Pain Management Coding Alert

Published on Tue Feb 03, 2015 PDF

Remember, the best options will help boost your office efficiency. 

You can improve office efficiency and effectiveness with medical practice management (MPM) software, but only if you choose wisely. The key to picking the best MPM for your practice? Be realistic about how your office already functions and know that the program offers the versatility you need.

Start by Learning Some MPM Basics

The first question you're likely to ask yourself is: Why would my office want to pay the high costs for an MPM software system? Here's why.

MPM software incorporates the day-to-day operations of a medical practice, allowing staff to capture patient demographics, schedule appointments, maintain lists of insurance payers, perform billing tasks, follow up on accounts receivable, and generate reports.

Important: MPM often encompasses electronic medical records (EMR) systems. While some information in an MPM system and an EMR system overlaps - for example, patient and provider data - you'll use the EMR system for assisting the practice with clinical matters, while you'll use the MPM system for administrative and financial matters. 

Most MPM systems are designed for small to medium-size medical offices. However, some of the software is designed for third-party medical billing companies and large central billing offices (CBOs). Be sure you determine the type of system your office needs and then make sure you're not buying something that's too much or too little for your needs.

Watch for Flexible Features

Before you go system shopping, look carefully at how your office functions. Document processes and look for places, such as accounts receivable, where you can improve efficiency and quality. Then, look for an MPM software program that follows the same processes but provides you with the added efficiencies you're looking for. Be realistic in the expectations and wants/needs your office has and ensure that the software system you select can meet your operational and billing needs.

Best bet: Ideally, you want to operate a paperless billing system. Therefore, you will need places to store notes, insurance card images, and other billing-related information and documents. For example, you may need a place to store referral authorizations from payers.

Caution: Some programs may make your practice function inefficiently. One of the pitfalls a practice should look for when choosing a system is to not overbuy. For instance, getting the biggest, most expensive system with all the bells and whistles may prove inefficient for your practice by making things more complicated and time-consuming by running reports and processes you don't even need. 

Pain management consideration: One feature that some pain practices need in their MPM is the capability of handling patient accounts with more than one current active injury, such as a workers' comp issue and a non-workers' comp issue. 

"The practice must be able to create multiple separate accounts for a patient, one for each injury," says Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, of MJH Consulting in Denver, Co. "Or, check that the MPM can have active 'sub-accounts' under a primary patient account that could be used for separate injury claims. This is particularly important for HIPAA privacy so that if you need to send billing and documentation to the payer it's applicable for only that injury or claim."  

Know How to Make Your Choice

You'll have three basic types of MPM system to choose from: desktop-only software, client-server software, or Internet-based software (ASP - Application Service Provider software).

Option 1: If you plan to use the system on one computer or have only a small number of users who can share access, you should look at the desktop-only options.

Option 2: If you want to allow multiple users who can share the data and the workload, client-server software is a better option. This type of system usually requires you to purchase or lease server equipment to run server software on. Individual workstations have client software that accesses the server.

Option 3: Internet-based software is another option you may want to consider, since it decreases your need to run your own server and worry about maintenance, security, and reliability. For many practices and even midsize billing companies that aren't big enough to support an IT department, an ASP is a good option because you don't need a dedicated IT department.

Consider: Whichever option you think is best for your practice, verify that the MPM system is ICD-10 ready, Hammer advises. "Be sure that it's capable of reporting the ICD-10 code set with a 'flick of a switch,'" she says. 

CMS has a free "Technology Vendor Assessment" form on its Road to ICD-10 web page (www.roadto10.org) that could help practices make an informed decision about MPM in relation to ICD-10.