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Cost and EHR questions Word or PDF or Google docs for EHR

  • 1.  Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-13-2019 11:08
    Hi Everyone,

    I am at a stage of only considering IMP type of practice, for the second time (created and sold one before and went back to work for a hospital) now thinking of giving it another shot and of course exploring costs.

    1) Wondering, has anyone tried to use just the Word or PDF or Google docs or the like as their EHR without the actual formal EHR vendor, and if so, any problems you experienced or foresee?

    2) I am reading that G Suite from Google Business offers HIPAA compliant platform with Google docs, Schedule, and unlimited cloud back up for $12/month per person who can access.
    While I am comfortable using EHR, for my personal practice I do not like the idea of depending on EHR vendor for both upkeep and cost, and if I have to move to be able to take records with me to have them available for patients for 7 years etc.

    Does anyone see significant problems with just that: creating and keeping templates and all your notes and all scanned documents as your EHR in Google cloud with a local backup, each patient in a folder with all accompanying docs, scanning labs etc?
    Anyone did it?

    3) I wonder about doing that and paying for a stand alone EPCS DrFirst $800/year (in stead of $1400/year for Amazing charts plus additional fees for EPCS interfacing with EHR)

    Anyone knows cheaper EPCS stand alone? In Maine now you have to have EPCS unless you want to give up Rx of controlled drugs completely.

    4) Quick look at Liability insurance in Maine where I am, looks around 4K occurrence and from 1K to 4K claims made (gradually increasing), does that sound right? high? low?

    5) I see Google has an interfacing online scheduling platform called Apointlet $10/person who can schedule per month. Anyone used that or anything similar, inexpensive and efficient? to allow patients to schedule online?

    6) Does Medicare credentialing still take more than 6 months these days?

    Many thanks in advance to anyone who can comment on any of these questions.

    ------------------------------
    Oleg Reznik
    BAR HARBOR ME
    ------------------------------


  • 2.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-14-2019 08:01
    Hi  Oleg
    Oh please please:)
    My niece just moved to  work at Jackson labs and cannot find a doc:)
    Medical Mutual is about 6,000 a year They are wonderful For the past several yrs- though things go in cycles - they have done well and we all got a few hundred dollars rebate They will come out for free and assess what you  need in your office to prevent trouble  (Rick assessment) very helpful

     Pam Wible in oregon had word only stuff  etc There are lots of EMRs all with some good and bad.  I do Practice Fusion which is  o k   99.00 a month. If you want your data  one button is print chart.In this world I think you cannot get away with Word only   Yes you  need e- rx but then most basic thing like drug interactions and billing and easy to do referrals with the meds and problem list pre set into the template etc- really I do not think malp wold even cover you?


    Now dare I touch the in house or  outsource billing question  People here feel strongly but my biller helped get me credentilaled and she is a coder and it is like having staff Physcians Coding and BIlling in Auburn talk to Suzanne or Lacey  Everyone I know who outsources billing is happier int he end

    Practice fusion has online scheduling and reminders of appointments for patients I arranged evisits thoughmy web site that sneds message through the portal Mildly clunky but I do 3-4 e visits/mo at 35.00 each   I am not doing tele health  yet but could the same way  The portal is fine  It lets people see their labs I think not notes However I cannot get the lab to play so only if I type labs in are they in the chart .I use a diffeernt work flow The lab book is terrible One has to  create flow sheets  PF will import some data for you - demographics but then you do not  need  that as you are starting new

     call if I can help
    Welcome

    ------------------------------
    Jean Antonucci
    ------------------------------



  • 3.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-14-2019 11:06
    Jean, your web site and practice description look like a dream I've always had. I had started a similar practice in Oregon, sold it because we had to move for family reasons, practice was working well and I used Microsoft Word then, 10 years ago. Thank you for the contact for outsourced billing, I used to outsource it too and was happy to give up the 7% for all they did.
    Does $99/month with practice fusion include e-Rx and EPCS (electronic prescribing of controlled substances), interaction check?.. real time insurance drug coverage check?.., or do you pay extra or give up those fancy features that hospital now have?
    What a wonderful practice you have.

    ------------------------------
    Oleg Reznik
    BAR HARBOR ME
    ------------------------------



  • 4.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-14-2019 11:24
    You are cracking me up here
    There is not a lot of market for a DPC practice here the insurance companies are only part of my problem there are a lot of issues that make practice difficult but I would Tell you absolutely totake insurance and therefore Microsoft Word won’t work well
    yes the $99 a month includes the e prescribing and of control substances and interaction check

    I have no idea if it is real time insurance drug coverage check I think so I don’t pay much attention
    the lab book is the messy part if your local lab won’t play with practice fusion you find workarounds there are other people on this list serve it to practice fusion I’m sure they will chime in
    If you want to survive financially you’ll need to be in an ACO your choice would be the northern lights system I think that’s what the Ellsworth hospital is now part of this been a lot of turnover at Ellsworth recently down east hospital mostly with the ER docs

    Sent from my iPhone




  • 5.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-15-2019 04:37
    Hi Oleg,

    I am starting a solo practice. Medicare credentialing took me 1.5 months. I have google business, which can be hipaa complaint if you sign a business agreement online. MDtoolbox offers eprescriptions for about $30 per month (it has great reviews) and I will use their free trial this week, it qualifies by medicare but it is not a EMR.

