Practice Management Alert

The word on the status of HIPAA-compliant practice management systems (PMS) is that you're just going to have to wait and see. Practices are required to conform their systems under the transactions and code set standards (TCS) component of HIPAA, but with a contingency plan now in effect it is unclear just when you'll find out how the systems are faring.
 
While most experts predict at least some initial snags in the system, you may wonder if these concerns are valid. Will this be another Y2K scare getting us all worked up over nothing?
 
"Unfortunately, I don't have a specific answer, and I don't think anybody does," says consultant L. Michael Fleischman, with Gates Moore & Co. in Atlanta. Practices won't know they're having problems with their electronic filing until they start receiving denials, which could potentially be any day now, Fleischman says. When denials do start coming in, they should clearly state what the problem is (usually a data-entry error) so you can make haste to correct it.
 
The only thing practices can really do to prepare is to contact their PMS vendor to see if the system has been tested and is ready to go. It's the vendor's responsibility to a practice to have the PMS certified and working correctly "before the vendor actually sends them the software," says Jeff Gardner, senior programmer analyst with Accounting Systems Technology Inc., a PMS vendor in Casselberry, Fla. 
 
Vendors gather as much information from the clinical side as possible before they run their tests with payers. Their electronic files get sent back with a report citing any problems. The software is considered certified once those problems are fixed. Certified PMS vendors don't anticipate any format glitches when practices begin using their software, Gardner says, but proper functioning will be "dependent on [coders and billers] making sure they enter the correct information." There will be changes in data- entry requirements for many systems, and staying in contact with your vendor should ensure you know what's going on.
 
An easy way to verify that your software is ready is by visiting the PMS directory Web site at www.hipaa.org/pmsdirectory. The site is sponsored by a coalition of national physician associations and lists most of the practice-software programs, indicating which programs have been tested and can support HIPAA transactions.
 
That's a great site to visit, Fleischman says, because your software vendor might "feed you a line," but here you can check for yourself. The site also offers helpful basic information on HIPAA transactions and compliance.