Home Forums Discussions Problems Calculation and Exportation of Charges

1. Numerous miscalculations of total charges
2. "Top 4 icd9" are all that are exported
3. Not all my in house labwork is related to "the top 4"
4. The secondary insurance is not consistently exported

In exporting the data for my billing service, these other
codes are not picked up, even though we painstakingly entered them on each superbill. This has resulted in us having to go through each individual encounter again and resubmit the charges.

This is doubly costly because our reimbursement is delayed and we are having to do everything again

Looking for a billing program that works. It's either find another billing program or going to beauty school.

UUUUUUggggghhhhhhh

We ran into the same problem. Still working through the solution and for now we are only using the 4 ICD9 codes maximum.

Part of the weaker practice management aspect of AC.

Only way I can see to do this now is to build your own queries based on the AC tables. Kinda what Al Borg was leading to in some of his previous posts when we were discussing an SDK for Amazing Charts.

Without being a real pain or rehashing old CCHIT here, do a search for "Bad Numbers" or Financial Section or something like that. Ever notice the declaimer that pops up when one enters the financial section of the Admin options??? That's because a long time ago I foung that the numbers don't add up and something is wrong in the math. It was supposed to be fixed a long time ago but keeps getting pushed back. Now perhaps with V 4.0 there might actually be some real headway, but we shall see....

Also why I had other legitimate issues around here which on the face might have been seen as simply "bitching" without understanding the origins and the whole history. This is why we don't use AC for any serious billing. It is just not reliable and the company even tells you such. Read the disclaimer....

Thanks for your comments, glad to know it's not just me.
We have to find something sooooon

We are going to start doing something with MS Access or Excel

Vickie,
Although not cheap it is also not too expensive. Their website used to be better, but I did some serious looking at Altapoint and it seems to be one very strong and flexible program that can even be used in a billing company kind of way. They recently raised their prices but they are still almost reasonable considering the bang for the buck you would get out of the program. We have yet to pull the trigger especially with all the other changes we maybe soon implimenting around here, but if I were to pick one this is the one I would choose...

They will allow you to download a working copy and put 100 patients in it to play with it too... Not to shabby. What the lady and I who were researching most like about this besides the ablity to break down by even pratices so she could bill for us a few others, was you can enter separate fee schedules for different payors, make some serious custom reports so as really get a handle on your company, it could work P2P just fine and if you wanted to spend the extra cash it can x-link across to AC although, double entry actually has it benefits if you biller, practice manager is good at what they do. Now every claim is a mini chart audit because they know you and the patients, right? I love having the time to really review Nancy's invoices before they go out the door. Remember most docs undercode more often than they overcode because all of you are already scared CCHITless enough as it is.

Good Luck,
Paul

Paul, not more than a few weeks ago, I stated that if AC did not become more robust and modern someone out there would "eat it's lunch."

I was shouted down by the gallery. I was told that "AC works just fine," by more than one user on this board including you.

Yet today, you are recommending a program for "billing," because AC does not do billing correctly. Did it occur to you that AltaPoint also produces an EMR? Would it be such a stretch to imagine if someone found the billing component of AltaPoint attractive they would also switch to the AltaPoint EMR, instead of having to enter DATA TWICE? Please don't tell me about the "pricing" Vicki has already decided she is going to have "use something else," for her billing because she is losing money.

Not at all, but Altapoints EMR stinks and pales in comparison to AC. Now I'm more taken by what the ASP model (I'll never go there and you know why, ownership of the software my data is created in) of OfficeAlly. Many AC users already have their billing and therefore their demographics in OA... So this is more the one I think we need to watch. And yes I do understand what you are saying. I not sure where you got the mis-impression that I don't think Jon needs to make a fairly competitive billing PM module from. Before you and your wife ever got here, I was one of the loudest people speaking out for just such a thing and attemping to warn Jon about loss of clients new and old. No less how a more complete AC with a PM that is AC's PM equivilant would just eat up the market....

Now now fellas this is getting a little too edgy for me.

I'm not giving up on AC, just the PM part of it.
I have hope that AC, my own, or another company will fill my need. I don't have enough energy for such debates.
Just trying to hang on.

Going to have to close my practice again to get caught up Ouch.

Paul, when I built my patient tracker v1 It had a great user interface and could be used with 5 minutes of training. The docs had not used it for 60 days when they began to demand BILLING. One Doc said to me "yes it makes rounding easier, but it doesn't help me capture my payments." That is where the line was drawn for me. I had to get out and learn about CPT, ICD9 codes in a hurry for version 2.

