Practice managers play a crucial role in helping physician offices run smoothly. Doctors are responsible for multiple administrative tasks along with patient care, making it nearly impossible for them to manage their practice without assistance.
In addition to implementing programs and procedures to improve operations efficiency and managing overall operations of the practice’s business functions, practice managers are employed to manage staff and oversee budget and financial functions. An important part of these functions is leading efforts with information technology (IT) to meet the demands for providing quality care and necessary communication within the medical community.
According to the Medical Group Management Association (MGMA), practice management IT objectives (IT) should include:
- Developing a technology plan, policy and budget that support the needs and goals of the medical group practice
- Illustrating a technology disaster management plan in accordance with HIPAA that safeguards office and patient records, establishes a data backup and recovery plan, determines key personnel and responsibilities and identifies a process of validation and testing
- Managing information integrity, including release and storage of information, security and confidentiality according to HIPAA
Plusses for Healthcare Providers
Healthcare technology aids in reducing costs by automating administrative tasks for more efficient use of physicians’ time, lowering staffing costs by using scheduling apps, improving claims processing and collections and optimizing the supply chain for value-based care. Most solutions are designed to help physician practices streamline workflow, reduce administrative burden and improve patient care.
For practice managers, technology allows them to assist providers in conducting multiple financial and administrative functions. Specifically, practice management systems and software help them quickly and easily capture patient demographics, schedule appointments, perform billing procedures, conduct authorization and referral management, increase reimbursement from payers, communicate electronically with patients and other providers, generate comprehensive reports and store documents electronically.
Most practice management systems integrate with electronic health records (EHRs) and securely integrate clinicals and financials. They also promote adherence to compliance regulations and streamline revenue cycle functions.
Advantages achieved by physician practices through practice management software include more efficient front desk and back office workflow, improved efficiency and accuracy, increased revenue and faster reimbursement. Benefits for patients consist of reduced wait times, improved security for protected health information (PHI) and enhanced patient satisfaction.
Practice management and electronic medical record (EMR) software solutions often are confused as being the same product, but they have multiple differences. Practice management software is designed to streamline administrative tasks, while EMR solutions handle the documentation and storage of patient medical data. Though each of these solutions can be utilized in a standalone manner, combined they aid physician practices in operating with speed and accuracy and connecting staff through an unbroken flow of information.
Most practice management systems are customizable to fit a provider’s specific needs. However, the ones that provide the most return on investment (ROI) are scalable and composed of multiple features. Each of these features should not only add functionality to the practice but also help reduce the administrative burden on both physicians and their staff members.
Following are three of the top features a practice management system should include:
Electronic Claim Submission
Leveraging electronic claims reduces the unnecessary errors that typically occur in the manual processing of claims and allows provider staff to electronically transmit corresponding data to payers for processing and reimbursement. Claims also can be more easily tracked and monitored in this process, enabling a provider to pinpoint any problems in the revenue cycle.
Billing Code Sets
Knowledge of ICD-10 and CPT codes is required for practice managers responsible for the financial sustainability of the provider who employs them. However, ICD-10 consists of more than 70,000 procedure codes and 69,000 diagnosis codes, too many for any one person to remember. Practice management systems that include this myriad of codes streamline the medical billing process and help to ensure a more accurate claim.
Patient Eligibility, Insurance and Copay Management
Having the capability to electronically view and verify patient demographics and allowable health benefits and other important billing data helps providers streamline payment processes for quicker reimbursement. With practice management software, this process can be completed while the patient is scheduling his or her appointment, thereby improving efficiency in management of patient eligibility.