Medical Practice Management Software Features and Requirements

You know what healthcare providers don’t have time for? Menial data entry tasks and micromanaging their practice. Luckily, you don’t have to worry about those things when you implement medical practice management software.

The hard part? Finding the right fit for your practice. A good place to start is by understanding the top practice management system requirements and how they can help your practice.

Get our Practice Management Software Requirements Template

Top Practice Management Requirements

This guide will help you:

• Identify the top medical practice management software requirements
• Figure out how to pick the best solution for your business

Key Requirements

We’ve onboarded over 100,000 users into our software selection platform. As a result we’ve gained a wealth of insights into their usage patterns based on industry, company size and user persona. By leveraging this data, we’ve identified key requirements you should consider to guarantee you get the best software for your business.

Create a custom requirements list to find the right fit for your business needs.

Medical practice management software doesn’t only save time and expenses. These tools make your workplace safer, informed, organized, efficient and faster. Staff can accommodate patients quickly, perform tasks faster, ensure codes and claims are accurate, and create a more cohesive office.

Most practice management solutions come with a wide range of features, including electronic medical records management, medical billing software functionality, document administration, and patient scheduling modules, among others. No two systems are identical, but all offer some level of functionality for these main features.

We’ve compiled a comprehensive checklist of practice management software requirements to help you get started.

Get our Practice Management Software Requirements Template

1. Clinical Management

The point of digitized EHR/EMR is to keep all the relevant records in a single place. Practice management software helps you store scanned documents from other providers, pictures of health concerns and lab test results within the patient profile.

Capture patient information, including the patient’s name, address, contact information and insurance details. Keep track of current medications a patient is taking and any allergies they may have in order to prevent dangerous interactions or reactions. Store all of it in a searchable database that’s systematically organized, up to date and accessible.

Practice management solutions can help you send automated vaccination reminders, calculate the correct dose recommendations and generate ePrescriptions, among other capabilities. You can also track patient referrals and collect patient feedback through automated surveys.

NextGen’s medication modules help physicians keep track of patient dosages and other treatment details.

EHRs and medical practice management are very different systems, but practice management offers most of the functionality of an EHR alongside others.

2. Billing and Claims Management

Practice management systems can automate all billing and claims related tasks. You can record charges and send them over to third-party payers as claims to be reimbursed. Get real-time access to insurance eligibility, claims history, missing claims, electronic superbills and more.

Follow up with insurance companies and submit appeals to check on denied claims. Track the insurance payers your office supports, so you never have the nasty surprise of discovering an improperly covered patient after treatment completion.

View invoicing reports, such as account statements, insurance aging and claim reports using Kareo Billing.

You can post copays, deductibles, government and commercial payments, and record them to individual patient accounts. The claims rule engine helps validate claims before submission. Claims scrubbing capabilities detect and rectify errors, reducing the need to re-submit claims so you get compensation promptly.

Compare denials to an up-to-date database that keeps track of new medicare rules and modifiers. Practice management software can help flag denials and categorize them for effortless review and resolution.

Get our Practice Management Software Requirements Template

3. Collaboration

Some of the most valuable practice management software capabilities center on collaboration. Dedicated portals help patients access communication tools like direct messaging, phone appointments and automated reminders. Simple tools like this can vastly improve patient interactions with your office, as well as develop more effective interpersonal relationships.

Practice management software also enables physicians to digitally input prescriptions that are easily accessible to patients. Patients can request refills, upload treatment files and other necessary documents, and communicate with physicians through emails and text messaging.

Add eSignatures to invoices, prescriptions, consent forms and more. You can even share educational materials with patients via a patient portal. This encourages them to be more aware, involved and proactive about their own healthcare.

• Communication portal
• Electronic signature
• Email communication
• Prescription refill requests
• Text communication
• Documents scanning and uploading
• Broadcast messaging
• Electronic faxing
• Educational materials

4. Dashboard and Reporting

Once hidden away in business intelligence software, reporting is one of the fastest-growing sub-categories of almost every other type of business software. The use of management software that offers reporting capabilities enables practice staff to extract detailed data on financial performance and patient financial histories. This helps you identify performance gaps and trends.

View patient appointment timelines and individual records using DrChrono’s dashboard.