The lesson of that experience was clear: it doesn't matter how "easy IT is" if it doesn't capture the charges they will look elsewhere!!!

I will leave you with this:

Every morning, in Africa, when the lion wakes up it knows it must outrun the fastest gazelle or it will starve to death.

Every morning, in Africa, when the gazelle wakes up, it knows it must outrun the fastest lion, or it will be eaten.

So when the sun comes up, in Africa, whether you are a lion (big company) or a gazelle (small nimble company), you'd better be running!!!

Gee Money, I totally agree with your running thing there. It is a great metafore and I will remember and use it. It is why I was hounding and begging Jon to make something happen that really works and even works for a practice, billing company type situation. So perhaps some small cottage industry biller could possibly service multiple AC practices in their community. Now you are capturing new clients on both sides. I gather AC is loosing many potential customers with this one issue alone. Now many IMP's that are semi or totally cash only can probably use AC and quickbooks and get away with that. But the more traditional practice is going to need to have something more. And even we who may soon by going cash only are going to need a decent program to track some of those self pays...

Better get up and running... And as a hockey official that just took four days of power skating and classes. We too, the third team on the ice, must keep up with the other two teams....

"Game On!"

What's an imp?

Bert,
Got your gears spinning do we??? Can you practice on and treat adults or is that a total no-no for those who have done an ped residency? Would you have to go back and do a whole FP thing? Not that I think it would be worth it... seeing that both sides get the same short end of the stick all the time...

Cash only IMP's across the nation baby!!!!

"Health insurance does not equal or mean healthcare" Support your local IMP....

I must say that I have downloaded and played with Altapoint. The EMR is a nightmare. When I opened up the combined EMR/PM system, my first problem was I couldn't figure out how to open a chart!!! Once I did, I couldn't figure out how Vicky was going to use it!

But the PM section actually has a "Post to Quickbooks" function. Hocky, I know you were playing around w/ Altpoint. Did you try that function out?

Wayne,

Is the EMR a nightmare because of what you are used to? or is it just a bad UserInterface

I just looked at the demo screen shots

http://www.altapoint.com/emr/OnlineDemo/default.htm and it looks pretty standard to me.

It is a template driven (no user controled or created if I remember, I never considered the EMR side much) drop down, button click kind of thing if I remember. Not the creative, actually chart what is on your mind, what you are seeing, create your own templates kind of thing like AC is. It is pretty lame from what I remember.

And Gee there is the rub. Most of these companies start as one or the other and they are never as good on the opposite side from the one they understood and where really strong at. It's like say that just because someone was really good at carpentry that they should or could be as strong as an electrician or plumbing. Usually they have their strong side and their weak side. Altapoints weak side is the EMR for sure. AC's is the PM side for sure. That is the state of affairs as it stands right now.

Now that doesn't mean that someone who gets it and was kind of good at both couldn't pull it off, but as of right now if just doesn't seem to really be there yet. Great idea and that is what they are trying to do or pretending to do, but they ain't doing it yet....

HockeyRef wrote:


Paul, you have just made the case for why AC has to "open up" and/or get into discussions with other Software Developers or developer houses. Is this not the SAME CASE I've been making all along?

Although I am becoming increasingly aggravated with my current PM program,who by the way specializes in the PM aspect, (I spent 0ver 30 minutes on hold this afternoon before finally getting to talk with tech support), for me, the appeal of AC was not PM. It was the simplicity and the price of the EMR. I think that is the case for a great many of us who already had a PM program and were looking for an EMR to add to it. I really would not care at all if Jon does not develop a PM side but rather concentrated on fine-tuning what he is best at...the EMR. There are many offices that do not desire to do in-house billing and,for them, a full-blown PM module would serve only to increase the price of the entire product. The ACUC showed me (unfortunately) that AC really does not yet have a grasp on what a PM needs. So, if he does develop one, I hope it will be an optional module. And, yes, I do double entry of demographic and billing data. I am not opposed to AC being able to link with established PM programs which have stood the test of time.

Leslie

i'm grappling with this too...for now, we're also doing double duty, but at least the PM side is really cheap (office ally, and it only costs us like 20-25/month is cuz we are >50 medicare, free if you're < 50%). but has AC's batch export worked for anyone? i'm testing it w/ OA right now, but haven't done it enough to make a judgement.

It is a bad interface. Back when I was programming, we had a guy that would talk to our designers. He was called a "Human Factors Engineer." They need one of him.

