Home Forums Discussions Coding and Billing AC Practice Management -- initial experience

Day #1 with ACPM:

I thought I would share our experience getting started with PM and use this thread to invite others to do so.

Last night the AC tech staff turned on the Practice Management module and did the data migration from AC into PM. It took about an hour. We use AC in the Cloud so I didn't have to be hovering around my computers at the office during the change over--I was home having dinner.

Today was our first day using PM and thought I would share our experience. Despite the training that AC provided prior to today, we all felt a bit overwhelmed. The reality of running PM is quite a bit different from what I imagined--like most things in life, I suppose. We thought we would be able to enter charges starting with day #1 but realized we're not ready for that yet. We thought we would start using the appointment scheduler in PM today (PM has a new and improved appointment scheduling module) but realized it wasn't as simple as we thought and put that on hold. All the appointments in AC have to be manually re-entered into PM. The data transfer does not include appointments--apparently the two programs are not fully compatible. We are going to continue scheduling appointments in AC for now.

The main surprise is the fact that AC and PM are not as well integrated as I had hoped. For example, some of the demographic data (name, address, phone) transfers back and forth from AC to PM but other data does not. You have to enter the Language Preference, Race, Ethnicity in AC or it doesn't count for MU. The insurance info has to be entered in PM. So about all we really accomplished today was to start entering insurance info on patients into PM.

The nuts and bolts reality of transitioning from our current billing program (Medisoft) to PM is more complicated that we realized. The main reason is that the data transfer process does not include extracting data from our current billing program and transferring to PM--so we are starting from scratch. What will we do with all our accounts receivable that were entered into our old system? This and a variety of others questions remain to be answered. For now we are going to continue to use Medisoft until we get going with PM.

The good news is--none of my staff quit. I got home at a reasonable hour and am only mildly aggravated. :-) The tech support staff were very helpful and spent a lot of time on the phone with us today. I'm sure in time it will all work out--but it's going to be a lot of work getting everything up and running. Fortunately we are prepared to have very little money coming in for a while during this transition.

Thanks for the info. Eventhough not using the cloud it is good that this thread be kept alive with experiences. We were initially thinking of going with the PM component but decided to hold off. will keep a watch on this thread.

John, thanks for taking the time to write and post this. I agree that it is helpful and hope that you will update in the future and others will add their experience.

Thanks for posting
I was thinking about using their PM, I have now decided to hold off.
I guess "fully integrated" means different things to different people
Plus having to re-enter the appointments is just ridiculous

When you have a chance to look, I would be interested in finding out if their PM scheduler gives you a list of no shows for the day, week, month, provider? the built in scheduler in AC does not. Major oversight in my opinion.

Yes, Gerardo, the new PM scheduler is considerably more powerful and includes the ability to generate a report on now shows using a variety of criteria.

Thanks. That is good to read. It should be AC's priority to fix the transfer of appointments from the local database to their PM. That is a big deal.

Does the ACPM require that the AC databases be hosted in their cloud? I rather keep them in house.

No, ACPM doesn't require the cloud.
Yes, the transfer of appointments will take a lot of work by my staff but it wasn't a deal breaker for me. The fact that AC and PM are integrated (even if incompletely) should in the long run save my staff time. They won't have to keep entering demographic info in two separate systems. They won't have to enter cpt/icd codes when billing because that info flows into PM from AC when I sign my note. This will become even more important with ICD10.

I have received feedback the providers that we have implemented thus far and do understand the additional work that has been involved in entering the schedule and insurance information. We are diligently working to make this enhancement in the product so that we can migrate the schedule and patients insurances. I will be providing updates as we continue with testing and roll out of this enhancement.

Thank you
Laurie Hart
Product Manager, ACPM

please supply definition of fully integrated

Day #3 with ACPM:

Yesterday and today we continued entering insurance info for patients.
We started entering charges for patient visits manually (directly into PM) and via AC. In the past when I signed my notes I would enter the CPT code for the visit but we only did that to get credit for MU. Now we are really taking advantage of this feature in AC and it's going well. After I finish the chart I enter the CPT codes, check the ICD codes, and then sign the chart. The codes go directly into PM. In the past we used a paper system ("Encounter Form"). This process is helping me be more rigorous about my coding and helping me get ready for ICD 10.

