So I've been looking over the software, and I'm trying to get down exactly how AC works with the office flow.
For example, my staff collects co-pays before I even see the patient. So for those of you who do this, how are you doing this in the software? Is your front office staff starting the superbill before you even see the patient? When you see the patient and put in your CMT codes, does this add to the superbill that your staff started? I'm a bit confused.
Can't be done! One of my biggest gripes with AC but they say "We are not a PM pkg." While this is true (and they are working on something) I have missed posting numerous co-pays because they can't be entered until the note is complete and signed off. A simple suggestion would be to at least add a field to the sign-off screen along with Quick Codes, etc that would allow the co-pay to be entered. This would at least alert us to the fact that a co-pay entry may be pending.
Bruce. Internal Medicine (and some Pediatrics) North Central Ohio
Hi Gregory, I just sign off my notes after I enter the icd9s and my comments. I do not enter cpts or do billing with AC. I am currently in a contract with a billing service that is satisfactory for me.
As much as I wanted to be a purist and stay paperless, I have had to go to a paper flowsheet/encounter sheet. I also had trouble keeping track of nursing care. To solve that we have gone to having 2 notes- a doc note and nurse note for each encounter.
Two encounter sheets for each visit are made and placed on a clipboard the day before-they have the pt name, a place for chief complaint, vitals (we lost a lot of notes at first and couldn't recover vitals), and check for pending labs, xrays, er visits, etc. The bottom part of my sheet is a grid that I put in cpt and associated icd9s.
The nurse encounter sheet is exactly like mine, except they do not record the vitals on their sheet. They use their sheet for all the clia waived tests, injections, vaccinations, etc that they do. They put the cpt and appropriate icds on the sheet. They also document these procedures in their note. They then send the note to me to sign off.
The nurse checks chief complaint, vitals, reconciles med list, and does any pending labs and has previous lab results on the clipboard before I go in the room.
I give my encounter sheet to the nurse after each visit. They staple them together at the end of the day. We then enter all the billing the next morning.
This works well for us. I hope you find a system that works well for you. We also have the vitals and labs on paper in case there is a problem saving the note for one reason or another.
Hi Gregory, I just sign off my notes after I enter the icd9s and my comments. I do not enter cpts or do billing with AC. I am currently in a contract with a billing service that is satisfactory for me.
As much as I wanted to be a purist and stay paperless, I have had to go to a paper flowsheet/encounter sheet. I also had trouble keeping track of nursing care. To solve that we have gone to having 2 notes- a doc note and nurse note for each encounter.
Two encounter sheets for each visit are made and placed on a clipboard the day before-they have the pt name, a place for chief complaint, vitals (we lost a lot of notes at first and couldn't recover vitals), and check for pending labs, xrays, er visits, etc. The bottom part of my sheet is a grid that I put in cpt and associated icd9s.
The nurse encounter sheet is exactly like mine, except they do not record the vitals on their sheet. They use their sheet for all the clia waived tests, injections, vaccinations, etc that they do. They put the cpt and appropriate icds on the sheet. They also document these procedures in their note. They then send the note to me to sign off.
The nurse checks chief complaint, vitals, reconciles med list, and does any pending labs and has previous lab results on the clipboard before I go in the room.
I give my encounter sheet to the nurse after each visit. They staple them together at the end of the day. We then enter all the billing the next morning.
This works well for us. I hope you find a system that works well for you. We also have the vitals and labs on paper in case there is a problem saving the note for one reason or another.
I don't know why I wasn't logged in before. I wanted you to know who this came from. I have received so much help from these Boards and the AC staff. Folks have been very generous to me. Hope this helps you or at least gets you started thinking about a flow that will help you. Vicki
Vicki Roberts, MD Family Medicine of Southeast Missouri Sikeston, MO
I had office flow questions before I opened in September. My comments probably won't help much with your question though.
I don't use the financial parts of AC at all. After reading here and other places and talking to a few docs I decided to try Office Alley's online practice management. It's free and not bad for a small office like mine, although it is not very intuitive navigating through their system. We do some double entry of patient demographics in AC and OA, which would slow down a large, busy office.
I am a solo FP with one multifunctional employee who is my chaperone, medical assistant, biller, receptionist, etc.
Here's my office flow once a patient is in the office: 1. Patient calls for an appointment and my employee quickly collects all demographic information including insurance numbers. She then verifies their benefits before their appointment. The patient visits my website to fill out medical history forms. 2. Patient arrives, checks in, signs a few forms, copay is collected, insurance card and ID are scanned, and encounter form is printed with documentation of payment, and given to me on a clipboard. If the patient and employee have done everything right, a new patient spends less than 5 minutes in the waiting room. 3. I see the patient and document the visit in AC. I jot down the ht/wt and maybe a few vitals on the encounter form. I also jot down the ICD and circle the appropriate CPTs. Personally, I like to have some paper trail in the event of an electronic catastrophe or if a patient visit note "disappears" (which occurs more than I would like.) 4. I walk the patient back up to the front and give them their prescriptions. I give the encounter form back to my employee who posts all the info into OA at this time and submits the claim.
-The day's schedule is printed out in the morning (same day appts are handwritten into it as they occur). -Patient checks in (fills out demographic forms,etc if they are new which, along with their insurance cards are scanned in and imported to their chart). Receptionist enters their demo info and collects a copay, which she records handwritten on the printed schedule. -Receptionist opens the chart, as if to start a note... double clicking on their name/time slot in the schedule opens the note with the reason for visit pre-populated -Receptionist forwards that started chart to the nurse. -Nurse takes patient back, records their vitals on a slip of paper, and records this info into the chart at a workstation computer, and forwards the chart to me, the provider. (If the patient is in for only a nurses visit, she records the visit/shot/whatever and forwards me that chart to sign off). -On days when I am without a nurse, the receptionist forwards the chart straight to me when the patient arrives. -I open the chart from my inbox, write and sign off on the note, complete with codes and modifiers. -The following day or so my office manager/biller records all the copayments into AC from the paper record then uploads the day's charges to EZ-Claim, making sure all the codes and modifiers match up.
