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The approach for evaluating an EHR for a Pediatric practice can vary depending on a few factors. For instance, a Pediatric Super group with over 50 Pediatricians will have different on-site resources such as a large IT team, Revenue Cycle Management and Admin team. This blog article is focused on factors to consider for a small Pediatric group (less than 8 Pediatric Providers). There are four primary roles in a Pediatric practice: Front Desk, MA/Nurse, Pediatric Provider and Medical Billing. As a practice grows to a certain size, there is usually a need for a Practice Administrator. For most small practices, this role of Practice admin is managed by one of the owners of the practice. Some comments related to these four core roles in a Pediatric Practice:
- Front Desk, MA/Nurse and Pediatric Provider Roles: A Pediatrician or Pediatric Provider, even early in their career, maintains years of experience engaging parents and patients in managing the overall Healthcare of Children. From this strong clinical experience, Pediatricians and other Pediatric providers usually have good knowledge of how Front Desk team members as well as MA/Nurses should engage and perform their basic job duties with patients and parents. The Pediatric providers should hire, coach and evaluate employee performance for the front desk, MA/Nurse as well as other Pediatric Providers to align the practice operation to the goals of the practice owner(s). If the practice grows to multiple providers, there might be another person in the practice that becomes the office manager to manage schedules, staff and HR functions (many times the Pediatric owner does this on her own for smaller practices).
- Medical BIlling Role: The billing function requires additional training, monitoring and learning by the practice owners. While Pediatricians and Pediatric providers maintain a wealth of knowledge and experience and have the ability to learn the basics of the Medical billing role relatively quickly, the daily work, detail claim management and benchmarking to achieve optimal results for the Pediatric practice requires much time, focus and resources. In many cases, the time invested by the Pediatric practice owner to supervise this role reduces the time available to expand the practice or time off. Most Pediatric practice owners do not enjoy the constant administrative detail and time required to manage the Medical Billing function. We have worked with new clients that had on-site billing staff who were missing revenue from improper billing or improper follow-up that added up to thousands of dollars per year per provider.
A choice by a Pediatric Practice owner is to manage or outsource the medical billing for a Pediatric practice. A strong Pediatric Billing team should be benchmarking performance for the practice and achieve results that are above the national averages. If the practice is below the national average, a high-performing Pediatric Medical Billing team should be able to show the collection rate and other Key Performance Indicators to evaluate the medical billing in an objective manner. Not all organizations are providing the same service and results related to Pediatric Medical Billing. Many companies providing Pediatric Medical Billing services perform insurance billing but might not include claim follow-up and/or appropriate patient billing. Some organizations routinely change the medical biller(s) on the account of the practice. These factors as well as others is why it is important that a Pediatric Practice owner choose a Pediatric Billing service with consistent results, benchmarking and annual reviews.
A Pediatric E.H.R. designed for Office-based Pediatrics should be easy to use in the primary roles of a Pediatric practice since staff members will need to enter patient data by the Front Desk team, MA/Nurses as well as the Pediatric Providers. The Pediatric EHR should manage vaccines with an end to end solution linking the vaccine inventory to patient records. The Pediatric EHR should be able to provide a vaccine profit analysis on an annual basis. Some practice owners consider evaluating large enterprise EHR systems utilized for multi-physician specialties and/or leveraged by Health systems. Many Pediatric practices that choose to leverage a large multi-specialty EHR system find that the system can be challenging to utilize and operate effectively for their small Pediatric Group. There are a number of reasons for this experience including that these larger systems are designed for organizations with hundreds of employees with much more overhead staff members that are not cost-effective roles in small pediatric groups. Some of these vendors providing these systems require training on top of training just to get started, schedule patients and close charts. Consider that these vendors have strategic accounts (larger practices or health systems) that are the most important to their organization (so a smaller Pediatric group is ‘lower priority’ for the organization overall).
A smaller Pediatric group should consider a Pediatric EHR company that provides a Pediatric EHR as well as cost-effective Medical billing approach for their practice. Evaluating total cost and total value is very important for choosing a Pediatric EHR. Many small practices can save thousands of dollars per year by choosing the PediatricXpress system EHR by PhysicianXpress, Inc. versus other Pediatric EHR choices. We are committed to providing a high-value Pediatric EHR service to Pediatric practice owners. When evaluating any Pediatric E.H.R service, consider the cost of the billing role (all aspects) as well as all costs associated with the Pediatric EHR system (some have hidden charges). The Pediatric EHR vendor should be able to customize templates at no cost as well as connect to the two major lab companies Quest and Labcorp. While the government regulations can be challenging, choosing a Pediatric EHR vendor with a current certification (2015 ONC Certification) is another factor to consider. Some vendors will provide a high incentive for starting a practice but require them to sign a five year contract with them. While this approach might seem ‘good’ in the beginning, over time many practices over pay when locked into this long-term agreement. The agreement with a Pediatric EHR company should be simple, ‘reasonable’, in addition to providing a cost-effective Pediatric EHR to the practice.
There are other factors to consider when comparing Pediatric EHR choices. We discuss some of these factors in a previous blog post related to advantages of a cloud-based versus server based Pediatric EHR. (please see the following link: https://physicianxpress.com/some-advantages-of-leveraging-a-cloud-based-vs-server-based-pediatric-e-h-r-for-independent-pediatric-groups/ ) The Physician Xpress team has experience with both start-up practices as well as established practices that have switched over from other E.H.R. systems.
