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Selecting a new Physician Practice System?
Our software selection tool can help you!
 
The ON-LINE CONSULTANT software selection tool helps you create a Request for Proposal for a new Physician Practice Management System and automatically evaluate vendors' responses.

medical software,electronic medical records,medical practice management software,physician practice management softwareYou'll get off to a quick start with pre-loaded questions to survey users, ability to email RFPs (questionnaires) to vendors, automatically upload their responses... and easily generate detailed reports and graphs that compare vendors on functionality, cost, training, support, and other important factors.   See demo now!

In addition to background, general and cost sections, surveys are included for these areas: Patient Information, Eligibility, Authorizations, Scheduling, Procedure Entry, Billing, Accounts Receivable, Payment Posting, Provider Claims, Case Management, Management Reports, Clinical History, Chart Tracking, and HIPAA. 

Here are some sample functional requirements for the Physician Mgmt RFP template:

Patient Information
Maintain database of patient demographic, guarantor and insurance information for retrieval in registration functions (e.g. no re-entry of data).
Support pop-up windows to display valid codes or lookup functions in registration and medical record screens.
Provide ability to link multiple accounts for group or employer accounts (e.g. for employee physicals) for consolidated statements.
Support entry and tracking of referrals including name, contact, address, phone, type (e.g. pediatrician, hospital), and consulting doctor ID for insurance.
Support user-defined medical record templates consisting of at least 48 user-defined fields for clinical data.
Master Person Index
Support on-line enterprise-wide master person index (EMPI) consisting of patient demographic, insurance and visit history information for every patient identified to the health care enterprise.
Supply a single, universal identifying number for each patient seen at any provider facility (e.g. entity) of the healthcare enterprise.
Provide ability to add new patients to the master person index via registration and scheduling processes from interfaces patient information systems.
Support suspected duplicate EMPI record reporting with tools to merge and delete records, if appropriate.
Support HL7 interface standards for queries from patient information systems and sending back patient demographic, insurance and patient history information.
Eligibility
Maintain master file of health plans and payors including specific benefit options used in the adjudication and payment of provider claims.
Support EDI (Electronic Data Interchange) interface for inquiry into patient's pre-authorization status and eligibility from insurance provider's system or third-party network.
Provide on-line inquiry into member data including eligibility status, plan assignment, benefits and historical coverage records.
Support entry of free text comments to be associated with member eligibility records.
Provide ability to globally change eligibility data (e.g. change primary care physicians or health plan benefit options for a selected group of members) with minimal effort.
Authorizations
Support entry and tracking of detailed service authorizations at the procedure code level.
Provide ability to enter expiration dates and pricing in authorization records.
Automatically assign and maintain unique ID number for each authorization.
Automatically validate member eligibility and termination dates when processing authorizations.
Track member yearly and lifetime benefit limits by procedure and warn user when utilized benefits approach or exceed limits.
Scheduling
Support on-line scheduling of appointments for patient services.
Support appointment "templates" by individual doctor or resource to meet specific needs (e.g. intervals between appointments, start time in a.m.).
Provide ability to automatically find next available appointment slot for patient.
Track and manage schedule changes including bumps, cancellations and no-shows.
Print patient recall notices or letters including address, phone, reason, date, time, procedures, office address and provider.
Procedure Entry
Support entry and processing of multiple procedures per diagnosis.
Provide ability to look up doctor numbers, insurance companies, procedure codes and diagnosis codes while entering procedures (e.g. without having to exit entry screen).
Maintain ICD-9 diagnostic code master file including ICD-9 code, description and internal office abbreviation (e.g. mnemonic code).
Support alternative procedure codes in procedure code file for insurers that do not use CPT codes.
Provide ability to maintain a user-defined "standard" time by procedure for productivity reporting and use by the scheduling system.
Billing
Support editing and holding of bill generation pending completion of specific (e.g. user-defined) data elements.
Support family account (e.g. guarantor, group) billing of patients, producing single statement for related accounts.
Provide ability to print on-demand statements for patient at time of service.
Provide option to generate secondary bills for balance of charges to secondary insurance company.
Guarantee that ECS process complies with all HCFA regulations.
Accounts Receivable
Track accounts receivable by plan and by company.
Provide ability to automatically assign accounts to collection based on user specified criteria (e.g. number of days delinquent, minimum outstanding).
Provide on-line collection screens that display account status, billing dates, aging and payment history.
Automatically stop payment plan process if full payment is posted.
Provide ability to purge inactive patients with no visits past a user-specified cutoff date.
Payment Posting
Provide cash receipt batch controls including batch number, batch total, number of items, etc.
Provide ability to post payments to oldest charges first (FIFO).
Provide ability to automatically compare insurance payments to benefits.
Automatically calculate the approved amount, post payment and perform write-off for Medicare payments.
Automatically process write-offs, payment allocations and responsibility transfers when electronic remittances are processed.
Provider Claims
Automatically assign and maintain unique claim ID number for each claim.
Provide ability to look up ICD-9 and CPT codes from within claim entry screens.
Check for and prevent processing of duplicate claims (e.g. if services were provided with overlapping service dates).
Provide ability to receive electronic bills from physician offices and adjudicate them automatically.
Print check register sorted by check number listing date paid, vendor ID and name, amount and description.
Case Management
Automatically assign and maintain unique case record ID numbers for specific episodes of illness for individual patients.
Provide ability to link all claims for a specific episode of illness to a unique case number.
Display summary of authorized and actual costs on case inquiry screen.
Provide ability to mark events for HEDIS reporting and analysis purposes.
Provide ability to report similar cases (e.g. same type) for one or all providers to compare services rendered and results achieved.
Management Reports
Print revenue trend reports providing side-by-side comparisons of user-selected time periods.
Provide ability to print realization reports with summary totals by insurance company, HMO and PPO.
Provide ability to print realization reports with summary totals by provider.
Print referral trend summary reports listing source, number, revenue, MTD totals, YTD totals and practice-to-date.
Print referral reports summarized by: office.
HIPAA
Support an enterprise-wide single sign-on user authentication process that allows individual users to logon to different systems with one global user ID and password.
Support automatic log off of work stations connected to patient information systems after a site-defined time period of inactivity (e.g. 5 minutes).
Support data access controls that allows assignment of security at the data element level within files.
Provide mechanism for entity (e.g. unique individual) authentication such as: biometric (e.g. hand geometry, retinal/iris scan, fingerprint patterns, facial characteristics).
Provide contractual guarantee to deliver software releases and updgrades to ensure HIPAA compliance for current regulations within 12 months after go-live at no additional cost.
Technical & Support
Support graphical user interface GUI (e.g. Windows, buttons, toolbars, mouse, etc.) and menu-driven user control and initiation of system functions.
Support ability to use web browser (e.g. Netscape Communicator, Internet Explorer) to access system functions over Internet or internal intranet.
Provide keyboard shortcuts (e.g. Ctrl-C, Alt-F) or menu bypass functions for experienced users to quickly execute system functions.
Provide multi-level password security down to options within menus.
Provide commitment to support HL7 (Health Level 7) healthcare industry system integration standards.
More...

These are just a few sample requirements from our Physician Practice Management RFP. Items can be modified and weighted to reflect your unique priorities. You can also add your own requirements to create a custom RFP.

Best of all, you will not have to spend weeks evaluating bulky paper proposals... the ON-LINE CONSULTANT will do your analysis for you!


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