Medical Billing Forum

Medical Billing Software => Medical Billing Software Reviews => : mcneil.karen September 14, 2016, 01:39:43 PM

: Suggestions for Billing Software
: mcneil.karen September 14, 2016, 01:39:43 PM
Thanks to Alice and Michele for all the great resources they have provided through this forum.

I am starting a Home-based Medical Billing Business and have two questions.  I would appreciate your feedback:
      1.  Which Billing Software would be best for the business.
      2.  Would you recommend signing a contract for the billing software before gaining the first provider.

Thank you.

KAM
: Re: Suggestions for Billing Software
: PMRNC September 14, 2016, 04:34:02 PM
I've been doing this since 1997. My feeling with software is that you DO not need it. If you are an experienced medical biller you can work in any system/software. Why pay costs and force clients to transition if you don't have to? Years ago I saw the need to change my business model to accept clients using any PM system. I did this because I saw that clients rarely wanted to make the transition in time and of course revenue. If you are an experienced medical biller, you can work in any system, so why not keep your overhead low and diversify your services by working in the clients existing PM system? It makes NO sense to force clients to transition to a "preferred" system.. by working in THEIR system you can showcase your knowledge and experience w/out sacrificing time and money.

I won't say what is best sytem.. because the WORST system can be utilized by the best biller w/out additional costs or training. My clients LOVE the fact that I don't make them switch, there is no conversion time and best of all no overhead costs to me. :)

: Re: Suggestions for Billing Software
: mcneil.karen September 14, 2016, 05:03:49 PM
Thank you Linda for your timely response.  Great advice which will be beneficial as I move forward.
: Re: Suggestions for Billing Software
: Michele September 14, 2016, 07:14:41 PM
We do work in many providers systems as well.  It is good to be able to do that.  However, not all providers do have software so we also own our own software for those providers as well.  Just wanted to mention that so that you are prepared when meeting with a client.
: Re: Suggestions for Billing Software
: mcneil.karen September 14, 2016, 09:23:08 PM
Thanks Michele.  What software do you use?

: Re: Suggestions for Billing Software
: Michele September 15, 2016, 11:39:22 AM
We use Lytec when our clients do not have software.  We purchase our software through Murray at SMG Systems.  (We do not get any kickback for referrals, we just really like the company.) 
: Re: Suggestions for Billing Software
: mcneil.karen September 15, 2016, 04:19:18 PM
Thanks so much Michele.  What was your deciding factor to buy vs cloud? What clearinghouse are you using with Lytec? 

Kind regards!
: Re: Suggestions for Billing Software
: PMRNC September 15, 2016, 10:06:01 PM
On the very rare occasion a practice doesn't have a PM system I have a white paper with various software solutions they can choose from as well as discounts and demo's. This way the practice gets to make their decision and maintain the control.
: Re: Suggestions for Billing Software
: Michele September 16, 2016, 10:56:11 AM
We bill for several providers who go into nursing homes and do not have offices and do not want software.  They hire us because they don't want to have to mess with that.  Honestly about 1/3 of our business are providers that do not have and do not want PM systems.  If I tried to force them to get one they would go elsewhere.
: Re: Suggestions for Billing Software
: Michele September 16, 2016, 11:05:17 AM
Thanks so much Michele.  What was your deciding factor to buy vs cloud? What clearinghouse are you using with Lytec? 

Kind regards!

We bought Lytec originally over 20 years ago, before the cloud.  :)  Over the years we have looked at cloud based software and considered switching.  The main reason we have not switched is because we have not found a software that is as cost effective.  Most of the cloud based softwares charge per practice/provider and that just does not work for us as a billing service. 

We use Office Ally.  We pay $19.95 per month for unlimited claims.  For many years we paid $0 but now we have over 50% of our claims as government plans (Medicare, Medicaid, TRICARE) so we pay $19.95.  Again UNLIMITED.  We send thousands of claims a month so that is less than $.01 per claim.  Office Ally has been great for us.  Customer service is always awesome.  (We don't get any kickback from Office Ally either.  They have a referral program but we don't even mess with that.  We have used them for years and are very happy.)
: Re: Suggestions for Billing Software
: mcneil.karen September 19, 2016, 05:27:20 PM
Michele, your feedback is really great.  I can understand you purchasing the software 20 years ago.  In today's environment though, cloud seems to be the way to go.  I must agree with you they are very expensive.  I have reviewed quite a few and one of the biggest disadvantage is the pricing structure.  I will keep looking at others in an effort to find a good price.

Thanks very for your sharing.
: Re: Suggestions for Billing Software
: mcneil.karen September 19, 2016, 05:29:25 PM

Hello Linda,
Are you able to share the white paper with various software solutions.


