Home Forums Discussions General Discussion new user with integration q's

I have downloaded AC and have been playing and have some questions regarding integration to my practice..

1. I have an expensive PM system that I use for years with all my billing which is done in house. If I get a link created (there is none yet), how will this work? Is it seemless? Would I enter my demo in the PM or AC? How about scheduling..which system? Really don't want to give up my system...

2. Trying to think about the office flow..

- Can I write partial notes on ac, send the cpt to the biller and finish my notes later?

---Will these cpt codes subsequently pop into the pm system or need to be entered manually?

Thanks

I still use a paper superbill as I too do my billing in house and have a separate PM program. Although I always finish my notes before I leave the exam room, if I did not, I can always complete the superbill and send it over to the biller before completing my note.

We still use a separate PM system without the link. We talked about the link early on, but honestly just have found that we had so much to learn and issues to deal with that it never got addressed, and now it just doesn't seem that important. My vote would be be to not put a whole lot of effort into the link until all the other aspects of implementing AC are stable and second-nature, and let the billing staff stick with as many familiar things as possible.

As Leslie says, you can complete the note at the end of the day after the dust settles. I use AC in the room to take notes and review PMH, SH, etc. ; send the chart to myself; then as time permits, over lunch, or at the end of the day I complete the note and create the bill. That said, we have long since given up trying to collect at time of service, so having the bills generated at day's end does not matter.

Thanks...what did you do with the scheduling? schedule in both? pm only?

We schedule in AC only.

We use a separate billing software but do not schedule in AC. When asked, my staff prefer features of the billing software scheduler, such as color coding for different types of appointments and the ability to attach a note "pt owes $ and need to discuss payment" or "did not keep last two appointments".
I would prefer them to schedule in AC because that is the schedule that I look at, (I don't even know how to log into the PM software) and they sometimes forget to book the appointment ( or cancel it in AC. This makes me crazy but the billing person works off the PM schedule and can access AC and double check the note for the encounter before submitting the charges. so, they are happy with scheduling in the PM software, it is just the doctor who is cranky.
We submit the bill within a day or two of the encounter, I do not try to have the charts complete by the time the patient reaches the checkout counter ( although they often are complete).
I think accuracy is more important than speed and pressure to create/ complete the entire encounter by the time the patient reaches the check out counter might lead to documentation that is incomplete or has overly inclusive "template-generic" faults you see from many EMRs these days.
We use the X-link software but I am not really sure that it is worth the cost. There is some needed information that does not "flow over" such as email addresses and appointments. The information also flows at intervals (I think 5 minutes) such that some times I am ready to write an electronic prescription but the demographic info has not yet populated...( ?? my staff or the software???)and the electronic prescription will not transmit because the demographic is incomplete.
Oh well, in general I am very satisfied with AC and am looking for improvement in the PM sector of my practice but have NO intention of changing my EMR for another one.

Although my PM program scheduler is actually a little better than AC, we switched over and now use the AC one exclusively. This way I can see the schedule easily in the exam rooms and can book a patient myself if needed. If I want to see someone back in a few days, I can check the schedule and tell them exactly when to return.

Leslie, I keep thinking about this, and I honestly have no idea how I could even remotely accomplish that in my IM practice. What is your secret?

Me either. In fact, the reason I am on this users group right now is I can't deal with all the charting I have to do.

Well, it is just as easy to go to the scheduler and drag the name onto the schedule date and time as it is to write "Return in 2 days for follow up pneumonia" into the encounter note. Now, if only the encounter note noted that a follow up appointment was made at such and such a time (just as it notes what scripts and orders were performed) that would be ideal. Mind you, I do not do this routinely but, if the patient starts saying things like "Oh I have a hair appointment on Thursday at 3 pm and I just can't come that day", I pull the schedule up and, finding an opening, tell them "yes you can".

Leslie, I more meant how you can finish a note while seeing the patient.

I have a lot of templates, use Shortkeys, and am not concerned about making my patients sit there quietly while I type. I firmly believe they should see the hoops and hurdles we have to go through just to treat their sore throat. Also, I am committed to having another life outside of the office.

I agree with Leslie....it is extremely important that patients sit there and watch these hoops and hurdles....especially trying to get some sort of authorizations. If somebody is going to wait on hold for 20minutes for an auth in my office, it will be the patient. When a live voice comes on, I'll be right there. I actually say what I'm typing as I type so that the patient is aware of what I'm documenting. I do this with preop evaluations especially. And when I leave the office, my work is done.

Both are tempting arguments. The life outside the office I certainly get. I don't take stuff home, just prefer to do it in the quiet of my office a little later in the day. We cutoff patient appointments by 4:00. Also, I am sensitized by the number of people who come to establish with us who say "my last doctor spent all of his/her time playing with the computer and never really paid attention to what I was saying". Finally, just when I'm thinking templates will help with a simple hypertension reevaluation, the patient comes in and I have to chart "Patient's spouse is currently hospitallized with undiagnosed encephalitis, and prognosis is guarded for full congnitive recovery. He has two small children at home and no prospects for home care. He has lost 15 pounds and sleeps poorly. His home blood pressure cuff has broken, and he cannot afford a new one, so degree of hypertension control is unknown." Seems kind of important to chart that stuff, but not a lot of opportunity for templating.

I am now using dragon so as i use dragon i do it in the room with the patient. I feel this wya the patient knows exactly what i put in the note and when i put in the plan there is no confusion about what i said to the patient and what is in the note.

If you have enough templates and such it doesn't become a problem. I am with Leslie on this one that I am not in the practice of wnating to stay for two hours doing notes.

Also though now i am still not super busy, when i was doing residency and was busy with my clinic we didn't have dragon and I would just type out the note right then and there.