System Design

Our Medical Management System software is programmed in Basic, and is very flexible and user friendly. Control parameters allow practice managers to define how the system will handle patient accounts, thus tailoring the entire receivable process to their unique practice.

A special advantage is the ease with which changes can be made, requiring no programmer intervention at a later date. For example, managers determine the number of days in the billing cycle, how many statements will be generated, when delinquent letters will be generated, and payment requirements to maintain a current status.

Cashier

The Cashier function of the Medical Management System allows the charges and payments to be captured at time of services. Cashiering typically also generates a super bill or ticket which can serve as a charge document, as well as a patient receipt.

Payments received at the front desk can be entered (and receipted) when the patient co-pay is received, or at a later time. Patients who need to schedule a subsequent appointment are also accommodated during this transaction. Charges are then posted and billed to appropriate payors that evening, during the unattended End-of-Day process.

Appointment Scheduling

Appointment scheduling may be accessed from the cashier module, allowing scheduling of the patient for return visits, without losing the control audit of charge input and cash received. It also allows users to schedule patients for a prescribed period of time, depending on the anticipated type of service. Additionally, the appointment scheduling module also generates a charge voucher to be used when pulling medical records for the next visit.

Insurance Billing

The HMS Medical Management System submits all insurance electronically, wherever possible. Otherwise, insurance forms are generated daily to all third party carriers.

The processing of either inpatient or outpatient insurance may be delayed until late charges are collected after discharge. Outpatient insurance forms are normally produced on the same day service is provided. Payor billing, including secondary and tertiary insurances, occurs automatically, and does not require operator action.

Patient Billing

The initial statement date establishes a billing anniversary date for statement production. If the service provided is not the first visit, statement generation will occur on the next billing anniversary date. The daily billing concept evens out statement production and phone calls, keeps business office personnel to a minimum, and most importantly, maintains constant cash flow. Users may select from data mailers or professional laser statements, both an option from HMS.

Refunds

Credit Balance Reports are generated weekly, and refunds may be done at the manager's discretion (weekly, monthly, or periodically). Credit-balance accounts are researched and flagged for a refund, at which time the staff determines who and what amounts should be refunded. Up to four refund checks may be written per encounter.

A Cash Requirement Report determines the amount of cash needed, and produces a check register. Checks may be hand-written or computer generated. Patient accounts are automatically debited for the refund amount, and letters are generated to explain the reason for the fund. Finally, checks are reconciled when received back from Client's bank.

Report Printing

Because all daily reporting, including statements and insurance forms, are generated during the end-of-day process, operator intervention is minimal. An image of the system reports for the day will be stored on disk during the night. The next morning, after the proper paper forms have been loaded on the printer, the reports may be printed.

While the printing operation is taking place, other users can be performing a variety of normal office functions using the computer system, including registering patients, inputting charges, applying payments, and inquiring on patient accounts. Because monthly reporting occurs unattended, the management of all areas of accounts receivable is enhanced. Monthly reports provide information on procedures, payments, payors, locations, physicians, referring physicians and all areas of revenue responsibility.

Audit Controls

The Medical Management System has been designed with stringent audit controls to assure the accuracy of your operation. Daily balancing procedures protect against lost charges and revenue, and prevent the possibility of loss due to theft or data entry error.

In addition, System Security Features limit access to the various menu options to further protect the integrity of your accounts receivable. And all data entry and modifications are date and time stamped with users initials providing excellent audit trails.

Delinquent Follow-up

Delinquency follow-up will become easier and permit closer monitoring with the system's paperless follow-up feature. The system prompts when additional follow-up becomes necessary due to an agreement between the collector and the patient. Letters of audit and delinquency are produced in a timely manner, with the letter content and frequency of production completely controlled by the business manager.

The budget payment feature helps evaluate patient accounts, and permits the review of arrangements between the practice and individual patients, assuring payments are received as agreed upon and in a timely manner.