WonderDoc, the leader in chiropractic software present their white paper on the essentials of practice management software. Know how to make an informed decision on which practice management system to choose.

1. The Essentials of
Practice Management (PM) Software
WonderDoc, LLC
Advanced EHR and PM Systems

2. INTRODUCTION
Using practice management software provides a number of business-related benefits. According
to Chiropractic Economics, the top five for chiropractors specifically include: 1) speedier
reimbursement for treatment sessions; 2) financial savings due to increased staff productivity
(which occurs with software-related process automation and integration); 3) streamlining of
relevant office functions; 4) more simple records management; and 5) having a record-keeping
system that is scalable as your business grows. While these five advantages paint a picture of an
effective and swift office, sadly, few practice management software systems can deliver on all of
these benefits.
That’s why it’s important for practice management software to have certain capabilities that
maximizes the productivity of your office as it grows. This requires that the software have these
four basic, yet absolutely essential elements: EHR/EMR capabilities, billing options, ease of
scheduling, and report-based functioning. Now let’s take a closer look.

3. 1. EHR/EMR CAPABILITIES
Under the Health Information Technology for Economic and Clinical Health (HITECH) Act,
prior to 2015, healthcare providers were eligible to receive financial incentives for “meaningful
use” of electronic health record (EHR) systems. However, this same act calls for penalties if no
EHR is in place after that date, which means that you can save your practice from government-
imposed fines by ensuring that your practice management software has EHR or EMR (electronic
medical record) capabilities. What type of EHR/EMR capabilities?
Integration
Ideally, the EHR/EMR portion of your software should integrate and automate as many
documentation tasks as possible, thereby improving productivity and patient care. This means at
a minimum, providing patients with a waiting room kiosk that allows for quick and easy check
in. Many kiosks allow patients to record their chief complaints, medical history, outcomes
questionnaires or other intake forms.
Your EHR/EMR should also be capable of sending reminder alerts to providers to support their
clinical decisions and patients to follow up on their care. Provider alerts would remind users of
when patients need a re-exam or when treatment is contraindicated. Patient alerts would send
reminders for follow up appointments or updated health information.

4. Additionally, the software should integrate with reports to show statistics on diagnostic and
treatment data. Such clinical reports help providers coordinate care plans over a broader patient
base. They also prove to insurance auditor the quality and effectiveness of your care.
Lastly, the EHR/EMR system should manage patient health summaries through both online
patient portals and document management tools. Patient portals allow patients to view and
download their health records online 24/7. Document management tools allow users to scan
paper records or digital files to the patients EHR. Together, patient portals and document
management tools keep provider and patient care on the same page.
Certification
You’ll also want to make sure the PM software you choose has an EHR that is government
certified. As the American College of Cardiology explains, there are actually two types of
certification you need to be aware of. The first is Complete EHR certification, which means that
the EHR “meets all of the criteria for the relevant certification year and is certified as such.” The
second is what is called an EHR Module Certification, in which each module “must be separately
tested and certified for the certification criteria.” Essentially, choosing a modular EHR system
enables you to build your own EHR so it has all of the functions you need…and none of the ones
you don’t.
Security
Another factor to think about when choosing practice management software and its EHR/EMR
capabilities is the type of security it offers. To help you pick one that which adequately protects
both your office and patient records, here are some questions you should ask:
 Is it cloud vs. server-based system? Why does this matter? According to Your Security
Resource, if you are using a cloud-based server, you really need to ask yourself how
much you trust the company you task with storing your data. Have they ever had a
system breach? If so, they may be putting all of your private and confidential information
at risk. Plus, if it’s a cloud-based system, you need the Internet to access it and will likely
have to pay a continual fee in order to have access to your records whereas a server-based
system stores your own records so you can access to them anytime for free.
 Does it provide automated on and off-site backups? The more automated your
EHR/EMR, the fewer actions you have to take when it comes to saving your business
information, thus the more time you save. Additionally, by backing up information off-
site, you’re covered should something happen at your physical practice that could
potentially destroy your records, like a fire or flooding.

