I hear a lot of practice managers, clinical directors, and providers say that they intend ditch their outdated, clunky software, and make the switch to one that's more modern and robust, as soon as their AR is caught up. But the truth is they'll never get caught up with poor software. I've seen this too often. Even after a series of support tickets, software support calls, and months of hopeful resolution, we find that some platforms are just fundamentally flawed.
When we identify trending problems being caused by the Electronic Medical Record (EMR) and/or Practice Management's (PM) drawbacks, our first goal is to work with the software support team to fix such issues. But if all efforts fail, then we're forced to move on, and the only thing worse than dealing with bad software, is repeating the initial mistake, by signing up for bad software again.
About 80% of my clients have had to change their platform at some point. It's a tedious process and the transition can be very frustrating. Migrating data from one platform to another is already a big task on its own. But if your new software is integrated with a different clearinghouse than the one that you were using before, then you have a big project on your hands (I'll cover clearinghouses in another article). And it will take months to completely switch everything over. Your EMR and PM will affect your day to day productivity and financial profitability. That's why choosing the right software platform for your practice the first time around is so vital.
The Best Talent with Best Tools Yields the Best Results
You could have the best billing team in the world (BONFIRE REVENUE' billing team), but if the tools don't cover essential necessities, you can't expect their performance to meet their top potential. Just imagine giving a pro race car driver a vehicle with slightly deflated tires and a sticky clutch. It's likely the driver will still do fairly well, but will the vehicle's drawbacks hinder the end-game results?
Every successful business experiences a bumpy road at the beginning and healthcare practices are no exception. But if you can avoid the sting of bad software by learning from others, then that's one less problem you'll face. Changing software can be overwhelming, we know. Even so, it's important that you don't drag your feet on this because doing nothing doesn't make anything better. Moreso, you'll just lose more revenue. So whether you're just getting started, or considering a switch, let's guide you to finding a platform that will put you on the right track for the long term!
Be Smarter than Deceptive Demos
First, it's important to keep in mind that when you schedule a software demo, that demo is commonly hosted by a salesman. This salesman will tell you what you want to hear. When you inquire on a feature, he/she may very likely display that feature and stretch the truth in reference to its reliability. It's not much different than buying a car. Where there are defects, you can expect a lack of transparency on those. This is one of several reasons why healthcare practices wind up using a platform that doesn't play out as they initially expected. Unfortunately, it's hard to catch problematic scenarios such as these, until a few months after already onboarding. Don't worry, this all just takes some due diligence.
Clearinghouse Compatibility
Before you potentially waste time with a software demo, find out what the PM's preferred clearinghouse is. Every PM should have a fully integrated clearinghouse. If you're required to download 837 or 835 files, then it's not a fully integrated arrangement. The clearinghouse vendor can make or break the software platform. I've used decent software in the past, only to discover how awful the clearinghouse was, and how much it affected the software's functionality for worse. It's much like a marriage that comes with bad in-laws. The bad in-law drama is very capable of intoxicating that marriage.
Learn more about choosing the right clearinghouse here.
EMR to PM Integration
Just like the clearinghouse, the EMR and PM need to be fully integrated. This means that when superbills are generated in the EMR, their data is transmitted directly over to the PM, wherein that superbill can be configured to create a claim. A patient balance and/or ledger should also reflect the same data shown in the PM. This shouldn't require much data entry either. Seeing that all financial data is transmitted fro
m one to the other will validate a fully integrated platform. In most cases, I would recommend using EMRs and PMs that are accessed under the same login, and thus carry the same branding.
Common Pitfalls
Having a checklist can be quite helpful. I'll attach one for you to reference at the end of this article. For now, here are some of the features that I find most frequently to be lacking or completely missing in EMR and PM products.
Facilitating a corrected (replacement) claim is easy and quick.
Encounter or Claim has option to view a print preview of the 1500 or UB04 form.
Send claims to secondary payers after posting/allocating the primary payer's payment(s) and/or adjustment(s).
