Our experience with TotalMD thus far has been considerably better than Keidra's. And, with all due respect to Keidra, I find some of his complaints to be invalid (though not all). In the interest of keeping things fair, I should also point out something we all already know: I'm not a typical end user (queue smart remarks by Indy). I'm clearly one of the most technical persons here and certainly the most knowledgeable about Microsoft Technologies. These things should be taken into consideration when one sees a situation where some user XYZ says they are having issues with some kind of tech and then I come up and say I have no problems at all.
With all that in mind, let's get started.
I agree with Kiedra that TotalMD's sales person, Nelson, is top notch. He did an excellent job demonstrating the product to us and working on price. Because our company has special needs, TotalMD gave us access to a developer. We have literally dozens of custom reports and dozens more automated processes that require direct access to the TotalMD database. TotalMD's database is a bit more complicated than most since it was designed to do Dental, Institutional, and Professional billing (you will see references to "Dentimax" in the literature and the program as you use it). TotalMD also gave us the credentials to access the database directly upon first request - no hassle.
Giving us the database password without any hassle was a surprise to us since we usually have to beg or coerce for such information. Allowing us direct access to their senior developer made us wonder if we were still in our original dimension or had been teleported somewhere much more magical.
Because of my technical expertise, I have not had to call technical support for anything with TotalMD. That being said, not everything has been all roses. There are some issues to take note of such as:
* The TotalMD database design is very complicated. Not as bad as eClincalWorks or that beast known as Centricity, but complicated nonetheless. As noted, this database was designed to bill dental, professional, and Institutional claims.
* The TotalMD database is based on DBISAM which is very different and not as popular as, say, SQL Server. While getting SQL Server tools such as SQL Server Integration Services to work with TotalMD was a bit challenging, it is very doable. Some things to watch out for are how DBISAM handles connections, the fact that it doesn't like null values for certain data types such as Boolean, and is case sensitive.
* The 837 claim generator used by TotalMD is sold separate and by database. If you have only one database (i.e. only one client or you are a single practice that needs only one database) then the extra $400 is not a big deal. But if you are someone like us with 90 clients, which means 90 databases, that $400 becomes a big deal. This doesn't matter to us, however, since we (and when I say "we" I really mean "ME") are writing our own 837 generator for TotalMD. We are doing this because we need to maintain control over the generation of claims files to deal with nuances with various carriers.
In regards to Kiedra's remarks, I do have a few comments:
* TotalMD in the cloud. As I have stated on this forum before, pretty much the only cloud vendor I trust is
www.bestforyourpractice.com. The rest just plain suck. Your data gets up there and you can't get it back and/or support is inadequate. If you want someone to host your TotalMD for you, get Indy to do it. The fact that "all cloud users get the same features at the same time after the programmers <allegedly> are sure all the bugs are worked out" is actually a staple of cloud service from any cloud provider. In fact, they all advertise that fact as the number one advantage of the cloud.
* Interfacing. I don't know of any interface between any billing software and EMR or any billing software and clearinghouse that is perfect or works well ---except for the ones I've made with our clients. Each software, billing and EMR, has guidelines and so forth for what they expect to receive and what they will send and that's pretty much about it. There is very little customization and what little there customization there is available is often very expensive. If you want interfacing done right, do it yourself. This user forum is replete with people complaining about some interface with some software.
* Time Zone differences. TotalMD is located in Arizona which means they are Mountain time. It is not feasible to expect every vendor you deal with to be in your time zone. Finding out when support is available should be one of the first questions asked to the sales rep, not one of the last. In regards to the quality of support once you get through to them, I cannot speak to this as I never have had to use support. Again, consider who I am.
* Regarding training, some companies do it the Amazing Charts way which is to post videos online. Others do training by the hour and charge for it. TotalMD does it by the hour, as does AdvancedMD and countless others. Training should, again, be one of the first questions asked and not one of the last.
* Reporting. I cannot speak to reporting. We make our own reports to our needs and as stated previously I have dozens of reports to port over to TotalMD. Yay, me. I'm sure we'll find one or two in TotalMD we can use, if not, that's no skin off our teeth.
I am truly very sorry Kiedra has a poor experience with TotalMD. Some of his issues, such as reporting, are valid. Unfortunately, I also feel most of his issues were avoidable if more discovery had been performed. TotalMD does have a 30 day trial available that should be used before making any decisions.
In regards to Kareo, I have heard many good things about it. However, I would caution Kiedra, or anyone else using an online system, to make sure you can get your data back when you ask for it. And this process should be tested. Just because they give you a bunch of files on a USB stick doesn't mean you can use them. All relationships come to an end. Business Continuity should be given due respect.
JamesNT
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