or Lease Prices

• Varies by optionswide range
• Buy and own, then elective updates
• Yearly lease and required yearly updates
• Monthly lease per provider or per station

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PMS Purchase or Lease Prices
Varies widely and changes - many options
- must contact vendor
perhaps

• 200 Medisoft
• 600-2000 MedWare, Lytec
• 7,000 NextGen per provider
• 15,000 IDX, Medical Manager

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Where to Go for Information

• www.acponline.org/PMC/practice.htm
• www.ComputingForClinicians.com by ACP Fellow
• www.aafp.org/practicemgt.xml user
  comments
• www.ctsguides.com/medical.asp buy reviews
• www.HealthComputing.com/KLAS buy reviews
• www.MGMA.com
  members only
• www.KnowledgeStorm.com needs free
  registration
• www.CivicResearchInstitute.com/mi5.html

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SUMMARYon Leveraging
Your Practice Management System to
Save You Time, Improve Efficiency,
and Improve Your Practice

• 1. Everyone Working with Patients can Schedule
  and Has Access to Registration Data
• Just seconds to reserve an appointment
• Need to know the health plan and contact numbers
• Registration data effects your medications and
  tests
• Old unused data to archives
• MS Office type featurescut/paste, drag/drop,
  tag

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SUMMARY on
Leveraging Your Practice Management System
to Save You Time, Improve Efficiency,
and Improve Your Practice

• 2. Your software will serve you needs betterif
  you can easily import, export, and query almost
  every field in the PMS
• List of who is on a medication if a new alert
• List and of patients on a HMO
• Export your data to your new software
• 3. Need ability to track expected payments for
  each
• insurance company as the payment comes in
  

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SUMMARYon Leveraging
Your Practice Management System to
Save You Time, Improve Efficiency,
and Improve Your Practice

• 4. Need ability to easily find, complete, and fax
• paper
• e.g. Referral formwho, what, where, when, why
• 5. Inexpensive programs like Quicken can easily
  manage key functions Maybe everything in one
  program is not a good idea
• 6. Every work station needs office e-mail

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Questions
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Practice Management Systems

• Features That Will Save You TimeAnd Might
  Improve Your Bottom Line
• Steven D. Atwood, M.D., FACP
• satwood_at_pol.net
• www.adultmedicine.com/presentations/practice-manag
  ement-systems.ppt