Binary Spectrum, a Microsoft Gold certified partner and a member of theSun Partner Advantage Program has years of expertise in designing and developing custom Practice Management Software and HL7 integration solutions for integration of Health care applications . In an effort to present our understanding and expertise in the Health care software development space we have prepared these articles. Don't forget to browse through our casestudies section and also our FAQ sections.
The Practice Management System (PMS) is used to deal with the day-to-day operations of a medical practice. Its users can capture patient demographics, schedule appointments, maintain lists of insurance payers, perform billing tasks, and generate reports using it.
Binary spectrum specializes in developing Practice management software meant for use in small and medium sized practices. Our range of practice management software solutions is spread over desktop, client server, web based configurations. MeetingHIPAA, HL7 and ANSI X12 EDI standards our systems have achieved global acceptance.
A Practice Management System (PMS) usually connects to EMR (Electronic Medical records)Systems. In fact some of the information in both these system overlap for example the patient and provider information. However broadly speaking, the main difference between the two is that while the Electronic Medical records (EMR) system relates to capturing the clinical charting details of an encounter, the Practice management Application (PMS) is used for administrative and financial matters.
After a patient visit, a set of charges corresponding to the particular service rendered to the patient is entered via the practice management system. These charges are entered using a combination of Current procedural terminology(CPT) and International classification of diseases (ICD) codes and have a fee typically associated with it.
If the patient has a valid insurance policy, these charges are then send as an insurance claim using either the paper format (CMS 1500 form), For Hospital charges (institutional) these charges are sent using the UB-92 forms. Claims are also sent out electronically using the Industry standard data interchange standards (HL7 and ANSI X12).
The ANSI X12 EDI standards provides for electronic medical billing directly to payers or to a clearing house. Paper billing is accomplished using a HCFA 1500 form. A clearing house provides a service of accepting claims from a variety of payers and then distributing those claims to the appropriate payer.
A clearing house for medical claims differs from a medical billing company. A medical billing company provides billing, collection and accounting services. Generally if a medical clinic uses a medical billing company that clinic will not need a Practice management System (PMS).
The medical billing company handles accounts receivable and sending statements to patients. A clearing house sends a claim to the payer, but does not handle accounts receivable or collection services. In many cases a medical clinic will need a Practice management System (PMS) to collect the information for submitting a claim to a clearing house and to manage the accounts receivable after submitting a claim. Many clearing houses offer a variety of services and there is overlap between the services from a medical billing company and a clearing house.
A Practice Management System (PMS) is capable of automating the office's workflow and daily procedures. The systems perform the essential functions necessary to effectively manage the day-to-day operations of a healthcare provider, including patient management, report generation, claims processing, patient invoicing and appointment scheduling.
The system is capable of billing claims for a variety of medical specialties, and can process HIPAA-ready electronic claims to Medicare, Medicaid, Blue Cross / Blue Shield, any clearinghouse or directly to the insurance carriers.
The Practice Management Application that will help you automate your office at a cost effective price. And with four versions of Practice Management Software, you can be sure that Binary spectrums Practice managemnt Software (PMS) can serve your organization, regardless of the size of your practice or the number of locations you wish to manage.
Core Functionality
Restricts access to data and system functions - based on user and/or group settings - with built-in multi-level security
Create a variety of internal data codes, including fee schedule, modifier, payment and visit codes
Reminder notes for physicians and staff
Multiple locations can be managed as one company or individually by easily switching databases
Share data with other Windows-based applications
Multiple windows can be opened simultaneously
Automates your patients' visits with minimal required keystrokes, from patient check-in to scheduling follow-up appointments.
Streamlines many of your most time consuming tasks through the system's integrated workflow management - increasing office productivity and providing a greater return on investment.
Improves current account revenue by reducing denied claims via the software's advanced claim scrubbing technology.
Generates reports that can identify your most popular and profitable procedures, top referring physicians, outstanding accounts receivable and more.
Manages a variety of critical patient data, including demographic details, insurance information, billing history and more.
Patient Management Applications are used to:
Store a variety of patient information, including demographic information, multiple insurance providers (primary, secondary & tertiary) and prescribed medication
Attach patient and office documents in a several different multimedia formats, including images, movies, audio files and Microsoft Office documents
Set follow-up notices concerning patient-related issues, billing, scheduling and more
Save date, time, and user-stamped notations about patients, billing issues and more
Monitor how patients are referred to your office
Post co-payments or credits to the patient's account prior to creating claim transactions
Data interchange standards used in a Practice Management System
PMS often needs to interface with the outside world. There are a number of standards that are used:
HL7 — used to communicate with hospitals, or EMR systems
ANSI X12 EDI transactions, including:
270 — eligibility & benefit inquiry - Is the patient an insured of this payer?
271 — eligibility & benefit response (response to 271) - A yes or no response that the patient is insured.
276 — claims status inquiry (follows 837 submission)
277 — claim status response (response to 276)
835 — claim payment/advice (follows 837) - 837 medical claim is paid, and amount of payment and the patient's financial responsibility
837D — claim submission for dental claims
837I — claim submission for institutional claims
837P — claim submission for professional claims
With years of experience in successfully providing Custom healthcare Software Development solutions for clients across the globe, we have honed our processes and skills to cater to your specific business needs. For outsourcing your Practice management software development requirements to Binary Spectrum, contact us with your project details at info@binaryspectrum.com. A senior member of our customer engagement team will get in touch with you within 24 hours. Become a member of family of clients that regularly do business with us.