We had a problem with the demographic data transfer from AC into PM. We found at least two patients that didn't transfer. Our tech support person showed us how to fix that: the patient is entered into PM and then "mapped" to link to the correct patient in AC.

My staff likes the fact that any of us can access PM from our computers. Our old billing software, Medisoft, was only working on one computer. As we learn more about PM it's becoming clear that our old software was a bit of a dinosaur.

Next week we are going to start sending out some insurance claims.

P.S. This is just our experience. It would be helpful if others would share their observations about getting started with PM. It should be useful for all of us and perhaps give the ACPM team some useful feedback.

Does anybody know if the vaccine administration codes has been fixed? Using v8.02 now and it is still not fixed. I can imagine the nightmare when switching to PM and all those wrong codes are transferred for coding.

We're looking at migrating to PM and this thread has been very helpful.

John, can you tell me how you decided to handle patients with outstanding balances in your old system. My account associate at AC tells me that there is no way to enter a "balance forward" amount in ACPM. This means we'll be running two systems for a number of months until we either collect or write off all balances from our old PM.

If this is the case, I'm not seeing much of an advantage to switching, since I'll be paying licenses for two PM software systems for at least six months.

When we converted to MEDfx after all insurance was processed we moved the balance to MEDfx by creating a superbill dated the day before go live and used a CPT we called BALFwd and we have a Misc diag code.

Joel, that's a great idea. If we can't bring forward a balance in the system, that will work for us.

Day #11 with ACPM:

So, I'm afraid I can't report any progress, but in fact significant regress, since my last posting on Day #3.

Our implementation specialist (IS) was supposed to help us get started sending out bills to the insurance companies two days ago. However, she discovered that there's a glitch with the info going from AC (cpt codes and icd codes after i sign off my note) over to PM. It had been working initially but for some reason quit. Our IS and the development team have not yet been able to resolve the issue.

Then yesterday PM went down entirely. AC was working fine. Today it was still down. Our IS worked with us but was not able to resolve the issue. Apparently MedFx did some sort of upgrade for PM and no one (not even our IS) was able to get on the program today.

One other curious glitch I discovered is that the "Help" files for PM contain no content. Ah well...

Hopefully all this will get resolved with time. We got all the patients seen today and my staff is holding up fine. Financially the delay is having a big impact but fortunately we were prepared for that.

Keep you all posted.

John


P.S. This is just our experience. It would be helpful if others would share their observations about getting started with PM. It should be useful for all of us and perhaps give the ACPM team some useful feedback.

Day #16 with ACPM:

Still no light at the end of the tunnel. PM is non-functional. The system was down completely for a while today. Now at least we can login. We tried to send a claim to the clearinghouse (Claimremedi) but it didn't go through. AC and PM are still not working together as they should.

We decided today to resume using our old billing program (Medisoft) until the issues get resolved.

John

John, did you have to do anything in particular to maintain billing service through your old PM Medisoft (assuming it doesn't also use Claimremedi)?

I was afraid that once we signed up with Claimremedi/ACPM we wouldn't be able to fall back to our old PM should ACPM fail to send claims.

Our IS told us today that we could go ahead and use our old software for the time being. We've been told previously that we couldn't do this. I hope the most recent advice is correct. :-)

Hopefully it is allowed. But I don't think they know the rules for sure. Only time will tell if you get a claim receipt acknowledgement tomorrow.

The issue may be in the clearinghouse.

If your information has been transferred to the new clearinghouse, the old one MIGHT reject your claims. Perhaps they could be forwarded to the new clearinghouse but you probably need to know which one is active (and for which payors.)

You may be able to change clearinghouses in medisoft, but I have no idea how difficult this may be.

Wendell et al-

Are you using the AC PM? How is it working? Transistions/adjustments are always hard - I would love to here from some users on the "other side" of the tunnel - Now that you know the system - how is the work flow?