    Best regards,

    Daniel Mendoza
    Pearland, TX

    ------------------------------
    Daniel Mendoza
    Pearland TX
    ------------------------------



  • 6.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-15-2019 08:47
    Daniel,
    Thanks, do post after you use MD toolbox a couple of days. Glad Medicare didnot take long. Do you know if other insurances will accept Google docs (Hippaa compliant version) as EHR?
    Where I am I tentatively thought of credentialing with Aetna, Signa, Tricare, Martins point, in addition to Medicare and Medicaid.

    ------------------------------
    Oleg Reznik
    BAR HARBOR ME
    ------------------------------



  • 7.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-15-2019 09:13

    Do Anthem  Anthem is huge  It does all the teachers and  state workers Itis 25 % of my practice
    --



         Jean Antonucci MD
         115 Mt Blue Circle
         Farmington ME 04938
    ph 207 778 3313   fax 207 778 3544
    www.jeanantonucci.com

    Virus-free. www.avast.com





  • 8.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-15-2019 19:43
    Insurances cannot force you to use an EHR (at least in Texas) and google documents should be fine as long as you follow HIPAA rules (signing a BAA, encrypting your computer, not sharing your password, etc). I am in the middle of contracting with UH, Aetna, Cigna, BCBS, Tricare and no one requires using any EHR. Medicare does not require an EHR either, however they can penalize you if you do not use certified EHRs. Use the following link to see if your EHR is certified:

    https://chpl.healthit.gov/#/search







    ------------------------------
    Daniel Mendoza
    Pearland TX
    ------------------------------



  • 9.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-16-2019 08:39
    A free EHR that I would suggest you look at is TalkEHR.  They started about 2 years ago and is a division of the medical billing company, MTBC.  I used it and they were offering when I signed up free eRx as well as controlled substances.  Many Practice Fusion users switched to them when Practice Fusion started charging.   It is a standard EHR like Practice Fusion but is completely free to use.  There were a lot of bugs in the software during the first year but nothing that couldn't be worked around and it got better as the year progressed.  They also have a few direct electronic connections to laboratories like Quest and Lab Corp but you have to have volume for them to build the interface.  There is also a patient portal that works with it.

    Cindy Go
    Lemont ENT





  • 10.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-16-2019 04:29
    I hope everyone is doing well. I opened my practice in Ocober 2015. I have been reasonably happy with practice fusion. 99.00 per month.  I can sent referrals, order labs and receive them once the connection is set up. By using updox e faxing we can receive and send faxes securely.  I also have e prescription for non controlled substances. It's really all in one. In the near future I will be trying to dictate my notes SINCE I CAN NOT TYPE!!! AND I AM NOT GOOD WORKING WITH TEMPLATES. I f you are good with templates PF will be great for you. I think you end up clicking a lot. will let you guys know. 
    Blessings to all.





  • 11.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-16-2019 09:19
    Practice Fusion is around $100 per month. However, it does not include billing. Companies such as Kareo which work with Practice Fusion charge $300-350 per month, so the total cost ends up at least $400 per month.

    ------------------------------
    Daniel Mendoza
    Pearland TX
    ------------------------------



  • 12.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-16-2019 17:30
    I too use PF and am reasonably happy - EMR, eprescribing including controlled meds, scheduling, lab interface, portal (not using much, I give patients my medical email when they want to reach me).  Frankly I liked when it was free, but dont see $99 a month per provider (ie all staff are free) as a big expensefor unlimited staff.
    It is not perfect by any means, but i doubt a google doc system would be better after each user is charged a monthly fee(not just the doctor), and add ons for scheduline, eprescribing, etc.

    As Daniel says, the bigger expense with PF is the billing / practice management software  of 250-300 per  month.   We use AdvancedMD which includes claim scrubbing, auto post,  and patient balance billing.  I hope this will go down in the future .

    Question - Quicken allows me to pay bills for about $10 a month, so why should electronic claim submission and billing be so much more?   I am always keeping my eye out for a less expensive billing options that can work with PF, so if anyone has a suggestion, please share it.

    I only have one FTE employee, so billing in house allows me to keep my employee busy and almost 1 FTE, and I have the benefit of chaperone, telephone handling, scheduling, collecting copays, etc.  I am told that people who use billing services still have to keep a close eye on the process.

