Home Forums practice management/billing in AC

A quick primer on how to do the billing in Amazing Charts.

Go to the view tab on the main interface, and select administrator options. You have a choice of whether to do the regular administrative stuff or the financials. Select the financials and a warning will come up indicating that the practice management function is not very robust. Ignore that and keep going.

You will then come to a window where you can select any time period, which will tell you what's been billed, what's been collected, what co-pays have been collected for patients seen within that time period. There will also be a list of all the patients who have been seen within that time period; a click on any one of their names will bring up their superbill.


From this interface, you can print out the list, and it will tell you all the aggregate and individual billing information for the time period selected with respect to what's been billed, what's been collected, and what's owed.

The only thing it won't give you is the total Accounts Receivable for any patient, and for all the patients, and any aging. Aging is just how long a bill has been outstanding.

What I typically do is export a billing file to office ally and upload it there. When we receive checks in the mail, my assistant will review the EOBs, and enter the appropriate information, enter the contracted amount and the contracted discount, any billing notes and the date that EOB was received. She'll also enter any co-pay received from the patient. With that information saved, she then prints a patient bill, which is set up so that it will fit right into a double window envelope. That goes into a self sealing envelope, a self-adhesive stamp is applied, and voilà!

If the patient owes any money and doesn't pay, when you run this list, you can see that, so you can then indicate that on the yellow pop-up window in the patient demographics. When they call to schedule and their name is highlighted, that little yellow window shows up in the lower left portion of the main interface, they can be told how much they owe and that they must bring their account current prior to being seen again. This is in addition to running this list monthly and sending out repeat bills which of course you documented in the billing notes on the super bill, so you know if it's time to send them to collection.

If you have patients who have secondary insurance, there are enough spaces to be able to indicate that on the superbill. Just be sure to save the superbill after you make any notes or any changes whatsoever.

Another caveat is to make sure on the demographics page that you enter the amount of the copay, if any. Do not leave it blank. If it is zero, enter $0.00.

As long as the superbills are sent out, either through electronic billing file, by paper, whatever method you use, and you receive the EOBs, and enter the appropriate indicated information and save the updated superbill, and you pull the Accounts Receivable monthly report, on a month by month basis, you won't have any problem keeping up. Be sure to indicate on the yellow pop-up window in the demographics if the patient owes money, and don't schedule them until the account is brought current.

Hope that's helpful.

LL

No financial attachment to Amazing Charts.

Larry,
You make it all seem so simple. Sounds like you have a nice little system there. I was just thinking about going thru my list of patients that have outstanding balances and putting that in their little yellow pop-up section myself.... Keep up the good work and thanks for the sage advice.

We use Office Ally for our billing. That said, we make use of the yellow box for outstanding balances and other things that have to do with scheduling visits for that individual. It's a nifty area that is probably under utilized.

Larry: How do you handle working with OA and AC? I use OA to submit claims by creating a report and exporting it to the Service menu where I then upload the HCFA report. How do you upload the financial reports? Do you do double entry and use practice mate as well? Any shortcuts?

first and foremost, only do the work that's necessary, that way, you avoid redundant data entry.
i use office ally with amazing charts; when the bills for the day are completed, by signing the charts, i use the pull bills by date function to export a billing file in office ally format, and save it in an appropriate folder; i rename it because office ally has a problem with the name if it's not short enough. also be aware that occasionally amazing charts will pull bills for a particular date but call the billing file a different date. check and make sure every time you pull bills. i create a billing file for every date there are bills. in other words, don't create a billing file for more than one date, unless you clearly indicate it in the name.
i typically name my billing files by date and add what it is, eg a billing file from today would be named 05032008 OA UPLOAD. then i go to the office ally website, and upload the billing file. because the interface between office ally and amazing charts is not perfect, the claims typically come into claim fix in office ally after anywhere from 24-48 hrs, where they can be edited to repair them, and then off they go! if there are any non-billable codes, or other problems, they will come back into claim fix, where any additional adjustments can be made. if any claims with errors do get to payers, they'll be returned to you, and then you can see what the problem was, and how to prevent it in the future.
in my office, i do not download the office ally reports because that's not where i keep track of what is most important to me for the continuing survival of my business. once again, EOB information is entered and saved on the patient's account tab for the indicated date of service in amazing charts.
that way, when i pull a collections report in amazing charts for any given time period, i know what's what, and where the problems are. then, if i need to look something up in office ally, i can search for that specific item. otherwise, i am not aware of the need to download reports from office ally, as long as i review the reports in amazing charts, and do so on a monthly basis, and follow up on any missing payments.
on a related note, i have no need for complicated accounting software, either as part of practice management within or outside of amazing charts; i use quicken home & business, and i download all my bank transactions electronically into the accounts i've set up in it.
that way, i have a complete personal and business accounting for tax purposes, and i keep non-amazing charts stuff out of amazing charts, and all amazing charts stuff within amazing charts.
make sense?
hope that's helpful.
LL
ps-- remember, just because a report can be done doesn't mean it should be.
no financial attachment to amazing charts, office ally or quicken.

