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Using the provider's practice management software

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mattsantos:
Hey guys,

I have been working for a chiropractor for about 2 years and am going to start my own billing business specifically for chiropractic offices. I was wondering what everyone's viewpoint is on connecting to the providers' current practice management systems over the internet (via GoToMyPC for example) and billing directly from that versus having your own system. It seems to me that there would be some drawbacks but they would be outweighed by the benefits.
Pros:

* Doctor's staff doesn't have to print out super bills or day sheets for you.
* Less double entry of claims and postings means less chance for human error.
* Less double entry also means a significant reduction in time needed to bill. (especially for high volume chiros)
* Posting payments and sending claims from their software allows the provider to check on stats/reports at their leisure.Cons:

* Some offices may not be comfortable with you connecting to their systems.
* Most all billing would have to be done during off hours to ensure that the computer you are connecting to is unused.
* You would have to be familiar with the office's computer system.
* They must have a system that is good enough to get the job done.
I'm sure that there is a lot more, but this is just off of the top of my head. Let me know what you think.

Thanks!
-Matt

Michele:
We do know a couple of people that do it this way.  If it works for you, that's great.  There are a lot of pros which you've mentioned.  For me the biggest con would be not being able to connect during the day, but if you can work that out, then it's not a con.  The only other con I can think of is if something happens at the provider's office (power outage, manual turn off by mistake, or other) and you're not able to connect, you can't do anything about it. 

Michele

Pay_My_Claims:
For me thats ok if you are working from home for 1 provider. I can't see anyone functioning having to log into several providers in order to process the work. I prefer to have my own system, this way I don't have to try to learn several from different providers.

As far as the double entry of claims, if you are taking over that, there won't be a double entry. The superbills can be faxed, scanned or DHL'd to you.

mattsantos:
If the providers are faxing you super bills, don't they have to enter that into their computer system or hand write it? Then you are copying that information by hand into your system. Maybe I am not getting a complete picture of the process, but it seems like double entry to me. Once by the provider and once by me.

What about posting checks? You are obviously posting checks into your system. Is the provider also entering a copy into their system? If so, wouldn't that be double entry as well? And wouldn't that be running 2 sets of books?

I don't mean to contradict what you are saying, I'm just a little confused and I could really use some help on this.

Thanks!
-Matt

Pay_My_Claims:
A superbill is a form created by an office or by providers(s) with the patient's information they are seeing, the most common CPT/ICD and HCPCS codes used by their office, and an update section for items such as follow up appointments, copays due or paid and the provider's signature. This is used by medical practitioners and clinicians so they can quickly complete and submit the procedure(s) and diagnosis(s) to a billing person or department or to an employer for reimbursement and track each patient's visit.

The physicians I have worked with create their superbill as the "encounter" form. Once they check in, the system creates the superbill and its placed on the Chart. Once they check out, the patient gets a copy, a copay stays in the office for the biller to key in the charges. Since he is now outsourcing, no charges are being keyed. No charges being keyed, no double entry.

Reports are sent to the physician as per your agreement, generally by the month. He is able to use your report, his EOB's and his banking statement to check on your abilities to 1. get his payments in. 2 make sure he is getting all his payments in. 3 make sure nobody owes him money.  His bank account deposits should balance with your reciepts in the reports you submit,.

There are no 2 sets of books. Even if you worked in the physicians office posting payments, he still deposits the checks into his accounts. At the office that I work at now, we make sure that the posted monies match the deposits. This makes it easier to balance daily/monthly. I can go by my reports to see what I received on 01/06/09 and what I deposited matched. This can be done whether you work at his office, or out of yours.

I hope this helps.

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