Most practice management systems come with pre-set reports and let you design customized reports. Some solutions come with reporting functionalities, decision support systems or related capabilities. Dashboards present the data collected by reporting modules in easy-to-interpret visualizations like charts and graphs.

• Reports auto-scheduling
• Visualizations
• Dashboards
• Reports customization
• Reports bookmarking
• Pre-built reports

Get our Practice Management Software Requirements Template

5. Medical Coding

Medical coding might sound like a secret language, but it’s actually a vital part of keeping our healthcare system running smoothly. Think of it as a universal translator for medical services. Medical coders assign specific codes to every medical procedure, diagnosis and service. These codes, like CPT, HCPCS, E&M, ICD and NPI, are used to bill insurance companies and track healthcare data.

Here’s a quick breakdown of these codes:

• CPT (Current Procedural Terminology) codes: These codes describe medical, surgical and diagnostic services.
• HCPCS (Healthcare Common Procedure Coding System) codes: These codes are used to classify medical services and procedures not included in CPT.
• E&M (Evaluation and Management) codes: These codes are used to bill for physician services, such as office visits and consultations.
• ICD (International Classification of Diseases) codes: These codes are used to classify diseases and injuries.
• NPI (National Provider Identifier): This is a unique 10-digit number assigned to health care providers.

Why is this important? Well, accurate coding ensures healthcare providers get paid fairly for the services they provide. It also helps track trends in healthcare, identify areas for improvement and supports research. So, while it might seem like a behind-the-scenes process, medical coding plays a crucial role in keeping our healthcare system efficient and effective.

• CPT codes
• E&M coding
• HCPCS codes
• ICD coding
• Taxonomy code and NPI lookup

6. Mobile Capabilities

Healthcare offices are very fast-paced environments, making instant accessibility and flexibility top functional priorities. Most medical practice management solutions offer mobile capabilities accessed through an Android or iOS application.

Customize workflows and access data remotely with athenahealth’s mobile app, athenaOne. Source

Mobile push notifications keep everyone in the loop, from patients to office staff. Healthcare providers and medical assistants can record relevant information for charge captures on their mobile devices.

Patients can use the kiosk application to remotely fill out intake forms, medical history and demographic information, and both patients and physicians can schedule and manage appointments on their phones.

• Charge capture
• Push notifications
• Native iOS and Android applications
• Patient kiosk
• Responsive web design
• Mobile appointment scheduling

7. Patient Schedule Management

Schedule patient appointments using intuitive interfaces powered by practice management solutions. If your patients would rather schedule their own appointments, they can do so through a patient portal. Then they’ll get automated appointment reminders, reducing no-shows and improving your office’s performance.

Enable streamlined operations using Tebra’s effective schedule management. Source

You know what patients hate? Waiting around at a doctor’s office. Practice management offers pre-visit patient intake forms that they can fill out electronically before they come in. This not only saves time, it also saves paper!

Scheduling modules can help scan for time slots, organize custom information and track individual patients. Form builders let you adjust the schedule and registration for custom information in subjective patient circumstances or statewide circumstances.

Patients can view the availability of physicians before booking appointments. A calendar view of appointments helps clinicians effectively manage their time. Some solutions provide color-coded views that indicate when slots are open, blocked or overbooked.

• Appointment scheduling
• Appointment reminders
• Follow-up scheduling
• Patient intake forms
• Calendar views
• Color-coded views

Get our Practice Management Software Requirements Template

8. Patient Payment Management

We’re well into the 21st century — and payments should be too! Practice management software offers a range of payment options, including cash, credit, check, debit and sometimes even auto-pay or direct withdrawal.

Avoid pricey processing fees by processing payments directly through your system instead of a third party platform. Some systems even enable photo capture of credit cards to make copays as easy as possible.

Use EpicCare’s flowsheets to get a comprehensive view of all patient data)

Create patient statements in batches and customize them according to the needs of your practice. Print them or send them over to the recipients through email. Practice management software also allows patients to settle their statement balances through credit card payments and other online gateways directly on the portal.

• Credit, debit, check or cash payments
• Customizable patient statements
• Patient refund and reimbursement
• Payment reminders
• Payment balance
• Patient portal payments
• Payment history

9. Platform Security and Compliance

One of the most crucial medical practice software requirements is medical compliance capabilities. Practice management has complete databases that allow you to look up diagnosis codes while providing additional resources to train your staff on ICD-10 and ICD-11 (adopted in 2019 and implemented in January 2022) codes. These medical practice management functionalities vary in automation.