Where I live cash only basis would result in starvation, but I can see why folks do it.

Actually I think there are one or two IMP's that may even be cash only near you or at least in your state. Now I'm pretty bad at your geography but check the IMPmap and check out the other docs and loctaions.

There is only one here, and the media went nuts about it. Like she was the only one who ever thought of it. But, the key is starting fresh. Unless you have VERY thick skin as you watch your patients go out the door.

I just had a big blow out with Nancy over a patient/friend who wasn't cooperating with his own very needed care with regular visits. And we have another patient who wants to switch her soboxone therapy from her present shrink to Nancy because she is her PCP, but the big pay-off for this treatment is on the front end when they start, not in the long term treatment and you can only have a max of 30-40 pts the first year with a max of 100 on your panel at any time. So we were arguing over only new pts or perhaps making them pay cash for the first few est'ing visits regardless of who started them... Why do I bring this up you ask???

Because my point is Just how much does the pt value any of you and your better more personal, more acessible practice? At what point and how much? Are they willing to put their money where their mouth is? Let them walk if they don't care to to pay you a living wage or cooperate with their treatment. Heck kick 'em out! You guys should all live on a hamster wheel while starving your ethics with no support or apperciation? Granted some folks are truely broke, but even those people seem to have cell phones for every family member, cable TV, money for smokes or drinking night, but they can't afford to pay their doc a few bucks.

I am tired of seeing supposedly broke and on public healthcare people walk in the door with $50 nails and hair jobs. We have a family on Medicaid who drives nicer cars, newer cars than we do... It is bull, at least some of the market needs to be put back into this. And all that garbage lobbying that we were talking about in our EMR PM needs to be exposed too. Why is the AAFP and the AAP not totaly tearing the AMA apart on the RUC that sets the relative value units that congress almost always uses (lobbying at it's best, inside committee recommendations) for office visits so low while taking care of their specialist friends at the expense of primary care and other high time spent, personal service, office visit based practices like chemo, endo, and primaries???

We are attempting to take the slowly weed them out approach and see how this works. It seems to have worked for a number of other IMP's. Get rid of the really bad paying ones or the ones that waste you and your staff's time with lots of bull and paperwork first. It is almost better to accept $5-$10 less a visit to not have to do any hours worth of prior auths all the time for every med and every referal, think about that one for a moment. So keep the better paying one and the ones that leave you alone and don't bother you. Use them as you balance out your panel again. Try to reach out to lots of PPO like patients that can stay on regardless of model because they have some out of network coverage. These are the ones who some will stay later on. The start weeding out the ones you kept for a while.

The way I see it is the patients and the plans all use you guys very badly all the time, it really is a very bad and broken model where everyone is trying to take advantage of the other. So return the favor in a way that at least is more favorable for you. Use the carriers as a temporary life raft to your new business model and then when you don't need them anymore ditch them. It is treating them just as they treat patients and doctors.

They try to cherry pick and ditch sick patients all the time, so you do the same with sick contracts and carriers, that just business. It is not your fault that somebody's employer picked UHC over some other carrier, you too must survive to fight another day. And honestly, you can not help anyone else until you are half safe and on solid ground, you owe it to yourself and all your patients to keep your practice on a solid footing, viable and sustainable and if that means using the rules on the old messed up model to your advantage then so be it. It is not only about the individual patient, but about the health of the doctor and the entire practice for all the patients that really matters. And that is why these twisted do good, but don't actually do what they claim to do, treat or charge everyone equally rules don't work. In the end they don't allow the doc to care for the entire panel or practice and they never actually have everyone being charged or treated the same as they claim to do. They only really serve the corporate SOB's, the carriers so they get the best deal. I threw that one back at our local BC once, I said to the lady, I don't want to say no to anyone, it is your terrible policies and contract, fees and the like that turn your patients into untouchables. We'll gladly see each and everyone of them once you treat my doctor better for caring for your patients.... Who is really mistreating and being treated unequal in all of these matters????

Anyone who wants you to starve and be ill from the stress of living on the edge like this, just how much do they really apperciate you and your time, your knowledge and skills, your access and person service??? Let them really apperciate you. And if they balk, ask them if they have a cat or a dog and then ask them what they plan to do if Fido or Whiskers gets sick tonight??? Checkbook or Visa anyone????

She should have gone to Cornell.....

Paul

Thanks for the imp info-will check it out when I get a breather. I glanced at it-looks neat.