I am using MedFX, the company that from which AC bought the PM program. I have not upgraded to AC because they are currently swamped and I am letting things settle down a bit. The two are almost the same. I understand AC has a few tweaks to make it a bit more user friendly. AC version is $50/ month less expensive and they use a different clearinghouse.

Overall, it is a very powerful program with lots of options and choices but it is not very user friendly. For me and my staff it works.

It took several months to get up and running, I understand that is also the case with AC although they are working to streamline the process somewhat.

We are about 6 weeks into having ACPM installed and are getting the bugs worked out.

Problems to watch for:

1. insurance table contains many unnecessary insurances. Addresses are also missing.
2. ClaimRemidi - the clearing house has a list of payors and how to sign up for EFT/ERA: USEFUL!!!
3. stylesheets are needed to make nice encounter forms. We need someone to write the xslts or at least a model that could be recoded.
4. There is a lot of tweaking that the AC team is doing - just send a clear email
5. Service locations: hospitals need full 5+4 zip codes
6. MAPPING - learn how to map providers, locations and patients using the ADMIN view - there are missed mappings if you have inactive duplicate patients.
7. "codes" for insurances, referring providers can be customized. we code providers as lastnameFirstinitial: smithJ for John smith.
8. Dates for hospitalization was added when we asked about it in charges.

We could use an ongoing edited blog/email feed for these type of comments/hints/resources

Brentwood,
Thanks for your feedback. Could you clarify what bugs you are getting worked out and if they are critical or not? Are they the problems you mentioned below?

Also, have you experienced similar to what John above experienced, regarding ACPM going down and being inaccessible?

Day #34 with ACPM:

It's been a while since I've posted to this thread. Sad to say, we're still not able to send out bills and the program keeps locking up on us--a "white screen of death." We went back to using our old software. We're still trying to be patient and stay hopeful that the problems will get resolved.

I was encouraged to hear from Brentwood (above post) that PM is in fact working for them. I would love to hear from anyone else--is PM working, not working?

John

I can't technically say whether it's working or not because our May 1 go live date has been postponed until, I suspect, all the bugs with the PM and now ClaimRemedi are resolved.

I must say this thread is almost too discouraging to keep me committed to switching over to ACPM. It all rests on how assuring my IS will be on our next phone call.

We "went live" March 1st. System is running pretty well. We are not fully set up with all payers yet (still waiting on Medicare, Medicaid & Tricare), but most commercial claims are going through fine. We still are able to use our previous billing service for the others, so that hasn't been a huge issue. I find it totally incredulous that no one in the regular AC Tech Support knows anything about the PM side. It has been very hard to get answers on some issues because the few IS they have are having to cover way too many clients and I would love to be able to do a quick live chat to get an answer to something like I'm used to doing with the regular tech support staff. It sometimes takes more than a day or longer to get an answer to a simple question, depending on how busy they are. We pay alot for tech support & should be able to use it fully! The online user guide isn't much help either. I agree, it would be nice to have a separate place to share information and be able to ask questions amongst ourselves!

We have had PM installed 10 days. Not live yet and I anticipate it will be a bit before that happens. There is LITTLE logic to the way anything is done in the PM. Okay, so I may be overstating that, but the important issues...like billing and getting paid...I can see follow NO logical progression from entering charges, editing or modifying those charges, changing insurances for a patient without having to delete an old insurance and enter the new (even with the same ID numbers). Little is known about the PM with live chat. The online users guide is very limited. I had a very logical and very good PM system that staff can easily and logically handle, but started with AC for the EMR (which we are pretty happy with). I see a nightmare of an issue with the PM and MUCH more time involved with all aspects of it, even after we are fully trained on it. Not sure I am willing to wait...unless my 12 month contract that I signed has bound me by that.

For anyone that does not have a PM (that is none of you...right?) I would really wait...I seriously think this is NOT for you. This is really sad and I really think that AC is going to have BIG problems going forward due the bugs in the new version of AC and the problems with the PM. FULL INTEGRATION...I think not! I am a very calm individual, but this short transition period to the PM has been a double valium transition.

