What you need in a practice-management system

Practice Pointers. By Karen S. Schechter, AMNews contributor. Aug. 21, 2006.

PRACTICE POINTERS

Answers to questions about the business side of your practice

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Question: There is so much hype about electronic medical records, but is anyone still looking at practice-management features and functions when they are shopping for new systems? Is there anything new that I should be aware of as I look for a new system for my practice?

Answer: With or without an attached electronic medical record, the office's practice-management system is critical to its value. This system supports scheduling appointments and billing and collection functions necessary for the practice to realize revenue for its services, whether documented on paper or in the EMR.

Because of the constant changes in health care reimbursement, government programs and other influences, physicians must make sure that their practice-management system provides the features and functions necessary to address those challenges.

Most practice-management software systems are able to capture the data important for billing and collections. The key is to make sure that once those data are entered, the office staff has access to them in a useful format. The basic data elements that the system must be able to capture and process cover patient information -- number of patients by plan, age, gender, ZIP code, ICD-9-CM and CPT codes -- and billing information by payer -- charges, payments, adjustments and denials.

With this basic information, the physician can determine a lot about the health of his practice in the managed care environment. By reviewing the ZIP codes of patients in a specific plan, the physician may begin to understand the socioeconomic status of that population.