Doctors’ offices are notorious for paperwork. Practice management solutions majorly simplify this by digitizing your records and providing a global search tool to sift through them. Receive prompt notifications regarding authorizations, claims, rejections and more through email and SMS.

Multi-language support on practice management solutions elevates user experience by making the system more inclusive and accessible.

Practice management solutions also have sturdy security features that ensure your patient data is safe according to HIPAA standards. If it offers ANSI 5010 compatibility, it enables users to securely transmit medical information to other providers or offices in a standardized format.

10. Integrations and Extensibility

Integration comes in many forms for medical software. Some larger practices may find that practice management is beneficial for scheduling but needs to be more robust for their charting needs. In this situation, you need your practice management solution to fully integrate with your EHR/EMR to ensure accuracy and organization.

This is also true of billing. Clearing house functionalities enable automated payments and are often a separate system or a medical billing software module. To ensure your insurance claims are properly processed, seamless integration with your clearing house is crucial.

Electronic data interchange, or EDI, enables fast, accurate data transmission between systems. To correctly transfer medical data to other providers, you need to be able to convert that data into a standardized format that their systems can understand. Barcode scanning technology is another critical integration that allows users to directly input complex data rather than trying to enter it manually.

Custom API access through third-party apps, cloud storage access, data transfers and payment processing platforms are other useful forms of integrations. You can also get access to well-known laboratories and patient financing systems through the software.

• Clearinghouse software integration
• Electronic Data Interchange (EDI)
• Patient financing software integration
• API access
• Cloud storage integration
• Data export and import
• EHR or EMR system integration
• Insurance card scanning integration
• Lab integration
• Payment processing software integration

Get our Practice Management Software Requirements Template

How to Pick the Right Solution

Choosing the right software is a multi-step process — and though it might sound tedious, resist the urge to skip your prep and research! With the right medical practice management software for your practice, you could reap benefits like:

• Reduced Errors: Document modules can help you integrate invoicing procedures and convert manual paperwork to digital records, and automatic spelling correction to reduce human errors in data entry.
• Major Time Savings: Automated tools take care of daily tasks that can be monotonous, tricky or time-consuming. This can help physicians and admin staff to free up their time for other crucial jobs, including patient care delivery, appointments and patient-physician communication.
• Better Communication: Secure communication channels simplify interactions with internal departments, admin staff and patients, helping facility members gain clarity by quickly handling emergencies and other problems.
• Streamlined Scheduling: Automated functions like scheduling modules let patients self-schedule and cancel appointments by themselves. Patient portals help reduce no-shows and alert patients of their subsequent visits.

But to get the most out of your software choice, you need to find the right fit. That’s why we recommend getting your own requirements checklist ready before getting into market research to see what products are available. You can base your list off of the one we provided above, tweaking it or adding specific features where needed.

Going into your search with a thorough checklist prepared not only helps you find exactly what you’re looking for, but also ensures that you have a clear end goal in mind. You can allocate resources appropriately, accommodate specific business needs that might not be totally obvious from the jump, create a traceable record of decisions to improve accountability and plan for future needs as your practice grows.

To get a sense of how it works in action, here’s a real-life success story: Virginia-based Centra Health. They knew they wanted to handle revenue cycle management and compliances more effectively, so they picked a solution that offered functionalities like structured invoicing and data security through HIPAA compliance.

And it paid off — Centra Health achieved a 20% growth in revenue plus a 30% drop in claims denials by choosing a solution well-suited to their needs. So don’t go into your search blind. Set yourself up for success by figuring out what you need from the get-go.

Get our Practice Management Software Requirements Template

FAQs

Get our Practice Management Software Requirements Template

Next Steps

Using inadequate or incompatible medical practice management software is like trying to drive a car on a flat tire — it’ll slow you down and might even leave you stranded.

When you implement effective practice management software, you’re not just boosting operations. You’re also ensuring quality service while staying compliant with regulations. So, choose wisely!

Selecting the perfect medical practice management system for you starts with knowing what you need — and now you do! Use our free practice management software requirements template to quickly see, prioritize and customize your key requirements. Good luck in your software selection journey!

What key medical practice requirements did we miss? Are there any features you need help understanding? Let us know in the comments!