Author Topic: Office Ally  (Read 14610 times)

PMRNC

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Re: Office Ally
« Reply #15 on: April 01, 2013, 01:20:02 PM »
Don't misunderstand.. I do NOT think the medical biller is OUT.. I think the Practice MANAGER is in. I've always hated the label Medical billing but I knew I had to use it in marketing.. I think the medical biller is going to be struggling and the practice management companies are going to thrive. JMHO

"Now, with EMRs, PMs, Patient Portals, electronic remittance/EOB, computerized phone calling to deadbeats, and even patient statements automatically printed or sent to patient's e-mail, hardly anything is on paper."

I don't agree with that at all. The clients I consult with we always talk about "options" but not just THEIR options, MOST good doctors WILL think about what their patient's want. With all my consulting clients we go over data and reports and create patient survey's. It is REMARKABLE the amount of patients that do NOT want to access online and they WANT those patient statements.  I have my clients also doing their own newsletter (as a biller/practice management we should NEVER be involved with patient marketing) and got them connected with physician marketing management companies and even they will tell you today that patient's STILL prefer the paper :) 
Linda Walker
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Billergirlnyc

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Re: Office Ally
« Reply #16 on: April 01, 2013, 02:22:47 PM »
... need to have ... something that can be multi-layered and handle all these things without me needing to have 3 different software that do 3 different things.

Sometimes it is better to have software that performs a specific task, and performs it well.  Often, software that is designed to do multiple tasks does none of them well.  That is just a comment and not an argument.  I know your brother can customize the sofware to meet your specific needs, which will no doubt function much better than commercial software that is trying to meet everybody's needs.

Given the push to interoperability and the HL7 standard, I'm reading about your brother's programming skills with interest.  The biggest thing I need right now is a data input screen where the input fields can be customized (patient demographics, insurance info., etc).  I'm guessing there is an emerging market for such a screen that every user could attach to whatever software their vendor / client is providing.  For example, imagine someone with ten different clients, and each wants the biller to use their own software.  It would be wonderful for the biller to have one (or two if necessary) screens that would interface with all of the different client's softwares/databases.  Having such a standardized screen(s) would speed up the biller's work and cut down on the potential for error as the biller switches from one screen layout to another to another, as s/he moves from one client' software to another to another.  Just a thought.  (Edit:  I'm talking about the screen used to put new patient information in, and/or used to verify a current patient's demographics and insurance info - not all the other screens a biller would use in the course of billing and generating reports.)

I made reference to interoperability at the following link.  The link I gave there to an interoperability article no longer works, but I quoted from that article, so you can read a bit there if interested.

http://www.medicalbillinglive.com/members/index.php?topic=7034.msg21003#msg21003

I agree sometimes having a software that does it all isn't sufficient either, but paying someone yearly fees for 3 different programs isn't cost efficient, and that's what I'm doing now. If I can at least incorporate 2 out of the three, I'll be happier and so will my staff. This is strictly for my business, of course we work with our client's software, but the little girls, the 1 and 2 doctor practices are bread and butter clients, who too want to keep their cost down. I don't just do medical billing, never have, actually. So my needs are varied and always inline with keeping my business growing.

As to your date input screen. I too would love something like that. I hope you don't mind me copying your entire message and sharing with my brother. I'll report back what he says. I think that would be an extremely smart interface to have. And if I'm reading you right, it would work with any software right? Great idea! My collections software does something like this when we're reporting to the credit agencies like Transunion, Equafax, etc. It's actually the smoothest piece of software we work on. Not even my credentialing software is as smooth as my collections software.
Don't worry. Be happy.
~Dalia, CPC, CPC-H, RHIT.

RichardP

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Re: Office Ally
« Reply #17 on: April 01, 2013, 02:32:04 PM »
I don't agree with that at all.

I only meant to say that the technology is not coming.  It is already here.  No doubt, its use is more visible in the larger cities and around large medical centers and Universities where there is a larger population of younger folk.  But the technology is here.  The adoption will follow, as those who know how to video chat with each other on their cell phones begin to crowd out those who still think of making phone calls with a rotary-dial phone.  Where I am, I see the older doctors resisting the change.  I also see the younger doctors, with younger patients, embracing the change.

RichardP

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Re: Office Ally
« Reply #18 on: April 01, 2013, 03:02:07 PM »
I hope you don't mind me copying your entire message and sharing with my brother.

