However, interfaces might be a necessity for practices that have difficulty finding an integrated product to meet their needs. Illinois Bone and Joint Institute, for example, a 90-physician orthopedic group with 20 locations in the Chicago area, uses the Vision PM system from Allscripts interfaced with an EHR system from SRS.
"An integrated system is easier to navigate but our challenge was finding one that serves our size, and Allscripts works for us," says Kristie Martinez, administrator at Illinois Bone and Joint's nine-physician Gurnee, Pa., division. "But we have real-time interfacing between Vision and our EHR. The minute an appointment is made in the Vision system, it is uploaded into the patient's EHR."
Finding the right PM system requires researching and vetting different vendors upfront, says Bellile. But that time is well spent if you find a system that accommodates the specific needs of your practice.
"A lot of practices underestimate what needs to be done in terms of selection and setup," she says. "We spent a lot of time talking to other physicians and practice managers and having in-house demonstrations from both of the vendors that we were considering."
Any product you choose should come with extensive support from the vendor during and after implementation, says Asia Blunt, practice management strategist at the American Academy of Family Physicians. She advises asking vendors what's included in their monthly or quarterly maintenance fee, such as system upgrades and service calls; how frequently the system will be updated; and whether they provide cloud-based hosting (most vendors do).
"You may find that some vendors have a higher fee upfront but that it saves money in the long run if upgrades and maintenance are included," says Blunt. "It pays to shop around because there are many different prices and options."
One of the most valuable functions of a PM system is automating the claim submission process. Most systems not only create electronic claims but also use "scrubbers" that work in the background to validate the diagnosis, procedure, and modifier codes against insurers' standard coding edits and rules.
"Scrubbers have edits from all insurers built in," says Anderanin. "It will put claims through the coding edits overnight and you can correct them before the claim goes out, which reduces denials on the other side."
"We've seen a 30 percent revenue increase since implementing our PM system," says Werner at Tri-County Eye, which uses NextGen's Real Time Edits scrubber add-on. With claims going out faster and cleaner, the practice has seen its average collection period for accounts receivable drop from 31 days to 17 days, she says.
All new systems are equipped to handle ICD-10 coding requirements that go into effect Oct. 1, 2015, says Anderanin. However, some practices may have to run ICD-9 coding in tandem because not all types of insurers (i.e., those not covered by HIPAA) are required to make the conversion. In those cases, systems can be programmed to automatically switch to ICD-9 coding for certain payers.
For example, Illinois Bone and Joint often deals with workers' compensation and auto insurers on claims relating to accidents and workplace injuries. The PM system is programmed to automatically apply ICD-9 codes for those payers who will not accept ICD-10, says Martinez.
At Premiere Dermatology, after claims are submitted, the system allows insurers to deposit funds electronically into the practice's account, says Bellile. The payments are immediately processed and adjustments posted to the patient's account.