Jon wants to have a brainstorming session about the Practice Management features of AC at the User's Convention in Branson next month.

I wanted to have a User who could present a talk on this topic in Branson, but I have not located anybody so far.

I was hoping Larry might be able to come to Branson, but he is giving a talk on Amazing Charts at the Ideal Medical Practice meeting in Rochester.

If there is somebody coming to Branson who has strong viewpoints on this matter, please PM me. It is probably too late to add another speaker, unless one of our present speakers drops out, but we do have plenty of room for participants in a round-table discussion.

If any of you are not coming, but have specific requests or concerns, please post your questions or PM me and I will make sure that they are passed along.

Brian,
A long time ago I sent and posted some suggestions. Now I am by far one of the worst people to speak to certain specifics on this topic for I am at the begining of my learning process on it now. But that being said, about a year ago now, a very very good biller here in my area and I were looking and researching answers for us. It was her very firm conclusion and recommendation that of all the programs that AC interfaced with Altapoint seemed by far the best for both flexiblity and customizing of reports to assist us in minding the store. It also has the ablity to be set up for a billing company with multiple practices, various log-ins, filters so we could only see our practice or doctor, while the billing company could see all practices and doctors.

Now I know AC is supposed to be for that doc or practice only, but by creating something that is more universal it allows guys like us, and small responsible hardwork, kitchen table billers to have a good working relationship. And it could seriously expand Jon's reach into this new market. Imagine AC the PM module allowing someone like our friend Heather to be able to have a license or two herself and now she could service a number of the AC the EMR and PM practices around the area and even more. I am also considering setting up a dedicated hardwired peer just for Heather to be able to do the "Mr Scott" to access and work our stuff while she teaches me the ropes to take over the duties one day.

But none the less, I recieved a spiral bound copy of the old version of Altapoint's user manual back then, 6.0 I believe, still got it at home. Now even though this manual was thick as half a brick, the program seemed incredibly AC like in it's intuitive controls and operations. I don't even really understand billing too well and yet I was able to understand what they were getting at and how to basically do it no less. And billing is a sticky subject with terms and things of its own.

And I must say I really do love a good spiral manual. Fold over the page you need, place it in your lap and slowly follow the directions. I think Jon should really download the free 100 patient version that they allow one to download and take a look at both the features as well as the layout. I think it would make a very good jumping off point for him to brainstorm from. Heck I am on the verge of purchasing a few licenses right now, so we can take back control of this sinking monster. Nancy sends out more and yet we are still seeing about the same and frequenlty less.

Furthermore, seeing that a number of us need something more immediate, if he could build an interface or import from most of these other products so a practice could switch over easily I think that would help him win over the practices that have had to do something in this void period waiting for AC the PM.

Now when you guys say Rochester, do you mean Rochester an hour or so down the road from us here in the Syracuse area. I know that there are at least a few of AC users in and around here, that might care to all hook up if we can not make the main event out in Branson. It is my goal to still try and get more regional user groups together so folks can get together a shoot the breeze without so much travel involved. East Coast, MidWest, you get the idea. And obviously anyone who wants to travel and hook up with another region's meet, they are always a welcome brother or sister. This is how my old Slant-6 club of America used to do it. We even handed out a "Long Distance Award" on the honor system via odometer readings. But I know there are a few other Rochester's around the country, so is it here in NYS or somewhere else???

Paul:

Great reply. I don't know which Rochester they're going to.

I will say that the age of the nice spiral manual is probably over, especially for a low-cost product like AC. It's a cost issue. You can always print off help files, punch and bind them!

Here's a response from a user on another forum:

Here's another:

*Note - Larry Lyon says we basically just need Accounts Receivable and Aging Analysis.

This is the beauty of the Altapoint. You will die when you see all the power this thing gives you at an almost AC price. I would much rather give Jon some serious cash if it will for once and for all, let me see this side of my business, for better or for worse. As I said about tech, I can not fix what I can not see, duplicate or track. Good reports are worth their weight in gold, trust me on this one.

