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Accessing the Health of Medical Practice Management Solutions

Posted April 16th, 2018

Choosing the right medical practice management solution is a critical undertaking, and the focus of a new Smart Decision Guide scheduled to publish in Q3. After all, its functionality and usability are sure to have a direct correlation with the practice’s overall productivity and long-term financial success.  PM technology capabilities have evolved dramatically in recent years, partly in response to the passage of federal healthcare laws. Software that can organize medical records and patient information and speed the completion of common tasks like scheduling new appointments and processing billing and insurance claims was once seen as cutting-edge. Today these capabilities are considered to be table stakes.

The benefits of next-generation solutions range from optimizing process workflow and resource management to streamlining operations and enhancing revenue cycle management. Some solutions feature automated task management functions. Others include advanced scheduling capabilities designed to optimize the utilization of staff, rooms and equipment. Some solutions include cutting-edge information storage and retrieval technologies. Others come with data analytic tools that can be used to generate key insights into claims data, payment activity and reimbursement patterns.

Importantly, many PM solutions offer seamless integration with electronic health records (EHR), public registries, decision support databases, and other third-party information sources. Most solutions are designed to maintain compliance with government regulations and healthcare mandates. These mandates include the latest privacy and security requirements related to healthcare information handling and exchange, and critical changes to HIPAA electronic standard transactions, HITECH Act, Omnibus Rule and ACA requirements.

Next-generation PM solutions also support ICD-10, which, as every beleaguered office manager knows all too well, went into effect in the United States last year, bringing sweeping changes to medical coding and compliance processes. Practices can no longer submit claims with incorrect ICD-10 codes.Those that do are likely to see those claims categorically rejected, resulting in delayed reimbursements that can have a significant impact on cash flow. Next-generation solutions can ensure compliance with current and future regulatory requirements and healthcare reform mandates.

Next-generation PM solutions have evolved almost beyond recognition in terms of sophistication and comprehensiveness — in some cases, morphing into unified information, communication and management platforms. That said, no two PM solutions are exactly alike. In fact, the front- and back-office features of different solutions can vary in fundamental ways. So, too, can the requirements and priorities of individual practices. Matching the right practice to the right PM solution generally requires research, knowledge, patience — and, again, the right framework for assessment.