Thank you
: Re: Suggestions for Billing Software
: Michele September 19, 2016, 10:46:20 PM
Even though our software is "server based" Lytec offers a "cloud based" version.  A couple of our providers use that and we can access their software from any internet.  If you find a cloud based that is cost effective please share.  I think it might be with Big Foot.
: Re: Suggestions for Billing Software
: PMRNC September 20, 2016, 11:34:07 PM
MOST practices have a PM solution in place. In marketing a medical billing company the way to market when the practice has a PM solution is of course to show the practice they don't lose any control over their existing PM solution.  Again.. IT is VERY VERY rare today to run into a practice that has NO PM solution..but if you do, there is still a way to maintain a low/no overhead by just merely giving the practice solutions to software and letting them setup and the billing company has access.

It's MY opinion that a billing company today does NOT need to maintain any costs associated with PM software/systems. Those practices that DO have a system in place they want to replace can be easily maneuvered with a list of software companies they may want to setup with. For those practices with an existing PM system that the billing company can access there is NO wait time, no transition time, nothing stops, reimbursement goes on nice and smooth.. if your a billing company that is transitioning a practice to your PM system there is a setup time, transition time and reimbursement DOES slow down. To me that is the best marketing angle.. NO WAIT, no TRANSITION. 

I have personally seen too many billing companies LOSE clients because the client did not want to undergo a transition to a new PM system or software. In order to accommodate those types of clients a billing company must be diversified in how they will work.
: Re: Suggestions for Billing Software
: kristin September 21, 2016, 12:08:17 AM
I have seen the total opposite to be true, in regards to the clients the billing companies I work for have. NONE of them have had a PM solution/system in place(over 20+ providers total). In some cases, it is because they had always used billing companies in the past, and never had the need to have their own PM system, in others it was because they were new providers just starting out.

That said, I agree with the rest of what you are saying...if you can access their existing PM system, do so. Be willing to learn on what they have in place already. Makes them happy, saves aggravation and time, keeps the money coming in.
: Re: Suggestions for Billing Software
: Michele September 21, 2016, 09:55:47 AM
We see the same Kristin with two other scenarios:

1.  provider left a large practice to open his own office
2.  provider sees patients in home or nursing home and doesn't have an office location. 

Whenever we meet with a practice that has a PM we ALWAYS use theirs if that is what they want.  We have never made a provider switch to our system.  We had two times where we did not want to renew the contract because the providers PM system was so bad we did not want to work in it.  The work took three to four times longer because the system was so bad.  In one of those two the provider switched her PM system (but she purchased a new one, she didn't switch to ours) because she also did not like the system and it became non compliant (HIPAA).  The other we just parted ways amicably.
: Re: Suggestions for Billing Software
: kristin September 21, 2016, 11:18:22 PM
I have one who fits # 2 on your list, he has no office, just goes to ALF, NH, SNF facilities, and patient homes.

Out of curiosity, was the bad PM system Intivia/Insync? That is hands down the worst EMR/PM software I have ever dealt with. I wouldn't wish that software on my worst enemy. They are clearly based "elsewhere", and have the worst support and integration/set up ever.
: Re: Suggestions for Billing Software
: Michele September 22, 2016, 10:46:01 AM
No, the bad system was MedFX.  The other bad system was Office Ally's free PM system.  I have not worked with intivia/Insync.  We try to work in all systems but occasionally we find one that is just so difficult that it is not cost effective to keep the account.  It is not common, but it happens!
: Re: Suggestions for Billing Software
: mcneil.karen September 22, 2016, 02:51:35 PM
Thank you Michele.  I will definitely share!
: Re: Suggestions for Billing Software
: mcneil.karen September 22, 2016, 03:04:23 PM
Michele and Kristen, Thank you much for your input.  I can understand both views on the subject.  Using the practice's PM software will definitely reduce a biller's overhead which is great.  Question to Michele, how do you manage multiple PM systems?  I don't believe all providers are using the same one.  Will the biller have to become a multiple PM user, navigating between the different software? how about training and support?
: Re: Suggestions for Billing Software
: Michele September 23, 2016, 02:32:35 PM
Question to Michele, how do you manage multiple PM systems?  I don't believe all providers are using the same one.  Will the biller have to become a multiple PM user, navigating between the different software? how about training and support?

We have 10 people here total.  When we take on a provider with a new system I always start it.  I have a bachelor's degree in computer programming and it comes easy to me to learn new systems.  Once I learn a system I train one or two others in the office so we have multiple people who are fluent.  Some of our employees are good at learning new systems and being able to work in more than one.  Some are not.  We use our employees strengths.  As for training and support we either contact the company directly and utilize their training materials.  Or someone in the office gives us a quick training session.  Many times I just figure things out myself.  There are usually tutorial videos available.  Often the provider has support so we can also contact the company directly as well.
: Re: Suggestions for Billing Software
: nanap February 22, 2017, 12:02:27 PM
I use TOtal MD which is now cloud based and love it. $99 per month per sign in user
: Is Billing Software Necessary?
: Shawn August 01, 2017, 06:00:21 PM
I was just reading an old topic thread, "Medical Billing Software Reviews" and Michele mentioned HIPAA compliance... "the provider switched her PM system (but she purchased a new one, she didn't switch to ours) because she also did not like the system and it became non compliant (HIPAA)."

