Identify and confirm patient insurance benefit eligibility level and copay quickly
Implement your choice of the many clearinghouses that our software integrates with
Receive patient payments faster with integrated online patient payments
Customize patient statements generation by Locations, Business Units, Rendering Doctors, or Attending Providers on a specific day of a month
Post EOBs/ERAs quickly and efficiently
Streamlines communication, simplifies administrative and financial tasks, and enhances physician and staff productivity
Time-proven implementation methods for successful Practice Management software transition
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Manual claim processing often results in unnecessary errors. Electronic claims mitigate those errors and enable medical practices to use software to transmit corresponding data to payers for processing and reimbursement. By electronically submitting them, practices can track and monitor claims and better understand what’s being done to get them paid.
Claim denial occurs when a claim is processed and then repudiated by a payer. All rejected claims are put into a bucket that can be monitored daily for refiling. The denied claims area within our Practice Management Software gives you the ability to sort, and group denied claims to work. Templates are available for appeals, which can be faxed directly from the claim screen. The clearinghouse functions incorporated in our Practice Management Software give you the ability to refile claims at the clearinghouse level versus logging into the payer’s website.
Quick and easy access to necessary reports and documents is an essential part of the management of financial reporting, which helps optimize practice operations by identifying revenue cycle trends and proactively addressing them. This type of reporting also is utilized for customized decision support and advanced denial management processes.
Electronic scheduling gives providers the option of sending secure, HIPAA-compliant, paperless intakes to patients. This eliminates the need for patients to complete the time-consuming task of filling out paperwork when they arrive for their appointment. It also can be used for scheduling procedures and combined with appointment reminders for improved patient communication.
Missed healthcare appointments cost the United States an estimated $150 billion annually. When patients schedule their own appointments, though, they're more likely to show up. Automated appointment reminders allow physicians’ practices to easily communicate with patients, saving time and money while also reducing cancellations and decreasing no-shows.
PrognoCIS Practice management software aids in streamlining payment processes and facilitating quicker reimbursement. Providers can electronically view and verify patients’ demographics and allowable health benefits, including access to insurance, deductible, co-pays, and other vital billing information. This task can be completed when the patient’s appointment is scheduled, thereby improving efficiency in managing patient eligibility.
A code set is defined by the Centers for Medicare & Medicaid Services (CMS). This shared list of codes is used in place of longer names or explanations. The World Health Organization (WHO) created the International Classification of Diseases, a diagnostic tool utilized globally for epidemiology, health management, and clinical purposes. ICD-10 consists of more than 70,000 procedure codes and 69,000 diagnosis codes. Current Procedural Terminology (CPT) refers to a set of medical codes used by physicians, allied health professionals, non-physician practitioners, hospitals, outpatient facilities, and laboratories to describe the procedures and services they perform.
PrognoCIS practice management systems includes multiple interfaces to improve interoffice communication and collaboration. This type of interface eliminates the need for manual data entry and reduces errors by interfacing with QR code scanners.
EHR Integration improves clinical efficiency by allowing physicians to have a comprehensive overview of their patients' conditions. It also helps reduce over-utilization of services and redundancies, resulting in lower healthcare costs for patients and physicians.
A clearinghouse interface helps verify patient eligibility in real-time and offer advanced search options for data access. Aligning an intuitive interface with the clearinghouse reduces training time and allows the billing processes to run smoothly.
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Medical Practice management is the process of coordination and administration of tasks that are an integral part of managing the finance and administration of a doctor's office or an office of a medical professional. It comprises of :
Change occurs in every industry, and healthcare is no exception. New technologies, trends, regulations, and research continually shape the industry. The implementation more than a decade ago of the Affordable Care Act and the move from fee-for-service to value-based care have impacted patient care and the way physician practices operate.
Although doctors have administrative tasks in addition to their focus on patient care, it’s almost impossible for them to manage their practice without assistance. That’s where practice management comes in.