Don't mind at all.  Particularly if it fires his imagination to create something useful.

And if I'm reading you right, it would work with any software right?

That would be the ideal.  There is a need for building the data-input screen.  But there is also the need for building the HL7 interface between that data input screen and the Practice Management data-base software.  Once the data input screen is built, and once the interface for a given vendor (e.g, Kareo) is built, that interface should work for all who have Kareo and who want to use the data input screen your brother builds. Finally, there would be a need to connect the interface to the vendor's database.  That could either be a business your brother could run, or an individual at the vendor's location would need to be identified to do this.

And, to be clear - what I'm envisioning would be a screen where the data input fields could be re-arranged in sequence (or outright dropped from the screen) according to personal preference.  Once the data-input screen is built, there has to be a link between a given field on the screen and the location of that field in the data-base (e.g. SQL database).  Once that link is established, it shouldn't matter where on the data-input screen that field is located.

Given that the HL7 standard and the interoperability concept are being pushed by the government to facilitate this kind of innovating, hopefully the cost of implementing something of this sort could be kept to a modest (affordable) level.

My collections software does something like this ...  It's actually the smoothest piece of software we work on. Not even my credentialing software is as smooth as my collections software.

Perhaps your brother could find out who wrote that interface and subcontract some work to him/her.

DMK

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Re: Office Ally
« Reply #19 on: April 01, 2013, 04:04:52 PM »
I don't agree with that at all.

I only meant to say that the technology is not coming.  It is already here.  No doubt, its use is more visible in the larger cities and around large medical centers and Universities where there is a larger population of younger folk.  But the technology is here.  The adoption will follow, as those who know how to video chat with each other on their cell phones begin to crowd out those who still think of making phone calls with a rotary-dial phone.  Where I am, I see the older doctors resisting the change.  I also see the younger doctors, with younger patients, embracing the change.

I agree that the technology is HERE.  But I have also seen where it doesn't work well.  The technologies don't talk to each other well (yet), and garbage input by humans is still garbage in bad technology or good. 

I agree with Linda that there are still many many people who don't trust the technology, and people who INSIST on technology (whether it's any good or not).  You know what they say about good intentions........ : ;)

PMRNC

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Re: Office Ally
« Reply #20 on: April 01, 2013, 05:32:08 PM »
Quote
I agree sometimes having a software that does it all isn't sufficient either, but paying someone yearly fees for 3 different programs isn't cost efficient, and that's what I'm doing now. If I can at least incorporate 2 out of the three, I'll be happier and so will my staff.

Why are you paying out of pocket costs for clients software? I've never done that, any costs associated with using MY preferred software they absorb, in fact they have the contract, I'm just a user. They would be out that cost whether they used in house or not, I don't understand why a billing company would absorb those costs UNLESS they were paying ONE license fee for multiple users. If your paying a user fee PER client, it makes NO sense to come out of pocket and not pass on that cost. 
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

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Re: Office Ally
« Reply #21 on: April 01, 2013, 10:08:27 PM »
I agree that the technology is HERE.  But I have also seen where it doesn't work well.  ...  You know what they say about good intentions........ : ;)

Here is an instance where the technology is working well.  This is only one of a number of such instances.  I think it is only a matter of time before they incorporate some secure Skype-like feature where the doctor and patient can consult face to face through video chat, rather than just through e-mail.  When you have some time, look through this link.  It presents a microcosm of the future.

http://www.relayhealth.com/general/194059691.html

The following link provides a glimpse of how this technology is being employed in one doctor's office.

http://www.doctorcohan.com/relayhealth.html

Given that this technology can be displayed on mobile devices, the doctor does not need to be in his office, and the patient does not need to be either at home or at the doctor's office for the doctor and patient to have a visit regarding non-emergency matters.  Still can't draw blood with this system, so there remains some need to actually go to the doctor's office from time to time.

Billergirlnyc

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Re: Office Ally
« Reply #22 on: April 02, 2013, 10:23:48 AM »
Quote
I agree sometimes having a software that does it all isn't sufficient either, but paying someone yearly fees for 3 different programs isn't cost efficient, and that's what I'm doing now. If I can at least incorporate 2 out of the three, I'll be happier and so will my staff.

Why are you paying out of pocket costs for clients software? I've never done that, any costs associated with using MY preferred software they absorb, in fact they have the contract, I'm just a user. They would be out that cost whether they used in house or not, I don't understand why a billing company would absorb those costs UNLESS they were paying ONE license fee for multiple users. If your paying a user fee PER client, it makes NO sense to come out of pocket and not pass on that cost.