Best to all

Can anybody confirm that falling back to your old PM is actually working to submit claims, especially with Medicare? And receive ERAs?
We are receiving rejection reports through our old PM that our old clearinghouse is no longer approved for EDI. So none of our Medicare claims are going through.
And we've yet to get ACPM installed! I am so frustrated right now and I can not reach my IS either.

Did someone "delete" your old clearinghouse from your EDISSWEB account (I am assuming you know what this is...EDI support services)? You can have multiple claringhouses listed, but only 1 can reveive 835's.

No I have never heard of EDDISWEB. That appears to be for states out West. We are in FL and I can't think of an EDI service account that we use other than our old clearinghouse (Emdeon).

I am assuming that our old account with Emdeon was removed when we faxed over the new ClaimRemedi/Emdeon enrollment form from AC.

very interesting... I have been looking into the PM component as of late-- actually was poking around to see if any folks in Massachusetts had experience.... but am going to be holding off at this time based on what I am reading!!!

Day #45 with ACPM: Some good news!

We received payment on three claims today that were filed with PM about 2wk ago, one each from Aetna, Masshealth, Celticare. These are our first payments using the new system.
Because of the problems with PM we have not been able to send out any claims for about two weeks. Today we were able to send out claims for work we did on May 18 and 19. If things continue going smoothly we should be able to get the rest of our claim backlog sent out in the next few days.

There?s an issue with the addresses for some of the insurance companies?our IS is working on resolving this.

There are two issues that affect my work as a physician directly. When I do my Assessment in AC the ICD codes need to be complete (nothing yellow). There can't be more than four codes. When the note is signed off the information flows into PM. If it's not done correctly the claim will be automatically rejected. This means retraining myself to be careful with coding in the Assessment. Prior to PM we used a paper "Encounter Form" to record ICD/CPT codes for each visit.

To John: Thanks for taking the point and working out the bugs for the rest of us, at the price of your cash flow.

To AC: Shame on you for making John work out the bugs for you.

We finally had ACPM installed 2 weeks ago after a long 2.5 months of "implementation."

To this point we have not been able to take it into full "production" yet. We have only been entering in Pt insurances and then entering them into schedule in order to be prepared one day to do so.

First off I'll share my experience with the program.

Pros:
- Most payers are set up and I have been able to send some claims successfully and receive ERAs back
- Reports are aplenty and fairly straightforward to run
- Scheduler is very customizable and tracks cancellations/missed appt/reschedules very well (better than our old PM Medware)

Cons:
- All insurance information in the EHR is removed. We were not aware of this so while we re-enter it all into the PM (then it will reappear in EHR) you will not know what insurance your patient has and Orders will not print out with insurance information.
- Web-based software so if your'e internet goes down you lose the PM. Same if they lose connection. Basically like Updox.
- Eligibility is not-functional yet. This was a very appealing feature that made us switch. Apparently, the clearinghouse is holding up the process.
- Java-based interface is not intuitive. The screens for most processes require you to press Save multiple times and then Exit instead of just pressing a single OK/Save button once. If you Exit some screens before saving you lose everything you entered.
- Not keyboard friendly. Tabbing sometimes takes you to the next field. Many dropdown fields require the mouse.
- Receiving and posting EOBs/payments are very tedious processes involving multiple screens. Compared to our old PM it is not very intuitive.
- Signed-off visits in the EHR are not being properly transferred over to the PM for claim submission. Our IS is working on it but for the time being we are having to manually modify each claim in order for submission. Overall, the integration of the claim charges between the EHR and PM have been poor and it is unfortunate because its what they're advertising.

I'm not sure exactly how long ACPM has been around now but I would have expected these bugs to have been gone by now. I think its safe to say that we were unofficially given a Beta product which by AC's standard is unusual.

With time I'm sure we will get accustomed to the interface and workflow, but for now it is too prone to input errors and frustration.

My initial experience with my Implementation Support Specialist (aka Support) has been great. In my opinion they are understaffed for all of us currently signing up and those of us already implemented, so yes it is difficult to get a hold of them but they know what they are doing and will help you once you are having issues. I would much prefer support with the EHR to be more personal like with the PM. Its much easier to follow-up with the same person instead of having to explain your situation every time you contact support.

Unfortunately, but as expected, time is left to tell how well the PM functions once it is properly working.