According to the American Academy of Professional Coders (AAPC), the role of a practice manager is to manage all aspects of a medical practice, including financials, human resources, information technology, compliance, marketing, and operations. Their goal is to enhance patient care, ensure day-to-day operations of the practice run smoothly, and alleviate administrative burden on the physician(s).
What is Practice Management System?
Practice Management Software or Practice Management System (PMS) is a medical management program used by healthcare providers and medical practices to automate manual and effort-intensive financial and administrative tasks (like appointment scheduling, medical billing, etc.) and replace them with standardized electronic transactions and workflows. In addition to enhancing the efficiency of physicians’ clinical workflow, the right practice management system enables practice staff to accomplish the following:
Practice management systems are a critical linchpin to the success of a medical practice and achieving its goals of driving down costs and improving quality.
As with any new process or solution to maximize practice management benefits, the selection and implementation processes of practice management software must be well-defined, carefully planned, and based firmly on research-based practice management systems best practices. Systems can be implemented in practices of all sizes. The technology is scalable. Its storage and processing capabilities are not limited, like a traditional physical storage room. Although the prospect of implementing a new technology solution and training staff on its various functions might initially be overwhelming for some, the benefits far outweigh the challenges.
Because practice management and EMR software initially should work together seamlessly, selecting a fully integrated system is recommended. The combined capabilities offer
Some providers prefer to keep their practice management and EMR systems separate, but that can cause numerous problems because the two don't always work well together. A breakdown in communication may occur even among programs designed to work in sync.
Practices that choose to implement a server-based practice management solution must invest in expensive servers, infrastructure, and backup systems and provide the necessary maintenance and security to store and manage the data. Plus, they need dedicated space to house their servers.
Desktop-based practice management software is sometimes less expensive, but it’s typically used on just one computer accessed by only a few people.
Cloud-based practice management software can easily be scaled to meet the needs of a growing physician’s practice and doesn’t require the purchase of new servers or complex backup systems. That not only reduces your costs but decreases your physical footprint. This software also eliminates or reduces the need for costly in-house IT support and allows upgrades and software patches to be applied automatically after the critical operating window.
Although these two types of software appear interchangeable, they vary in numerous ways. The most significant difference is that practice management software streamlines administrative tasks, and EMR software handles the documentation and storage of patients’ medical data
Practice management and EMR software can be used individually. However, when combined, they help physicians’ practices operate with speed, accuracy, and ease and create a simplified workflow for physicians and staff members. Combining practice management with the EMR software keeps all staff members within a practice connected by providing an unbroken flow of information.
Because of advancements in technology and the benefits of cloud-based technologies, most applications based on client-server technology have been migrated to cloud technology. This makes it easy for practices to store, create, share, and track digital patient data, including billing and scheduling information.
By integrating EHR and practice management software, physicians’ practices streamline their operations and achieve better management of and easier access to electronic health records. This combination also makes it easier for practices to adapt to numerous regulatory changes and address reimbursement challenges.
Telemedicine has revolutionized medical practice by allowing both patients and providers to benefit from more personal, cost-effective, safe, and reliable methods of healthcare delivery. By integrating telemedicine services with practice management software, providers can give better quality care because they have access to a more comprehensive picture of the patient’s health and medical conditions beyond a single visit. This interoperability provides faster, more accurate diagnoses, improved efficiency in care coordination, quicker treatment, and more.
When using practice management software, documentation can be completed using a mobile device at the patient’s bedside or the point of intervention. The ability to instantly document, chart, or code minimizes errors that may otherwise occur when lags exist between the point of care and documentation. Many clinicians want to access patient data remotely. Practice management software systems optimized for mobile use gives them the option of electronically sending patients secure, HIPAA compliant information, scheduling appointments and procedures, and communicating important insurance and billing information.
A patient portal allows providers and patients to communicate with each other safely and securely over the internet. Physicians utilize the portal to set up automatic reminders for preventive healthcare checkup reminders and procedure due dates and electronically send patient statements and lab results. This creates a competitive advantage for practices by saving time and money by reducing unnecessary provider face time, staff time, and patient follow-up calls.