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Key Components of Practice Management Systems In today’s competitive environment and growing demand for professional healthcare needs, medical practices are facing a tough challenge in managing business operations, delivering superior quality services, and improving patient satisfaction. Practice management systems are a crucial part of healthcare that deals with effective handling and management of day-to-day operations of a medical practice, critical to the business. With complex business functions and changing demand of patients, it becomes remarkably difficult to handle the procedures efficiently. As a result, advanced practice management software is utilized for scheduling appointments, capturing patient demographics and medical records, generating reports, performing coding and billing functions with ICD 10 procedure codes, and maintaining list of insurance payers. U.S. healthcare industry utilizes high-tech PMS system, designed for small to medium-sized medical practices. There are certain technology solutions that are being used by third-party medical billing companies to streamline and speed up the process of claim payments. Medical practice management software can be categorized as desktop-only, Internet-based, and clientserver system. Desktop-only version is used only on a single computer by one or more users by sharing access. Client-server solution makes it necessary for providers to lease or buy server equipment and operate the software through it, which can be accessed by individual users in their workstations. Internet-based PMS minimizes the need for running a server or worrying about reliability or security. Essential Components of Practice Management Software Most sophisticated healthcare practice management software allows the users to feed and track patient information, schedule and manage patient appointments, facilitate medical coding via ICD 10 diagnosis codes, send patient statements and insurance claims as an integral part of collection process and third party payments, and generate valuable reports for clinical and administrative purposes. The advantage of PMS also involves keeping updated and bulk data including list of insurance companies, list of procedures and ICD diagnosis codes, providers, referring physicians, facilities, and much more. Discussed here are the key components of practice management. Patient Demographics – Capturing accurate and complete patient information is one of the most critical steps in effective claim submission and reimbursement process. It starts as soon as a new patient provides necessary information in the chart. The data includes name and address of the patient, contact number, employer, date of birth, and insurance information. The software might automatically evaluate eligibility of the patient for receiving benefits with respective insurance company. Scheduling Appointments – PMS often provides appointment scheduling component that allows creating and managing upcoming patient visits. Schedules are typically color-coded to help healthcare providers easily identify set of patients or time blocks.


Claims and Statements – One of the most critical areas of use is implementing ICD-10-PCS for accurate and prompt medical coding. This not only helps in streamlining the coding process, but also makes it remarkably easier to submit claims accurately for getting reimbursements on time. Reporting – Claims management software also include reporting capabilities, allowing users to seamlessly extract comprehensive data on patient financial condition and overall financial performance of the organization. The reports can be used in analytics and business intelligence purpose.


Key components of practice management systems