PMS Vendor Checklist
Company Information
- Has the company been in existence at least 5 years?
- Is the company privately or publicly owned?
- Does the company have clients in your state? Does the company have at least 10 orthopaedic clients whose size is similar to your practice? (i.e. 1 Doc, 2-5 Doc, 6-12 Doc, 12-20 Doc, 20+ Doc) Different sized clinics require different workflow and hardware requirements, especially with servers. Many times some of the less experienced vendors will sell you a downsized solution to compete on price, which will require you to spend more money in 2-3 years to properly support your volume.
- How is support provided—through a central team or through local VARs?
- Are clients assigned a designated rep to deal with ongoing needs?
- Does the company have designated sites for potential clients to visit in your area?
Practice Management Software Information
- The system includes rules engines that can be customized further by the practice (global periods, assist coverage, CCI edits, medical necessity).
- The rules engines can be overridden.
- The system maximizes electronic transaction capabilities.
- The system supports primary and secondary electronic claim submission.
- Electronic remittance is available for plans in addition to Medicare.
- Electronic claim status can be utilized.
- Referral numbers can be stored in the system.
- Paper referrals can be scanned and stored.
- A referral countdown feature is available; the feature can be set to exclude post op visits.
- Numerous fields are available for multiple referral and/or authorization numbers.
- The system supports electronic eligibility benefits requests.
- Benefits information can be stored (copay, deductible, etc).
- Batch eligibility is available; a summary report is produced.
- The system tracks denial codes and provides reports.
- Allowable amounts can be loaded into the system and compared to actual payments at posting.
- A report can be run to show payments not matching allowables.
- A report can be run by payor to show accounts past the prompt pay deadline.
- A/R workfiles can be created and provided to staff electronically; these can be refreshed on a schedule set by management.
- There is a way to track patient payment plans.
- Unlimited notes regarding collection attempts are available.
- "Tasking" is available to direct workflow and provide accountability.
- Schedules can be varied by physician and/or location.
- Schedules can accommodate office or surgery times for templates.
- Meetings can be scheduled in the PMS calendar (without creating a patient encounter).
- Multiple appointments can be linked (physician, cast room, etc.).
- Staff can schedule appointments in bulk (post op).
- Staff can search for the next available appointment based on various parameters (visit type, time, day or week, physician).