I consider myself a newbie even though I've worked (part-time) in Dr's offices doing front office and billing for 17-18 years, mainly Medicare up until 2015. My husband is an LCSW and decided to leave his salaried job and expand his small private psychotherapy practice to full time. Then he went into a doctorate program so I took over his managed care billing. He didn't have PM software so we just created a spreadsheet using Excel. I use Office Ally and Optum to submit claims. Long story short, I now have two other therapist colleagues of his that I bill for who also didn't have their own PM, so I've been using Excel for them too. Now I want to expand my billing business, ideally to have 10 clients at most.

Am I being non compliant by using Excel? If so, from what I've read it seems cloud based would not be cost-effective for a small operation like mine. Maybe Lytec as Michele suggests?

p.s. Alice & Michele's "Write a Kick Butt Contract" Ebook is terrific!
: Re: Suggestions for Billing Software
: PMRNC August 01, 2017, 06:09:45 PM
What you are utilizing for your husband's practice might be practical but might not be practical if you plan to start a business.

Is there a reason why you feel you would need to purchase/lease/contract with a PM solution to open a business? Many don't today. You can simply utilize the clients existing PM solution to work. I'm all for free..but you get what you pay for. With your husband's business you are probably doing a lot more work than you need to if you had a good PM solution to do it all, MOST practices (small, medium or large) do utilize a good PM system to do it all without the need of added work. That would be the whole idea of outsourcing so you might want to consider that if your going to start your own business.
: Re: Suggestions for Billing Software
: Michele August 02, 2017, 11:49:27 PM
I believe the issue is that none of the three clients (her husband plus the two colleagues) have a PM system so using theirs is not an option.  I don't believe you are breaking any HIPAA rules as long as the data is secure, but it doesn't seem like the most practical way to keep track of things.  If you are going to stick to solo practitioners you obviously want to keep your cost down.  But as you grow your current system may not be feasible.  Lytec has a monthly fee option with a cloud based set up (kind of) that might work better for you.  It is unlimited providers and they charge per user.  If you don't want to invest a lot up front this might work better.  Personally for us, the monthly fee isn't feasible because we have 11 employees. 

If you are interested we work with a Lytec reseller called SMG systems.  You could call for a quote and demo.  We get absolutely nothing for referring people, we just like them.  But if you do call, be sure to mention our name.  Sometimes they will throw in a little something for people we refer.
: Re: Suggestions for Billing Software
: PMRNC August 03, 2017, 08:13:08 AM
Am I being non compliant by using Excel? If so, from what I've read it seems cloud based would not be cost-effective for a small operation like mine. Maybe Lytec as Michele suggests?

Using Excel on the cloud would not be HIPAA compliant at all, I suppose if you wanted to take the extra steps to encrypt but store only locally you could do that. I wouldn't utilize Excel as a PM solution at all as it would be extremely inefficient for a billing company aside from not being compliant if the sheets contain any PHI.
: Re: Suggestions for Billing Software
: Michele August 03, 2017, 12:52:35 PM

Using Excel on the cloud would not be HIPAA compliant at all, I suppose if you wanted to take the extra steps to encrypt but store only locally you could do that. I wouldn't utilize Excel as a PM solution at all as it would be extremely inefficient for a billing company aside from not being compliant if the sheets contain any PHI.

Good point.  I assumed that the Excel was local only which is how we have ours.  I agree though, I would think it's very inefficient so as you grow you should look at other options.
: Re: Suggestions for Billing Software
: Shawn August 29, 2017, 04:47:43 PM
Thank you, Michele and PMRNC. My excel and other billing data is not cloud based, it's local and stored only on an external hard drive. I can already see how it would not be efficient as my business grows. The only other practitioners that I have spoken to use Practice Mate on Office Ally or just enter CMS-1500 claims on O.A. through the Service Center option.
: Re: Suggestions for Billing Software
: PMRNC August 30, 2017, 09:24:49 AM
The only other practitioners that I have spoken to use Practice Mate on Office Ally or just enter CMS-1500 claims on O.A. through the Service Center option.

You can work with that with your experience to start, it would be a better option than a spread sheet system and if the system(s) are setup with the client already, why make them do a backwards conversion to your system when they should move forward not backwards. While I will say that Practice Mate and Office Alley are not the best solution, they work ok for many small practices so why not utilize THEIR systems and save yourself the headache? Later if you find it necessary give them some software suggestions and let them make the choice down the road. My favorite saying is "If it ain't broke, don't fix it". :)
: Re: Suggestions for Billing Software
: medwave July 24, 2019, 04:15:16 PM
We use the following:

AdvancedMD, they bought NueMD (https://www.advancedmd.com/company/press-releases/advancedmd-completes-acquisition-of-nuemd/)
My Clients Plus
Practice Mate (forced to by client, not great)
Kareo

The thing is, I'd love to only use one, but there are relationships and contracts that exist inside provider offices. This is natural.