More importanly, you want to be able to filter and create you own reports. Only you know how your practice and contracts read. Being able to break it down by carrier or even product of carrier is so very important. I want it, I need it. So do all of you. How do you know which contracts to keep and which ones to ditch, if you can't get this kind of valuable data? A carrier that has a great fee schedule but is always jerking your chain and never paying, or lots of their claims need to be redone or are constantly being underpaid in the attempt to cheat you and hope that you won't notice; these are things you want and need to be able to break out. Percentage of different products in a carrier too. If a carrier has lots of pain in the @$$ managed care rules, but almost none of your patients fall under the POS or HMO products then perhaps you stay. If you have tons of these underpaying or paperwork demanding products with a carrier perhaps it's time to cut your losses. You want to be able to track this by number of claims, percentage of visits, percentage of revenue.

As this lady Heather and I agreed. I'm not even sure half the ways I want to look at my practice, but as I learn more about it via good reporting, then I'm probably going to want a product that allows me to create new and different reports that I can fine tune to our needs. And last I looked Altapoint does this and for about $1500 for three licenses too. That is not too bad in this messed up market. Not nearly AC, but pretty darn good.

And that leads back to my other point. I think at some point we all need to be willing to not shoot the golden goose that laid this egg for us. A real quality PM is going to mean research, new programers and lots of testing. If he could actually pull off the AC version of Altapoint, then we personally would be willing to support such a thing with some extra dollars. It probably is a bit much to ask for without new programs and even a few great billers as consultants and alpha, betas too. But it is a shame it is taking so long, there are going to be a lot of lost practices that are already too vested in other products to be willing to belly up after already running with some other decent product....

Oh, and one more feature that has to be included is the ability to create multiple fee schedules for various carriers and even products since many of them pay different rates for different product lines. Then, based on this data, as the claims come back in you want the system to ring bells and wistles and wave red flags at you when your presets are not met. Or even when they do. I was very busy, and like so many contracts we didn't get any notice that fees had changed. Well with this one HMO the rates for level 3's had gone up and we were suddenly leaving money on the table, because we were now undercharging. Now it wasn't that much, but when payment matches charges, that should always trigger a flag or a pop up or what have you. Then you know it is time to adjust your fee on that code.

So you see, there are two ways to look at this, simple point and shoot, send 'em out and post 'em up, or real meat and potatoes practice managment. The way I see it, most of our small practices really need the latter. It is these good tools taht may allow us to save what little is left of our practices. What I guess would be very cool would be to have an "Auto-Stick" like PM. If one wants they can use it like an automatic transmission, pop it in drive and go, while at the same time like my Jeep's auto in terms of off roading, I can down shift into one, and it will stay there no matter what and do lots of engine braking for my on a down grade. In a no clutch kind of way, I can still control the shifts. So if one wants to do more than can do that too.

I suspect one of the hardest things to do when developing a new program is to get good ideas from programs that are already out there and that have proven themselves. One can no longer Google a PM program, go to the website and download a free trial version and try it out. At least I don't think so. When I bought my PM program almost 10 years ago I could do that and did. Now it doesn't even give its price on the website. As I mentioned in a previous post, I wanted to add my PM onto another computer station in the office...not add a user, just another station. They want almost $1000/year EXTRA to do this. I told them to go to H%*#.

When the program first got started and I first got started with it, I could call one of the programmers and say "Geordie, I think this would be a really great thing to have" and Bingo, in a few weeks there it was in a download. I have stopped making suggestions because they have stopped listening. I am ready to chuck the whole thing as soon as I can find a worthy replacement (AC??). But whatever I change to, the MOST IMPORTANT ISSUE will be that they listen to the users. This has what has been so invaluable to me with AC. Should Jon get too big a head or stop listening to us, I am outta here, regardless of what another program might cost. In fact, I would even consider going back to paper ledger cards (like we did "back in the day") simply out of principle. If nothing, I think this group of AC users is big on principles.
Anyway, I am willing to let anyone at AC check out my PM program via Logmein while in Branson. Maybe they can take home some of the good and bad features and develop some ideas of their own. I plan to bring a laptop.

Leslie

That sounds awesome, Leslie.

I threw this in from another thread, as I see new posters bringing it up again and again.

Another good post from Vicki.

Another good thought from billl. My approach would be to have a tag for non-$pecific codes like NS or N$ or something, that begins the entry, like "N$ OTITIS". That way, you can see it even if highlighted. If you insist on picking that diagnosis, and you don't want the tag, you can just double-click on it and hit "Delete". This could also be something innocuous-looking like an asterisk or something.

i've been using AC for the EMR side of things, while ignoring billing. but now, after signing on with office ally, i wanted to see if i could integrate things. i liked the OP's post, and was wondering a few things...

1. for an individual patient w/ multiple superbills and payments made, is there a way to view a tally of what that patient owes and to make that into the invoice?

2. any updates to adding aging features?

for now, it seems best to do icd/cpts within AC, import to OA, and then do all the record keeping, invoicing via OA...

thanks!