Day #56 with ACPM:

Josue, great to hear your experience with PM which is similar to ours.

We have now gotten caught up on our billing. All the claims have been submitted and the process is working well. Payments are also starting to come in--though we have a lot of catching up to do. My biller says that if there's a problem with a claim (such as an incomplete CPT code) it will give her a pop up alert so that she can correct it before the claim goes out. This is a nice feature that was not part of our previous billing software, Medisoft.

We've figured out how to use the "Usual Charge List" to make adjustments to how much we charge for each CPT code. Unfortunately, the "List" only provides info on one CPT at a time and does not generate an actual list of codes and usual charges.

We finally got the Help Guide working. I needed tech support to help me unblock the file so that we could read it. The Guide has a lot of useful info but lacks important practical details in many areas.

We're trying to figure out how to use the Reports feature and decide what reports to run on a daily/weekly/monthly basis.

Laurie was a great help in the whole process. However, once the migration was performed (took four different tries because they were having serious issues with our database) and I showed up to view the product in the morning, I discovered that the insurances did not migrate over. I was not told this ahead of time and was dumb founded how such a large factor was not passed on to me. Well we are a very busy walk-in primary care office and did not have the time or patience to enter EVERYONE'S medical insurance so I had them reverse the process. Reading this post makes me thankful for not going forward and questions if this is the right product for us. Thanks to everyone who is sharing their experience.

We try to address each practice?s networking capabilities prior to following through on the complete implementation. Since each office has varying internet bandwidth that can affect system responsiveness, a cloud based solution may not be the best choice for all.

Based on the various feedback that we have received from our providers we are diligently working to enhance the issues that have been brought to our attention such as the entering of the patients insurance and scheduling.

Please feel free to contact me directly with any questions, concerns, or suggestions for future enhancements to ACPM. My email address is lhart@amazingcharts.com

I just joined the forum and I am so excited to find a community that is experiencing the same problems that I am. I am not excited about the problems that we are experiencing but, I am excited to know that there is a place where I can tactfully vent and find useful help.

Day #227 with ACPM:

It's been a while since I've posted to this thread but I've got some good news for a change! I talked with Nicole who does our office billing today. I asked her, "So, how are things going with PM?" She said, "I'm happy to say that everything is finally working just fine." Our accounts receivables are back where they should be. Bills are going out and getting paid. Everything is pretty much working as it should.

Day #49 with ACPM.

SECURITY ISSUES REMAINS UNRESOLVED. All levels of staff, including medical assistants and scheduling staff with access to Amazing Charts, ALSO HAVE access to our ENTIRE PRACTICE FINANCIALS AND REPORTS. "Permissions capabilities" is emergently required, please fix !!

I am holding my nose, hoping & waiting, even praying, for things to get better quickly. TIMELY SUPPORT REMAINS out of reach, but MUCH DESIRED. Waiting for improvements in the software and with support, and hoping there'll be no need to do a roll-back.

Some good news though, we are finally getting paid!... so ACPM is definitely working, but that's a really LOW BAR for a PM system.

We had other issues though. Not all our claims transferred over from the AC-EHR to ACPM.
Our 99213s for example did not go across from AC-EHR to ACPM, so tech support eventually remote into our server and after 3 tries, I think this is working, but waiting to find out for sure.

Some modifiers also not going through like U-modifier for behavior screening.

Also using the ICD10 diagnosis search box still a challenge. For instance when I type in the box to search for a diagnosis code, I get a RED-X error notice saying,
----Exception of Type "System.OutOfMemoryExcception" was thrown. ----.

Then I can't proceed timely to complete my notes as cannot choose a diagnosis. I just squandered my entire afternoon with this error so came here to vent.

Whatever anyone says, my take is that those of us currently using ACPM are the beta-testers!

I'd like to stay with ACPM, if issues are promptly addressed and support improves asap. Unlike the AC-EHR which is just about the mundane task of encounter documentation, using ACPM is about practice survival. I hope Amazing Charts takes this very seriously indeed, and put in more resources to fix bugs urgently.

