It seems that every time we turn around, something new is being introduced in the world of computerization, including more advanced ATMs, paying at the pump for gas, and the ability to get just about everything we could possibly need on the Internet. The reason computerization is happening at such a rapid pace is simple. Technology makes things easier and faster, for customer and provider alike. The benefits of computerization also apply to the chiropractic office.
Unfortunately, many chiropractic offices have avoided computerization, or have invested in a system that does not meet all of the practice’s needs. Many new doctors or first-time buyers buy the cheapest system they can find without fully evaluating whether it meets their needs. In addition, not everyone knows what to look for in a chiropractic software system. After all, a chiropractor goes to school to learn how to treat the patient, not how to bill an insurance company. That’s where a technical support specialist comes in. A good tech support person knows about computers as well as chiropractic billing.
Choosing the chiropractic management software that’s right for your practice need not be a guessing game. Read on to see what you should be looking for in your first software program, or to determine if your current software is meeting your needs the way it should be.
Y2K and ODBC Compliance
First of all, there are a few things you should look for before you even spend time looking at a software program. Obviously, you want the software to be Y2K compliant. Who wants to buy software that will be obsolete in less than a year? Software companies should have completed and passed Y2K compliance testing for Medicare and any insurance companies that are billed electronically. In addition, printed HCFA forms should have eight-digit dates. The ability to transmit and print accurate century data is crucial.
Equally important, but often overlooked, is Open DataBase Connectivity (ODBC) compliance. When a chiropractic practice has used a particular software program for a few years, the office has invested hundreds of hours worth of data input into the current software. If the office wants to purchase a new program, they have to be able to transfer their data to the new program or spend months re-entering patient information. To their dismay, some doctors find that their data is encrypted or written in some obscure language and cannot be transferred.
If a program is ODBC compliant, data are being stored in a format that is easily converted or transferred to a new format. With ODBC compliance, you have control over your future.
An effective and efficient chiropractic management software program should offer the following attributes:
- Ease of use: If you and your staff can’t figure out a program shortly after sitting down in front of it, don’t waste your time. Software should be user-friendly and intuitive. It is not cost-effective to spend hours and hours training your staff. A chiropractic office needs software that is easy to learn because it minimizes downtime caused by any staff turnover.
- Screen display: The program should access patient data and load screens quickly. Since all software seems to be turning to Windows or Windows NT, it would be smart to invest in Windows-based software. The big advantage of Windows operating systems (aside from the fact that it is quickly becoming the industry standard) is display. In Windows, you can layer screen on top of screen. By comparison, DOS-based programs force users to exit one screen entirely before loading another. Once you get used to Windows, a DOS-based program seems clumsy and clunky.
- Network: The software should be networkable or multi-user. In a network, two or more computers are hooked together, allowing multiple people to enter data at the same time. One chiropractic assistant could be scheduling appointments and processing transactions, another could be posting insurance payments (because your billing has become so efficient), while a third employee could be transmitting an electronic file. For a network to function correctly, the software must employ record-locking so that two people cannot access and change the same account simultaneously. In an ideal situation, the only fee for additional workstations would be the computer hardware for these additional terminals.
- Limitations: Before you purchase new software, be sure to gain a clear understanding of any limitations of the program. You will need software that has a database sufficient for your patient load. Except for those packages designed for new doctors, there should be no limitations on the number of patients or transactions allowed.
Insurance Billing Program
The next priority after the general software requirements is the insurance billing program. It should not take more than a few minutes to create a billing file, regardless of the number of claims being billed. You should be able to create hard-copy and electronic claims.
An important factor to consider is whether the software is an approved vendor for electronic billing in your area. It is certainly in your best interest to bill electronically to as many insurance companies as possible. It is faster, easier, and much less expensive. Most states have at least one clearinghouse that will process Blue Cross, Medicare, and sometimes Medicaid and commercial claims with no charge to the practitioner.
The software system should also have some type of prebilling summary that allows you to check the claims before you actually send them in, preventing many unnecessary, avoidable rejections. When you transmit claims electronically, a last-minute check for completeness is important.
Another important feature is patient statements. The ability to produce readable statements quickly should be a priority. There are systems on the market that take hours to sort patients who need to be billed. Other systems will print statements that even an accountant cannot understand. Ask to see a sample patient statement before purchasing.
