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6 key questions to ask when shopping for a billing program

Clearly, when it comes to practice software, there are no one-size-fits-all answers. Practices vary too widely for that, and therapists have widely different comfort level when it comes to integrating technology into their professional lives. Nonetheless, there are some basic ideas that are important regardless of what kind of practice you’re running.

In the chart, right, we provide basic pricing and contact info for six of the leading products in the field. And by the way, although we use the term "billing program" in this report, the products we’re looking at may do any or all of the following: 1) keep your schedule; 2) hold session notes; 3) notify you when you’re reaching the end of approved benefits; 4) handle electronic billing; and many other important tasks.

When you look at the programs listed here--or at any billing software--these are the questions you’ll need to answer:

1. What does it cost? That seems obvious, but every program you look at will package its available features a little differently. And prices vary so widely that it’s hard to figure out what’s going on. There are programs that cost $150 and others that go for $10,000.

Here’s the bad news: In this field, low-priced programs generally can’t be trusted. Over the years, we’ve seen several billing programs that were designed by enthusiastic amateurs. Sometimes they’re therapists with a flair for computer programming. In other cases, they’re professional programmers who’ve developed the program as a sideline business. Are their programs bad? No--sometimes they’re pretty darn good. The trouble is, these vendors don’t have the resources to really compete. You’ll buy their software and love using it--but two years later the company is out of business and you’re left with an orphan program. That means no updates and no support.

At the other extreme, high-priced programs may have been designed for large entities, or for medical practices. The software company is selling them to small-practice behavioral health providers to pick up a few extra dollars. You can count on them to be there down the road--but you might be paying for features you don’t need.

The sweet spot for solo practitioners is in the $500 to $1,000 range. For small groups, it’s more like $1,000 to $2,000.

2. What will it cost each year to maintain the program? Clinicians who’ve never shopped for specialty business software before sometimes feel that they shouldn’t have to pay anything. After all, when you buy Microsoft Word you can use it for years without a fee. Billing programs are different--you’re going to need updates. Even the best programs have small glitches that need correcting. In addition, there are changes in the law, in the DSM, and in insurance company data formats. With your whole practice tied up in that software, you need reliable tech support.

In general, service contracts cost between $150 and $350 a year--that should include routine updates and technical support by email and phone. At the lower end, tech support may be limited to shorter periods during the day.

3. How do I find a program that’s easy to learn? Stick to programs that have been around at least five years. Ten is even better. That means the rough edges have been sanded down, and major customer complaints have been addressed. That said, there is no substitute for spending time with a program demo. With most programs, the demo is actually the complete program, with a built-in time limit to prevent you from using it indefinitely without paying.

Of course, as a practical matter, you can’t learn every program on the market and know for certain which one is best for you. But you can tell a lot if a program seems to offer clear instructions on how to do the basic tasks. Try entering some sample progress notes. And if you do electronic billing, prepare an electronic entry.

Also, the company should give you adequate technical support while you’re testing the demo. If they don’t, that’s a bad sign.

4. Can I transfer everything from my existing software? Some vendors claim it will be easy, but it rarely is. And paying to have it done can be expensive and lead to extended headaches. It’s usually better to keep your old system going while you put new patients on the new program. Current patients can be entered on the new system without trying to include all their old records. Make back-ups of the old data--with printouts, if possible.

5. Is it worth all the trouble? Yes. If you can get your software working properly, your collection rate will rise, and you’ll get your money faster. And there is a great opportunity to improve your marketing efforts when you see clearly where your patients really come from.

6. Should I consider one of the new online billing systems? With these services, all office management tasks--including billing--are maintained remotely. You access your "virtual office" online. Many of these systems have come and gone in the last 10 years. Some may be gaining traction now--but we haven’t been in touch with enough of their users to make a judgment. This is a subject we’ll be looking into in the future.

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