5.  User Login/Logout with Access Control? The last thing any office needs is some
disgruntled employee having access to all your patients’ records. Just think about the
public relations catastrophe if this happened. So having active and inactive user logins
with specific access controls for every area of the practice management system is a must.
 Is it HIPAA compliant? The Health Insurance Portability and Accountability Act
(HIPAA) is in place to protect patient privacy. Therefore, your EHR system must also do
the same or you risk court litigation, not to mention your reputation. At a minimum, insist
on the software vendor signing a business associate agreement. This is a contract that
protects both the end user and the vendor in the event of a data breach.
 Does it encrypt data? This added level of security provides just one more layer of
protection against hackers in the event of a data breach. Thus, choosing an EHR which
offers encryption helps better protect you from someone who is intent on stealing your
private information.
Customization
Finally, the last component to consider when it comes to practice management software’s EHR
or EMR capabilities is the ability to customize the system to better meet your specific needs.
This is often accomplished by providing you with a variety of templates and macros that you can
alter based on your practice, patients, and specialties. This is especially important if your office
has multi-specialty functions such as offering chiropractic, massage therapy, physical therapy, or
any other provider type.

6. 2. BILLING OPTIONS
Once you’ve identified practice management software which provides the features you need in
an EHR, the next step is to look at the billing functions it provides. To start, focus on how the
billing system is integrated with other parts of the program. Also focus on its efficacy in
processing claims and tracking accounts.
Integration
When it comes to integration, your PM software should be able to seamlessly send treatments
and diagnosis information directly to billing. This type of automation offers significant benefits.
According to Docfinity, these include: making information immediately available by utilizing
digital records, expediting the payment process, increasing cash flow by encouraging speedy
payments, lowering error rates, and more effective audit compliance.
Additionally, your billing system needs to be capable of providing patient and insurance aging
reports as well as alerts (such as when balances are due). Together this allows you to pursue
prompt payments of services rendered and limiting the risk that patients will “forget” to pay.

7. In essence, you’ll want a PM software with billing functions that works cohesively and
automatically with all of the other areas of the system. This will save your staff time and money
and make it easier to get paid faster.
Claims processing
A major function of billing is accurate and speedy claims processing. To start, ensure the system
can produce both electronic and paper claim forms. It should also allow you the freedom to
choose the clearing house of your choice. This can give you the opportunity to save money on
some free clearing house services.
Additionally, use a claims processing system which allows you to post global payment entries
versus line item entries. There is no benefit to line item posting so global posting will save
tremendous time.
An even better way to post claims is to use Electronic Remittance Advices (ERAs). These are
files that are uploaded into the billing system and automatically posts benefits to each claim,
eliminated the need for manual posting.
Automatically posting reimbursable fees for each insurance company allows the user to
automatically calculate and charge for co-insurance and applied deductible amounts at the time
of service. No more waiting for the EOB to arrive 4 weeks only to bill out for co-insurance and
deductibles.
Account tracking
Another critical part of the billing portion of practice management software is its ability to track
accounts. This means providing alerts when a patient’s balance reaches a certain amount or
sending some type of notification to your staff if a patient’s insurance benefits are close to being
exhausted.
Account tracking prevents monies from slipping through the cracks. It also means the ability to
do 30, 60, and 90 day batch invoicing. This greatly improves your collections process by
increasing your cash flow and reducing your accounts receivables.
Auto-payment options are another software-related consideration as this makes it easier for both
you and the patients to manage payments. Examples of auto pay functions would be integrated
onsite and/or online credit card processing.