    ------------------------------
    Michael S. MD
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  • 13.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-16-2019 05:31
    I have been able to find several options for EHR that are cost less than that.  I deal mostly with billing, but have to deal with several EHRs.  Right now I'm going through some demos for Azalea, it looks like a good cloud based system and is working with the ClaimRemedi clearinghouse.  It seems to have some very friendly pricing options that are ala cart for specific needs.  If you would like me to set something up to see a demo I would be happy to help.  I have a really good contact.

    Let me know if you need any help.

    ------------------------------
    Brian Hanson
    eSolutions
    Overland Park KS
    913-276-7549
    ------------------------------



  • 14.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-17-2019 07:07
    Hi Oleg,
    I'm another Practice Fusion user-  EMR with electronic prescribing, scheduling and electronic sending out of referrals from one package is nice.  I still am trying to improve my efficiency with notes on it- spending more time than I'd like on that. Patients who use the Patient Fusion app can request appointments online.
    I do pay a monthly fee for ZocDoc for online appointments as well. Although it doesn't integrate with my EMR's schedule- that really helped bring in new patients and cost is more than covered by what we receive for new patients. Patients seem to like it.
    We use G suite for our staff (just 3 of us) to share documents, our email accounts, and the Chat feature.
    Medicare took about 2-3  months from what I can remember.
    Let us know how it goes- always good to get ideas from others!

    ------------------------------
    Demetra Barr-Reynolds
    ------------------------------



  • 15.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-17-2019 07:36
    Umm Demetra- why pay for Zoc Doc  My patients make their own appointments in PF  if they can sign up( some seem to have trouble) for the portal?
    signed
     cheapskate

    ------------------------------
    Jean Antonucci
    ------------------------------



  • 16.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-17-2019 08:17
    Hi Jean-
    I'm trying to encourage more folks to actually sign up for the portal. I have to figure out how to motivate people to follow through. It's great your patients are doing that! I've only had a handful of self made PF appointments so far.  Zoc Doc is popular in our area, so that's why I gave it a try. People use it for health care similar to how Yelp is used to find new places.

    ------------------------------
    Demetra Barr-Reynolds
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  • 17.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-18-2019 08:24
    Having staff help with portal sign-ups during check out can be a really helpful way of increasing portal enrollment... it is also something of an eye opening experience about how difficult portal sign up can be.




  • 18.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-19-2019 07:07
    I am a former Practice Fusion user but couldn’t justify the cost when they went from free to $1200 annually. I use Office Ally as my clearinghouse for medical billing. If you submit 11 claims per month or less, then there is no fee for the clearinghouse. 12+ claims per month is $40. I have found them to be quite helpful in setting up templates and training. This may be a good option while you’re getting started.

    For scheduling and e-prescribing, they offer a product called Office Mate. It is completely free. You can not e-prescribe controlled substances but that has not been a problem for me. They also have an EHR product which I have not used but I believe is $40 a month or less.

    Good luck with your new practice.




  • 19.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-18-2019 06:16
    Michael brought up an interesting point, Practice Fusion interfacing with AdvancedMD in-house billing software.
    I called AdvancedMD, they told me billing software if $429/month for one provider, but they also have their own ERH touting 7 day a week live support from within US and other features, for $470 combined as a start up special offer (EHR with billing) not sure of the price after the special offer expires, includes e-prescribe with no controlled substances and for $25/month extra controlled substances too, has interface with Quest and other labs.
    Has anyone used AdvancedMD EHR? Any pros and cons?


    ------------------------------
    Oleg Reznik
    BAR HARBOR ME
    ------------------------------



  • 20.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-18-2019 08:07
    If your looking for the best billing software, I use the ClaimRemedi Clearinghouse and it partners with many different EHRs.  The pricing is good too.  I can help if it's something someone wants to look at.

    ------------------------------
    Brian Hanson
    eSolutions
    Overland Park KS
    913-276-7549
    ------------------------------



  • 21.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 07-18-2019 08:15
    Oleg,

    Not certain why I pay only around $250 a month to AMD for claims and billing.   It may be because I am a "Part-time" provider.  You should enquire about that, especially since you would be slower in the beginning.

    PF was free when I started so AMD was my only expense.  PF includes controlled substance prescribing in NYS.

    Michael





  • 22.  RE: Cost and EHR questions Word or PDF or Google docs for EHR

    Posted 08-06-2019 16:45
    I am trying a DIY EHR with google docs.  I created templates and use google forms and forms publisher to spit out pretty PDFs.  This counselor (link below) made a good tutorial on how to do it.  A lot of work up front, but you can create nice looking templates.  So far, seems ok, but I am just getting started with my practice.
    https://practiceoftherapy.com/session-note-helper/session-note-helper-course/

    I use Bravado Health for e-prescribing for free.  I am a cash only practice, however.  If I took insurance, I would probably just get Practice Fusion.

    ------------------------------
    Bradley
    ------------------------------