Unfortunately, many doctors cling to their paper appointment book even though the computer does scheduling more quickly and easily. When a patient calls to inquire about the date and time of his or her next appointment, a good computer program includes a “find” feature that instantly locates the next appointment. A similar search of a paper appointment book can be painfully slow.
A good program should be able to adapt to your office schedule. You should be able to set the schedule up with chosen time increments and schedule multiple appointments at a single time for each doctor in the clinic. The appointment scheduler should navigate quickly.
The Importance of Reports
Reports should be readily available, allowing you to track your office’s growth, income sources, new patient referrals, or anything else you feel is important. A great feature is the ability to export these reports into a database program such as Microsoft Excel, which will allow you to transfer the data into graphs or charts, making any trends more obvious.
Sometimes you need access to data that is not included in a typical aged accounts receivable or income statistics report. The ability to create a customized report for your specific needs is also important.
The need for accurate, regular documentation has continued to increase in the past few years, and most doctors will agree that writing the narrative reports insurance companies request is not much fun. In addition, there is constant fear of “the audit.” Chiropractors are required to justify the treatment of each patient they see.
Often, it is not the condition of the patient, but the quality of documentation regarding the condition of the patient, that determines the amount of care that will be deemed medically necessary by the insurance company or auditors. Therefore, a good investment would be a software program that has found an easy, fast way to create daily notes and narrative reports.
Programs are available that work with touch screens, pen-based computers and voice recognition, all tools that can speed the documentation process. Your software should include both management and documentation components, or you should have two programs that can communicate with each other. Otherwise, you and your staff will spend a great deal of time inputting data more than once.
The program should be easily customizable, letting you keep track of any special tests or documentation that are unique to your office. There is also software available that can import items such as X-ray images and pictures that can make your reports more comprehensive.
The Importance of Support
“If you don’t have good support for your software, you don’t have good software!” is a statement that most doctors find is true. The most common reason cited for changing software vendors is poor technical support. Commonly, software companies charge an annual fee for support, which is used to pay for support staff, improvements to the software, and programming costs. Before committing to a software company, ask some questions about the technical support:
- Is there an annual charge?
- Is there a period of free support after purchasing?
- How do you get trained to use the software? Does the company come to your office, supply training material, or are you on your own?
- Is there a limit to how many times an office can call in a day? Is support available during your business hours?
- Will you get an actual person when you call, or a machine?
- Is the support staff well-educated in the software, quick in giving answers to your questions, and patient enough to spend time with you on the training that you feel is important?
- Does the support staff understand chiropractic?
- How long does it take to get an answer to a question?
- Do you receive updates and upgrades prior to announced changes in billing?
The best way to determine the quality of support a company supplies is to ask for a referral list of current users, especially from offices in your area. Talk to users first-hand and get their feedback about the level of support.
The software company you do business with should offer the following technology:
·Enhanced Technology: We have watched the fall-out in the software industry. For instance, a number of software products have gone belly-up rather than make their software Y2K compliant. Learn from that experience and actively seek a software company that has committed to keeping up with the ever-changing wave of technology. With advances in voice recognition and pen-based charting, computers play an increased role in the everyday workload.
- Internet Connectivity: It costs about $20 a month to have unlimited access to the Internet. With the increased use of the Internet, this small investment pays for itself quickly. Find a software company with a strong Internet presence. The company you choose should make upgrades and enhancements readily available through the company website so that you can download them at no cost. There are already Medicare carriers that will accept claims transmitted over the Internet. The software vendor should work with you to transmit claims via the Internet if that option is available in your area.
- Price: The price should be reasonable for what the software has to offer. There are some software packages that are very inexpensive, but do not offer a complete office solution. It is often worth investing a bit more to assure that your needs will be met. The software company should release upgrades to the program regularly, which are covered by the original charge and annual support. These upgrades include general improvements and changing requirements by insurance companies and the government. Your software company should keep up with the latest trends in chiropractic management and documentation software.
You can look at your software purchase as the beginning of an ongoing relationship. Like any good marriage, the two parties involved have to listen, communicate and work together for the relationship to be successful. If you pick the right partner, you will be working together for years to come.