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Buying Medical Software, Electronic Billing Information

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This page is intended to assist doctors and offices that are looking at purchasing medical office management software. Whether you are just going electronic from a paper billing system or looking at upgrading your existing software, there are a number of issues you need to think about.

Going Electronic From a Paper System:

  • You will need to obtain an electronic billing number. This requires an application form that needs to be sent to Manitoba Health. The contact for this is Esther Vermette at 786-7385
  • You can also obtain, at no charge, a diskette that contains patient demographics of all of the patientís you have billed over the past two years. This includes patientís names, PHIN, registration number, address, date of birth and sex. NB: This diskette will be sent directly to you. Your vendor cannot obtain this diskette directly from Manitoba Health.
  • Prior to being given an electronic billing number, Manitoba Health will require you to send in a test submission. This submission is required in order to review whether you, the doctor, are capable of utilizing the correct ICD-9-CA codes in assessing a patientís diagnosis. Most offices are directed to contact their vendor if a submission fails so that your vendor can explain why your submission was failed. This policy of Manitoba Health has led offices to assume that test submissions are failed due to some technical problems with the submission file. Our advice is to be pro-active.

    • Demand to know the reason for a failed test submission in writing
    • If the test submission has failed due to Manitoba Health staff assessment that ICD coding is incorrect, demand an explanation of which codes are deemed incorrect in writing. If you feel the assessment is incorrect, challenge it. You are the doctor. Who do you think can better assess a diagnosis? Yourself or a desk sitting bureaucrat who has never seen the patient before? (NB: To our knowledge no other province makes their doctors go through this exercise)
Software Vendors:

All software and all software vendors are not alike. There are many issues you need to consider before selecting a vendor or some software package. Whatever you do, donít take any advice from some desk sitting bureaucrat. Manitoba Health assures all vendors that they never, ever give advice to doctorís offices regarding software. If this occurs or has occurred, you should contact the Provincial watchdog and a lodge a complaint!!

  • Check your software license. Do you actually OWN the software you are paying for? Many vendors charge you for the software just as if you were purchasing it. Later, many have discovered that they have simply purchased a license to utilize the software for an exorbitant amount. Demand to know in plain writing, not legalese, just what it is you are buying.
  • Check your data license. Many SQL based vendors will charge for MS-SQL licenses on a per computer basis. Networks with five or fewer computers can utilize the SQL-2000 MSDE with NO license fees. Some vendors have been known to charge for MS-SQL licenses when none are licensed. Check on this issue. If you have been charged for an MS-SQL license but have been set up under MSDE, contact Microsoft and lay a complaint.
  • Check out the support fees. What exactly are you getting for annual support? Again, many vendors have tied the continued use of their software to so-called support fees. Stop paying the fee and the vendor demands a cease and desist on use of their software. Beware of this. Also, what is included with support? Does your vendor constantly go on site or log in electronically only to blame your hardware or user error? Do you then get billed for time? Many vendors will only give support for software failure. If you have an operating system glitch, make honest mistakes in using the software, etc., you wonít be covered under your support.
  • Does your vendor have open access to YOUR data? Many vendors will set up a third party utility such as Symantec PC-Anywhereô to allow them access to your data after hours. Are you comfortable with this?
  • Many vendors will encrypt and deny access to YOUR data. If you ever wanted to switch vendors, what is your current vendorís policy on that? Do you have access to your data without being held hostage to exorbitant fees and charges for services that take minutes to perform? Any vendor worth their word already has utilities to export your data to a readable file format in minutes. If they say they donít, theyíre either lying or incompetent. How would they update your billing fees and ICD tables if they did not have access?
  • Is your vendor local to the market? Do they have an office in your region or are they just represented by a here today, gone tomorrow dealer? Ideally, you want a competent local vendor whenever possible.
  • Does your vendor supply generic no name brand hardware along with their software? Would you represent yourself in court? Always buy your hardware from a competent name brand such as Dell or IBM. If your vendor wants to then blame the hardware, let them put it in writing addressed to Dell or IBM and see what happens then.
Going paperless:

Have you thought about going paperless in your clinic? Have you examined the proís and the conís? Many vendors claim to having paperless solutions, but does their software deliver any tangible benefits. If the only benefit of going paperless is having electronic rather than paper charts, then you are likely wasting your time and your money.

A paperless solution should save money, eliminate inefficiencies allowing you to see more patients per day and/or dramatically reduce the time spent each day at the clinic.

Do your patients regularly wait 1 Ė 2 hours past their appointment to see you? Do you spend time filling out lab requisitions and prescriptions by hand each day?

Paperless office solutions should deliver real tangible benefits. If they donít, then keep looking and talking with offices that have gone paperless and have actually seen these tangible benefits.

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