When did I say I'm paying for out of pocket for my billing/coding client's software? I know how to pass on cost to my clients, but I've yet to do that for any client, as they pay for their own software and use whatever system they have. Even the ones who don't have we simply make suggestions, but they're responsible for the fees. I don't just do medical billing/coding (something I've stated several times). I have other software for other aspects of my business, which I own/pay for directly NOT my clients. While, I pass cost on to clients it's still not cost efficient as these programs we use are all web based and have to be renewed annually. Not to mention if I don't renew and switch to a different program w/a different company, we have to rebuild these large databases, even if they gives us the data, it's just cumbersome and I honestly want my own, because I'd love to eliminate these vendors, which will happen as stated before.

And, yes, I'd love something like Richard is talking about on the PM side, because it would so much easier, since the key would be that it would work with any PM software. My brother said it would be alike a "capture" software, Richard.

To Richard: I passed on your second reply to my brother, he thinks you're genius about that interface. He's going to look at those links and I also told him how you suggested we reach out to the collection software company, because again it's the smoothest software we use, especially the component that reports to various credit reporting agencies, it's so simple, and does multiple checks before we submit. I love using it. We use to have to sign into each credit reporting agency separately, but this genius company built something that works WITH each company's software, and they got them on board, so that was another selling point for us.



Don't worry. Be happy.
~Dalia, CPC, CPC-H, RHIT.

Billergirlnyc

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Re: Office Ally
« Reply #23 on: April 02, 2013, 10:36:25 AM »
I agree that the technology is HERE.  But I have also seen where it doesn't work well.  ...  You know what they say about good intentions........ : ;)

Here is an instance where the technology is working well.  This is only one of a number of such instances.  I think it is only a matter of time before they incorporate some secure Skype-like feature where the doctor and patient can consult face to face through video chat, rather than just through e-mail.  When you have some time, look through this link.  It presents a microcosm of the future.

http://www.relayhealth.com/general/194059691.html

The following link provides a glimpse of how this technology is being employed in one doctor's office.

http://www.doctorcohan.com/relayhealth.html

Given that this technology can be displayed on mobile devices, the doctor does not need to be in his office, and the patient does not need to be either at home or at the doctor's office for the doctor and patient to have a visit regarding non-emergency matters.  Still can't draw blood with this system, so there remains some need to actually go to the doctor's office from time to time.

Very interesting. I definitely think software like this works well especially it's for established patients only, which, of course, makes the most sense, and for non-urgent matters, because not everything requires an in-person visit. I also like software that has a mobile component. That's such a huge push now.
Don't worry. Be happy.
~Dalia, CPC, CPC-H, RHIT.

PMRNC

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Re: Office Ally
« Reply #24 on: April 02, 2013, 11:06:25 AM »
I apologize, I had seen this:
Quote
I agree sometimes having a software that does it all isn't sufficient either, but paying someone yearly fees for 3 different programs isn't cost efficient, and that's what I'm doing now. If I can at least incorporate 2 out of the three, I'll be happier and so will my staff.

and with the annual fees mentioned so I thought you were coming out of pocket. I do same as you even with the ones who are web based and how I work it is they have whatever software (web or not) licensed through their own practice and such and I receive administrative access (separate of course to preserve audit trail). I do this because when I have to terminate a client it's just so much less of a headache and any data conversions/capture/backups is all their responsibility. It's not an added cost at all because if they had in-house staff they would need their own system anywhere and I've never had this an issue because either they already had a solution/software in place or like you, I offer suggestions and then they go and do what they have to do. 
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

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Re: Office Ally
« Reply #25 on: April 02, 2013, 11:21:11 AM »
I passed on your second reply to my brother ...

Thanks.  If he knows SQL, perhaps something useful will come of this.

Billergirlnyc

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Re: Office Ally
« Reply #26 on: April 05, 2013, 12:51:43 PM »
I apologize, I had seen this:
Quote
I agree sometimes having a software that does it all isn't sufficient either, but paying someone yearly fees for 3 different programs isn't cost efficient, and that's what I'm doing now. If I can at least incorporate 2 out of the three, I'll be happier and so will my staff.

and with the annual fees mentioned so I thought you were coming out of pocket. I do same as you even with the ones who are web based and how I work it is they have whatever software (web or not) licensed through their own practice and such and I receive administrative access (separate of course to preserve audit trail). I do this because when I have to terminate a client it's just so much less of a headache and any data conversions/capture/backups is all their responsibility. It's not an added cost at all because if they had in-house staff they would need their own system anywhere and I've never had this an issue because either they already had a solution/software in place or like you, I offer suggestions and then they go and do what they have to do.

