Best EMR for my new small practice

[ventana]

?

Starting a new medicare only geri practice

have experience in Athena, practice fusion and Centricity

 

What are people experiences with these and others?

 

Also need to know how they handle billing (Revenue cycle management)

 

Any practice owners out there want to pipe in?

[mooredc]

I own my practice and I am using AdvancedMD. It is no epic by any means but for the price it is pretty darn functional and I find that for the most part the support team is fairly accessible and can solve my issues pretty quickly.

[ventana]

55 minutes ago, mooredc said:

I own my practice and I am using AdvancedMD. It is no epic by any means but for the price it is pretty darn functional and I find that for the most part the support team is fairly accessible and can solve my issues pretty quickly.

Does it have billing?

pricing?

 

 

[rev ronin]

I'm looking at Jane.app right now. I don't have any experience with it, but it's built for Psych/LMP/DC/TCM practitioners and doesn't seem to have any desire to do built-in mandatory stuff that traditional EMRs assume (read: are demanded by medicare to include). For those not remembering, I do most of my work with injured workers, and zero electronic billing or any billing medicare/medicaid, so don't have to follow HIPAA.

I just did $5500 of billing by hand on Saturday that I'd been putting off for a while. We'll see how much of it gets rejected.  I do know I reprinted some CMS 1500's a couple of times because I found my own error after I'd printed the first one.

[HmTwoPA]

My wife has her own practice and uses Kareo. They stated you can do your own billing, but after a rough couple months we found it was worth it to just contract out the billing. She likes Kareo a lot though 

[rev ronin]

4 hours ago, HmTwoPA said:

My wife has her own practice and uses Kareo. They stated you can do your own billing, but after a rough couple months we found it was worth it to just contract out the billing. She likes Kareo a lot though 

Had she ever done billing/coding before? Billing isn't my happy space, but I look at the work I do to bill, and then I look at 8% of revenue, and I don't complain.

[sas5814]

The magic sauce if you are contracting out your billing is that they only get paid for actual collections. There's plenty of companies that want to get paid for everything they bill whether they collect or not. They will sling bills everywhere and care not whether anyone pays them.

[HmTwoPA]

Neither of us have done billing, and after 14 rejected claims we decided that the 5% we contracted with was worth it rather than not getting paid. Less headache and struggle for us. It's frustrating that our medical system has made it so difficult just to get paid for your services. 

[ventana]

1 hour ago, HmTwoPA said:

Neither of us have done billing, and after 14 rejected claims we decided that the 5% we contracted with was worth it rather than not getting paid. Less headache and struggle for us. It's frustrating that our medical system has made it so difficult just to get paid for your services. 

who did you use?

[HmTwoPA]

Bellmedex 

[rev ronin]

2 hours ago, HmTwoPA said:

Neither of us have done billing, and after 14 rejected claims we decided that the 5% we contracted with was worth it rather than not getting paid. Less headache and struggle for us. It's frustrating that our medical system has made it so difficult just to get paid for your services. 

5% of actuals is better than the 8% one of my SPs was stuck with.  I just spent 3 hours doing ~5000 worth of billing, so that's ~80ish/hour for me to do my own. What also tilts the balance is that I have to deal with ONE set of arcane rules that I can keep relatively straight, so I don't typically get rejections, and they use all sorts of kooky procedure codes for phone calls, paperwork, meetings, etc. which screw up third party bill clearinghouses which will choke on a 1073m.

I absolutely would NOT have tackled billing for my own practice if I hadn't had to do all the coding, including modifiers, for myself in family medicine from 2015-20 (and with an orientation to coding and friendly quarterly audits 2012-15 while working Group Health)  For me, the stars aligned perfectly so that I can document what I do, and bill for it reasonably proficiently. There's certainly some synergy there--I know how to write what I did, code for it, and bill for it, so I don't have to have a big meeting often.

[jmj11]

It has been over five years since I closed my practice so take what I say with a grain of salt. I will say, that billing was my achilles heel. I went through several billing situations. My best was when I had an independent company doing my billing and one employee was stellar. So I stole her from them, and she only did my billing. That was great. But then ... a situation arose with my EMR. 

I started with Practice Fusion (a lot of things I didn't like about it, but it was cheap), and then Kareo (liked it okay). But, I wanted a fantastic EMR that I could build on and adapt to my growing practice. I found such a software ( I won't mention their names but it was the only one compatible with Microsoft). We had a wonderful year together, but then as that company grew, they developed into one product, that was EMR and billing (they knew where the money was). I didn't want them doing my billing because I was happy with my biller. However (and I suspect lawsuits have resolved this situation by now) they required that I either subscribe to their whole product (EMR and billing) or close my contract and then I would not have access to my chart notes (stored in the cloud). I think a term that my lawyer used them was "data-hostage." 

Anyway, my short term plan was to accept the whole contract for their product while my lawyers and I could find a way to get my records and end our relationship. I even had an inside man at their company download all my data onto a hard drive I had mailed him. I knew it would be encrypted, but I have a son with a PhD in computer science from the Paul Allen Institute at U of Wash and I thought he could unravel it ... but he couldn't. While their EMR was fantastic, they were new to the revenue cycle processes and really screwed it up. All my CMS claims were reject, those submitted by them.

This company had been sued by another practice for the exact same thing and we were prepared to sue them. However, (even a longer story) my lawyers and I decided it would be best for me to sell the practice to a new entity (local hospital) because a suit would take a lot of time and money. I suspect this could not happen today, or at least I hope. But after that long answer, I wish I had stuck with an inferior Kareo EMR.

[ventana]

thanks for info

 

one thing I am aware of it the need to KIS

I will bill 99202-99215

plus AWV, Advanced directives and CCM

very outside chance of a house call

 

nothing else

this is only about 15 codes total

 

I am comfortable with billing and coding from prior experience

I have no experience with clearing houses - but am being told that the newest programs (allscripts and the like) do the claim scrubbing, submission, electronic reimbursement and posting of payments - have  a demo tomorrow with a few vendors on the billing software side - have heard Kareo for the billing is okay, but horrible for the EMR.  Practice fusion does send superbills to to Kareo if needed 

[ventana]

On 12/28/2022 at 7:28 PM, HmTwoPA said:

Bellmedex 

How is there ehr??