Home Forums Discussions Coding and Billing Office Flow Using AC

This has probably been answered, but I couldn't find a search button. We've used AC for years, but we've always still used a paper billing sheet. We're trying to make the switch to just AC, but I have a few questions if someone could please help.

1. How do orders work? I wish AC had more documentation. If I send to a "nursing" inbox, that doesn't go to all nurses, right? So I need to send to just one nurse? We have a large practice, so this isn't really practical, as I'm not sure who will have time to do a shot when I order it.
2. I'm not really sure about checking in process. The front desk person will check in then forward the chart to my MA then they will forward to me? Or is there a better process for this?
3. I'm having issues with HL7 and our billing system. We've used it for demographics for years, but HealthPac doesn't seem to be receiving billing info.
4. Also, if you order a flu shot for instance, this is automatically included in the HL7 interface? At what point? When it is complete?
5. Anyone have a working bridge for orders to Quest? What about Labcorp? Do they work well?
6. Any idea why AC is so stingy with their practice management modules? I get it, they want us to use their billing service, but I own a billing company, so that doesn't make sense. We can't even verify insurances in AC because they won't allow us to use/purchase just this piece of the billing module.

Sorry for all the basic questions, but any help is truly appreciated.

David Lee, MD
IM
Dallas, TX

AC has a lot of problems that have never been fixed, so we are using work arounds, and always have been.
Reception: Most EMR's have a check in feature where it changes the color when you check them in, and also starts a timer. It would be really useful to track the time in the lobby, the time in the exam room waiting, and the time with the doctor. We have double all the visits on the schedule, i.e. two Acute Visits, one has an asterisk. This is so the receptionist can change them to a different Acute Visit, a different Wellness Visit, etc on check in. This changes the color and the MA can see they've arrived. We've gone through several iterations with check in. One problem is you can really only have one chart in someone's hands at a time. (Another AC limitation). So we quit passing charts around. Generally in the morning I start my wellness charts, send my orders to my MA, and then save to my box. I am logged into charts in my rooms, with the windows locked on screen saver. The MA opens my box and opens that chart, enters the vitals, and then resaves and locks the screen. Keeping it in the box, saved, allows everyone to access the chart when needed. If you go back to your office and open the chart without refreshing the screen, it will open a NEW chart. This is another AC bug/short coming. You have to be careful to refresh the screen. (This software, despite all the years I've used it, is still very amateurish and unprofessional, IMHO. These bugs have been talked about with dozens of others and never fixed.)

Nursing: Each doctor has his own MA. You send orders to your MA. We use this continually: Labs, Referrals, Imaging, etc all goes to the MA who takes appropriate action. It would be a mess to send to a general NURSING box, but AC has that set up if you want to pool them all. If you order a flu shot, it goes to the billing sheet. I usually finish my notes during or at the end of the day, but I have a small "superbill" and follow up card to give to the patient who takes it to checkout. We have Quest online ordering with their web page, but I wish we could order Quest through the chart system.

Billing: I use an outside billing company. They are local, they are friends, they charge 6% but I do most of the coding.

Thanks Chris! Very helpful! I'm pretty sure Quest has a built in ordering system with AC, but not Labcorp. They are suppose to be building out Labcorp, but I'm sure that will take forever...

David Lee, MD
IM
Dallas, TX

Hi Dr Lee.

I'd be more than happy to set up a time to go through some workflow hints with AC. We can look at how your practice operates and figure on the best way to use some of the functions in AC to accommodate that. You can reach me directly at mdabeck@harriscomputer.com

That being said, let me address some of your issues here:

1) For Orders: When you are creating an order, if you want to send the order to a specific person in the practice, then you should select that person's name in the dropdown field in the middle of the order screen. Do this BEFORE selecting the test. This will then send those orders you select to that person. Orders has a specific workflow that has to be followed. Hard to explain, but easy enough to show you if you want.

As for documentation on orders, we do have several under our help section. Here is a link to the video tutorials on Orders. There are about 6 videos going over orders, including one on using Quest. https://help.amazingcharts.com/ac/Master/PDFs_and_Videos.htm

2) The check in process for AC is really up to you. I have seen several different workflows that practices adopt that work for them. The process you describe for your office (check in person sends the chart to the MA, then the MA sends to you) is one of them. Chris brought up another possibility as well (all charts go to the Dr's box and stay there). Again, this is something we could go over on a one on one appointment if you would like.

The typical workflow I usually will teach to client is the following.
- Check in person updates demographics/insurance info, then notifies the MA that the patient is ready to room (for this, I like having different appointment types for "check in", "ready to room", Room 1", "Checked Out" on the schedule that the front desk would use)
- MA rooms the patient and starts the encounter. They enter all they need (CC, vitals, history, etc), then forward the chart to the Dr.
- Dr will get the chart in their inbox (that is their notification that the patient is ready), go into the room, pull the chart from the inbox, and continue with the encounter.

That is the super simplistic workflow. Again, there are a ton of variation to this as every office has their own preferred flow that works for them. That is ok. Like I said, I would be happy to work with you on finding your best workflow.

3) I can open a ticket with support for you on this. Not sure why an HL7 interface would stop working.

4) If the HL7 interface you are referencing is the billing interface, then there are several points when it could be included, depending on how you have your options set up in AC. Usually, a practice will have the CPT automatically generate when the shot is given. In this case, the cpt will go to the superbill when the shot is entered in the CDS section (the yellow apple button). Again, it depends on the options you have in the practice. Some practices do not want that, and will have the CPT generate when the shot is ordered. Other practices will add the CPT on signing the chart. Its really up to you (my preference would be the first one, having the CPT auto generate when the shot is given).

5) I will let other users address this. We do have a 2 way bridge with Quest that works well. LabCorp was in development, but I do not know the details on that (I work on the training side, not the development side of things).

6) For practice management, we do have several options and our new CareTracker PM system is a bit more flexible. I can reach out to sales to see if it is possible to get just demographics and eligibility with that system (AC itself cannot do eligibility, so it would need a PM interface).

Again, I would be more than happy to review these things with you on a one on one call. Email me directly and we can set something up.

Mark,
Yes, that would be great. Thank you for the detailed response, and I'll send you and email.
David