8. 3. EASE OF SCHEDULING
Flexibility
The third element of practice management software deals with patient scheduling. By choosing
software that makes the process as easy as possible for patients and staff alike, you’ll be
providing both groups a more enjoyable appointment-creating experience.
Obtaining this type of pain-free scheduling begins with choosing a software that offers
flexibility. For example: does it provide the ability to view appointments for the day, week or
month? Multi-view scheduling allows users to quickly find appointments and openings.
Flexibility also means that the system should be capable of auto-blocking the correct
appointment time based on the scheduled medical procedure. Do you take an hour for a new
patient, half hour for re-exam or 15 minutes for an office visit? No problem. Instead of manually
blocking this time, the scheduler should automatically set the appropriate time block based on
the procedure.
And if you offer more than one provider, the PM software should also be capable of scheduling
multiple providers simultaneously. Additionally, you should expect to categorize appointments

9. based on color codes. This makes it possible to quickly and easily tell the nature of the
appointment whether it’s a no show, cancellation, or a reschedule.
Additional Scheduling Functions
Other scheduling functions that enhance your practice include the ability to search, sort, and print
appointments. This helps if you’re compiling statistics, such as which types of appointments you
have most, or if a patient want a list of past or future appointments.
A system which sends patients emails or text reminders is beneficial as well. In fact, one 60-
study review published in the Journal of Medical Internet Research concluded that, in more
cases than not, sending text or email reminders resulted in improved patient adherence to
treatment protocol as well as a greater likelihood that the patient would actually show up to the
appointment, reducing the occurrences of no-shows.
Another practice management function that can save a lot of time is batch scheduling for
multiple appointments. For instance, if you want to see a patient three times a week for the next
two weeks, then two times a week for the following four weeks, your software should be able to
automatically accommodate this.
Integration
The scheduling portion of your software also needs to be able to interact with your other office
systems as well. When a patient uses the kiosk to sign in, the appointment color coded status will
change to “showed”. Similarly if after 15 minutes past a patient’s appointment time the patient
fails to show, the color coded status would change to “No Show”.
Integrated scheduling also makes it possible to print status reports so you can quickly see the
number of patients that showed, no showed or cancelled. This is a powerful way to know how
you’re communicating the need for care to your patients.

10. 4. REPORT-BASED FUNCTIONALITY
The fourth and final element of selecting the best practice management software for your
chiropractic office is its ability to provide you with reports that allow you to effectively run your
business.
The types of reports you’ll need, include ones which supply information regarding:
 Gross patient collections
 Insurance collections
 Collections per patient or per visit (to ascertain productivity)
 Patient demographic data (such as patient age, geographical location, number of referrals
provided, etc.)
 Insurance-related reports (aging, and company specific collections)
By knowing where you stand in regard to each of these metrics, you’re better able to make the
proper decisions for your practice when it comes to collections, marketing, and even whether
you’re able to enhance your productivity in some of the key areas.
Additional patient-based reports that you may find helpful to running a successful practice
include those related to billing (such as aging reports), diagnosis and treatment (and other types

11. of clinical reports), and patient health status and maintenance (think narratives, daily notes, and
follow-up reminders). Each of these can give you a better overall view of your practice, making
it easier to steer it in the right direction.
Certain meaningful use reports can benefit your practice as well. Three of the most prominent
are: Automated Measure Calculations (AMC), Clinical Quality Measures (CQM), and Physician
Quality Reporting System (PQRS). All of these can help tremendously, especially if you’re
subjected to an audit or otherwise have to prove services provided and level of care.
This feature alone can prove to be absolutely necessary if you’re trying to avoid financial
penalties which can be applied in certain cases. For instance, with regard to the PQRS
specifically, the Centers for Medicare & Medicaid Services states that “those who report
satisfactorily for the 2016 program year will avoid the 2018 PWRS negative payment
adjustment.”
IN SUMMARY
Choose practice management software which provides these four elements—EHR/EMR
capabilities, billing options, ease of scheduling, and report-based functioning—and you’ll be one
step closer to creating a practice that can swiftly and effectively serve the patients it has now, as
well as the ones it will welcome in the future.
This ability to grow without having to replace your software system in the process means you
can enjoy all the benefits of success without any of the aggravation. At least, not when it comes
to your record-keeping system that is because it will provide everything you need…and more.