Gotcha and agree doing it this way is definitely less of a headache if and when contracts aren't renewed.  :)
Don't worry. Be happy.
~Dalia, CPC, CPC-H, RHIT.

Loyal Servant

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Re: Office Ally
« Reply #27 on: August 16, 2013, 02:44:14 PM »
Sorry to necro, I got pointed at this thread.. don't thrash me too hard ;D

I have seen a lot of the ePCR vendors over the years start billing services then steal our clients that were using their ePCR system.  >:(
Thing is.. they come in and do it for virtually nothing to get the customer base.
Then they do a bad job collecting....

Now as far as the interface aspects.... I may not be completely understanding what the discussion is about but if I
am reading this correctly that's something I have more or less in place now.

Data is extracted in a standardized format (NEMSIS) and then imported into the system.
It's scrubbed and passed thru several sets of eyes, coded, washed again by another person then the claims
are transmitted to [insert trading partner here].

The glue between these systems is XML data.
The user enters the data in the web interface or other ePCR system and then our system if i can do so will extract
the data my itself, batch it and show up in a list of ready batches to one of the users in our office.
If there is no mechanism to get the data in an automated fashion a user does it by hand with an extract feature
in the ePCR system the provider uses.

Is this what you guys and gals are eluding to?
The problem on my side of things is that very few of the ePCR system support such a featureset unless it's into their
own billing system.
Very few of the ePCR vendors play nicely with third party billers and usually fight us.

Is that the same issue you are seeing in the practice management systems or are the various vendors playing nice?




RichardP

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Re: Office Ally
« Reply #28 on: August 16, 2013, 07:26:38 PM »
My conversation is about specifically sitting at the computer and having to log into 10 different Practice Management systems over the course of the day, each with their own data input screen.  Each data input screen is organized differently.  The clerk typing in patient demographics and insurance information has to reorient themselves each time they switch PM's.

A desired situation is to have one data input screen for inputting patient demographics and insurance (two at the most) - that could be hooked up to each of the 10 PM systems the clerk is working with.  As the clerk logs onto different PM systems, the data input screen(s) of each would be identical.  I argued why this is desireable in my posts above.

This is coming from the governments push for "interoperability" - the requirement that any part of any medical system should be able to "talk to" any other part through the HL7 Standard.  PM systems, EMR systems, perscription systems, lab results systems, all should be able to talk to each other (through the HL7 interface), regardless of who the vendor is.  This led to the thought that perhaps a customizable data input screen could be developed.  Each office could customize the screen(s) to their most favorite screen layout, and that screen(s) could then be connected to any PM system (since we are talking billing here) - either through an HL7 interface, or the front end / back end technology of SQL servers (regardless of vendor), or some other method.

This idea is not about passing data from one system to another.  It is about the raw interface between people and machine - the initial point where data is input to the computer, either by the doctor (EMR) or the clerk (PM).

tallmanusa

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Re: Office Ally
« Reply #29 on: August 17, 2013, 12:42:53 PM »
Quote
" I have seen a lot of the ePCR vendors over the years start billing services then steal our clients that were using their ePCR system.  >:(
Thing is.. they come in and do it for virtually nothing to get the customer base.
Then they do a bad job collecting...."

Kareo started doing billing about six months ago; they are doing billing for 3-4% and include their EHR and PM in that price; of course all the providers who were paying for software and paying another 6% to the biller moved to Kareo billing.
Kareo promptly outsources its work to India.
How do I know?
Karoe rep would admit it, but besides that the outsourced company is a member of several organizations where they advertise " If we are good enough for Kareo, we are good enough for you".
I would like to know how the small biller is going to compete with likes of Kareo, ECW, Advanced MD, Care Cloud and a whole bunch of others who do billing at discounted prices, include their software, and then outsource offshore the actual work.

So you would hire staff at $10 an hour and make a profit and in addition make the doctor pay for the software? Of course it is all good, if you can find clients for whom money is no object.

I think the small biller ( less than ten clients) would be extinct, like the horse and buggy.