Generate patient statements for deductibles or coinsurance, wherein balance amounts are accurately pulled over (via automation) from previously posted insurance receivables.
Remember, just because the feature exists doesn't mean it works well and efficiently. Simple tasks should not take long. Make sure that the demo rep walks you through the whole process with sample data, beginning to end.
Don't Skimp on Phone Support
Don't fall for the limited time phone support. You're going to need help in the future, and some things just aren't well resolved over email or portal ticketing. Make sure you have unlimited phone support - even if it's going to cost a little more. Give their support line a call and test for yourself how long it takes to reach a representative. I have waited on call to speak with a live rep for over an hour with some software vendors. Prompt support matters and makes a difference, especially when you have a pile up of other tasks waiting on that one problem to be resolved.
You get what You Pay for
The quality to price correlation is very true when it comes to EMR and PM software. If the platform looks old, then it's extremely likely that it behaves as such. Old clunky software is not going to get the job done. Even if it's cheaper, it's not worth it. Before onboarding some of my clients, I discovered many cases in which they had lost as much as 50% of their revenue that would have easily been paid, had their software platform been half decent. That much lost revenue is exponentially more costly than the pricing offered by high performing software products. Believe me, I've witnessed others do it the hard way. Don't go cheap.
Don't Choose the First Option
You should be actively researching and have demos scheduled with at least 5 different platforms. The more options that you compare, the more specific and clear your vision will be for the features and flow that you want. In most cases, the first software option that you discover will not be the one that you ultimately choose. Also, remember to ask around amongst peers within your specialty that have a similar organization size and volume.
Automation is a Must-Have
When a software has the capability to do some of the work for you, then you're on the right track. Automation can save you hours of time o
n the daily. Some features in which automation should be expected include allocating (pre-posting) electronic remittance advice data (ERA - or electronic EOB), assigning patient responsibility through ERA adjustment and balance amounts, superbill generation built through chart visit routing, and outstanding claims tracking.
Customization Needs Balance
Every EMR and PM should have a certain level of flexibility and customization that caters to your preferences. One size doesn't fit all when it comes to software platforms. However, keep in mind that some platforms may proclaim so much customization that it becomes too much. If the first demo gives you an impression that the developers can essentially rebuild your entire platform to fit your preferences, then there should be a red flag. In many cases, over-customization leads to a lot of back-end issues, making your new, expensive, and modern platform feel like a beta in test phase. Choose a platform with a little bit of flexibility, but still maintains consistency for all users. This will ensure that the majority of potential bugs and glitches have been worked out.
Avoid Long-Term Contracts
Long term software contracts (and billing service contracts for that matter) are nothing short of risk to your revenue. Don't assume that you should have confidence in the product just because the sales rep is confident enough to propose an agreement that contains a long term obligation. Anything over 6 months is typically considered long term in my opinion. If your agreement reaches a year or more, then you might be setting yourself up for a massive headache and financial problems in the near future. If you find yourself already in this situation, my best recommendation is to consult an attorney in regards to your software contract. There may be a clause that enables you enough legal space to terminate without consequence, or at least dispute the contract in mediation or arbitration. If a software's performance is beyond reliable functionality, then it may not be very difficult to justify the software vendor's service as unfulfilled, which could give you the leverage to break free.
A lot of vendors will offer you a discounted plan should you sign up for the long term option they offer. Don't give into this discount until you've used the platform for at least 6 months and consider it reliable. Stick to the month-to-month until you're sure.
It May Come Down to Your Preference
Just because it's a good fit for others, does not mean it's the best fit for you. Perhaps your operations, treatment, and organization workflow has some unique elements and processes that require features different from your peers. In the end you'll narrow down the best options, and weigh their pros and cons with each other. But the fact that it may just come down to preference is important to remember. Sometimes there are high tier features that you won't actually need. Do what feels right, but put in the necessary diligence to determine which one that is.
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