SECURITY ISSUES REMAINS UNRESOLVED, all levels of employee, including medical assistants and scheduling staff with access to Amazing Charts also HAVE access to the ENTIRE PRACTICE FINANCIALS AND REPORTS. "Permissions capabilites" is emergently required, please fix !!

Of note SHOULDN'T POSTS show from MOST RECENT to oldest, so people can see the most recent issues and then read as far backwards as they want. It was tough to find my prior but recent posts, while issues from April were top of the thread.

Thanks for you prompt action to above issues.

Sorry, one more. How can I turn off the billing level from showing in my office notes.

Also is it possible to sign off my notes without the time stamp, that is with just my signature only.
Thanks.

Dear "Ak47":

Yes, it's been a struggle for us as well. But PM is making progress.

To fix the time stamp issue, check in AC: Edit>My Preferences>User Preferences>General Settings II>Be sure "Notes: Stamp each field in your progress note with your name and date/time of editing" is unchecked. This is how I would fix the problem in v8.2.5.

With best wishes,

John

P.S. It would be more personal and collegial if you might include at least a first name on your posts. "Ak47" conjures up an ominous image especially in light of recent events.

Dear John,

Your comment about .... "Ominous image especially in light of recent events" is quite shocking to me indeed. I've used that prefix for my email for more than 20 years, with zero concerns raised by anyone. The host of this forum, with whom I had to register had no issues with my member id either, and I see lots of posts with just a member ID.

Even though I agree with the ... "more personal"... part of your comment, I strongly resent the ..." not being collegial" ... part. After all, this is an informal forum, and nothing in any of my posts conjures up any ominous image or violate decorum or common etiquette. I reject the suggestion or insinuation by you that it does.

That said, thanks for the tip about getting rid of the time stamp.

Respectfully,

Akay.
Pediatrics, Springfield, MA.

Maybe I'm too old enough to give a schat but doesn't forum etiquette generally require comments in posts to stray little if at all from the topic and personal comments be delivered via the PM function???

Hello Akay,

Please share (send) this link: https://support.microsoft.com/en-us/kb/909678 to AC Support, regarding the "System.OutOfMemoryException" error that you are receiving. Communicate with AC support, the included link should be viewed by AC?s development team. Maybe, they can fix the problem on their end, or help you resolve the problem on the workstation that?s giving the error.

I hope this helps your ?System.OutOfMemoryException? problem.

Regards,

Dear Akay,

Thanks for sharing your name. Sorry if my comments gave offense. I should have done it as a PM. The whole issue of gun violence has been on my mind a great deal and the "AK47" set me off. But clearly I should not have said anything on the user board but privately.

With best wishes,

John

Thanks for the suggestion Lawrence, I'll give it a try. The problem is occurring randomly across my 7 workstations though.

Emailed AC support, still awaiting a response

Best.

Akay.
Pediatrics, Springfield, MA.

I am wondering if there a practice "out there" that has chosen ACPM after having been with MEDfx and AC separately? Is the integration experience different for the practices who have been with each separately prior to integration? We have been with MEDfx for approximately eight years and with AC for just over one year. Monitoring the forum has if anything made me quite reluctant to make the jump to combining the two. Does anyone have hands-on experience with this scenario?

MBM,

The migration from Medfx to AC is smooth and you will retain everything you had before the only difference would be how we transmit data to the system. The downside is that the initial installation/setup takes a bit of time. Our development team is actively working on improving the sync so that it parallels the setup time for a practice previously not on either system. I suggest keeping in touch with the PM Department + Sales as this improvement should be coming out soon (no eta)

We have a practice that just went live with ACPM today that was using MEDfx and a locally hosted server that serves their four locations.

Once the dust settles I'll post an after-action report.

Must still be pretty dusty............

Nudge received.

I'm on the road again today, but I'll look to post an after-action report by the weekend.

The users just got their training this week, so we don't have feedback yet on usability.

Overall, all locations were back in production by the second day. It could have gone faster if preparations had been made.

Hello, I am new to AC and looking for PM solution to be brought in-house. Does anyone have suggestions on what really works well and what is required to capture all the charges in PM that is not ACPM?

Thanks, Nisha