You’ve made the decision to become a doctor of chiropractic; invested money in your education, the perfect practice location, staffing, etc. Now what? Where can you go to find information on products, education and other goods and services to help grow your practice?

“What Are My Choices?” is a monthly column that gives you the information you need, straight from the experts: the companies themselves. This column focuses on companies that provide insurance and other practice services. Consider the wide range of choices available:

Analytical Research Laboratories, Inc. (ARL): A laboratory specializing in hair mineral analysis, used to assist health care professionals in evaluating minerals that are known to play an essential role in human health and energy production. Recognized as a leader in its field, ARL provides accurate and important information to assist the health care professional in optimizing the health and well-being of their patients. Dr. Paul C. Eck founded ARL in 1975. Dr. Eck, a scientist and researcher, has long been considered the foremost authority on nutrition and the science of mineral balancing.

Products and Services: Hair tissue mineral analysis, Vitamin and mineral supplements. Phone: 800-528-4067; Web: www.arltma.com.

Automation by itself isn’t enough. A physician practice with a practice management (PM) system that doesn’t serve its needs will soon be challenged to replace it or risk the financial consequences. Midwest Orthopaedic & Neurosurgical Specialists, S.C., in Sycamore, Ill., is primarily an orthopedic group with five orthopedic surgeons, one neurosurgeon, one podiatrist and 40 staff members. We see approximately 130 patients a day, and we are team physicians for the Northern Illinois University Huskies and Kishwaukee Community College.

In July 2003, we created a strategic business plan designed to take us to the next level of patient care and efficiency. A key component included improved transaction support to streamline workflow and to gear us up for eventual implementation of an electronic medical record (EMR).

Roughly five years ago, Merge Technologies Inc. was losing money, had almost no cash and was trading for less than $1 a share.

The company now has some of the best profit margins in its business, more than $50 million in cash and a stock that trades for around $26 a share.

The numbers get even better.

The company which completed the largest acquisition in its history in June is on track to post revenue of more than $95 million this year. That’s up from $12.6 million in 2000.

Wall Street analysts expect Merge next year to make an estimated $36 million on revenue of more than $150 million.

Merge, based in West Allis, develops software for diagnostic imaging centers and small and mid-sized hospitals. It also writes software for manufacturers of medical imaging equipment.

The company, which does business as Merge Healthcare, has attracted little attention in its home state. But until this year, Merge was just one of more than three dozen small companies in a fast-growing but crowded market.

For the past few years, claims payors such as insurance carriers, claims administrators and third-party administrators, and health care providers such as doctors and physicians groups, have been working to make their systems HIPAA compliant.

They’ve spent hours and thousands of dollars working to standardize electronic billing procedures, claim types and submission formats so that an insurance carrier can make sure it’s reimbursing a doctor for the services he or she provided to a patient. They are doing this while meeting the strict privacy requirements of HIPAA, which forbids the disclosure of information in the name of protecting the privacy of patients. The way in which claims attachments–additional medical data required to process a claim–are handled, however, has been causing big headaches for health care carriers and providers.

Sure, the vast majority of claims are submitted electronically in the blink of an eye and carriers routinely pay claimants without the slightest objection.

On the surface, Coshocton County Memorial Hospital (CCMH) in Coshocton, Ohio, enjoyed an environment that other hospitals might envy. It had a robust hospital information system, Affinity from QuadraMed, that was operational since the fall of 2000. It had strong executive leadership in Robert Miller, F.H.F.M.A., the organization’s CFO, and Bryan Martin, director of patient financial services. Its accounts receivable (A/R) days hovered around 65 to 68 days, certainly no cause for alarm.

But Miller, Martin and, in fact, the entire organization were living with a decision made by the previous administration to outsource significant segments of its business office functions, and that led to a series of problems no organization would envy. Fortunately, Miller and Martin took the bull by the horns. They decided to leverage their existing Affinity financial information software to not only solve problems but also to create more favorable financials and improved patient satisfaction.

ROHNERT PARK, Calif.–(BUSINESS WIRE)–Oct. 25, 2002

Medical A/R Solutions provides increased

data management, automated processing and expanded reporting

capabilities for medical billing software

Transworld Systems Inc., a leader in providing profit recovery solutions to the medical industry, today announced the launch of Medical A/R Solutions, an integrated accounts receivable management software solution from GreenFlag Profit Recovery(SM).

The product enhances data management and automates processing capabilities found in medical billing software to simplify the complicated patient account aging process, and identifies and electronically transfers past due accounts to Transworld Systems Inc. for recovery. With Medical A/R Solutions in place, medical practices can enhance their effectiveness recovering slow-paying patient accounts, accelerate reimbursements from insurance companies, and reduce A/R aging.

Interface Reduces Costs, Expands Medical Billing Software Capabilities

The Medical A/R Solutions data management component saves time and FTE costs by automating the accounts receivable review process.

Ongoing industrywide challenges in the management of healthcare information are acute; some providers, insurers, and practice managers find them overwhelming. In fact, operational difficulties in processing and man aging medical records and billing information have only intensified in the current environment of managed healthcare reimbursement, complex claims processing, and compliance with the Health Insurance Portability and Accountability Act of 1996.

Common Challenges for Providers and Physicians

Today, staff at many healthcare organizations, including medical practices and medical management firms, still manually extract data from complicated explanation of benefits forms. This is an increasingly time-consuming task in the current managed care environment. Rekeying this information into IT systems often introduces clerical errors, especially when staff is working with numerous nonstandard forms from several insurance payers.

The sheer volume of EOB documentation and the need to archive and store documents for several years make document organization, storage, and retrieval expensive and labor intensive. Employees dread having to rum mage in dusty dungeons where paperwork is stored, occupying space that could be used better for other purposes. This document storage and retrieval problem also wastes worker and management hours.

In the complex and tedious world that is health care billing, those who pay the bulk of the bills–insurance carriers and health plans–have always had their hands full managing bill payment to physicians practices and hospitals of all sizes and types.

But with the latest trend–consumer-driven health care–taking center stage in recent years, managing bill payment is growing more, not less, complex–even as simplifying bill payment continues within the industry.

Consumer-directed plans typically mean more choices of health plans and providers, as well as more financial risk, for employees and health care consumers. Simply stated, health care users, typically employees and their dependents, must pay for medical services for a defined amount with dollars in a flexible spending account, a health savings account or a health reimbursement arrangement.

Health savings accounts, for example, can be used by workers to pay for routine medical expenses, which count toward the deductible of accompanying catastrophic health insurance. Ultimately, consumer-driven plans shift more of the responsibility for health-spending choices onto the patient.

Ever since the passage of the Health Insurance Portability & Accountability Act of 1996, the health-care community has been moving toward a more standardized format for handling claims. A key provision of HIPAA, titled Administrative Simplification, calls for improved efficiency in health-care delivery by standardizing EDI, or electronic data interchange, and protecting the confidentiality and security of health-care data through setting and enforcing standards.

In response to HIPAA, along with growth in new technology designed to automate the medical claims management process, an increasing number of health-care providers have begun accepting electronic claims transactions from providers, health-care clearinghouses, billing entities and other third parties involved in the claims-handling process. As a result, the claims management process is growing increasingly more streamlined, as payers aim to reduce administrative expenses and promote partnerships with providers.

“There has been a great deal of effort invested in the last five to six years by health-care payers assessing the capabilities of their current systems regarding the privacy, security and administrative simplification provisions of HIPAA,” says Laurie Ringlein, director, health industries advisory practice, at PriceWaterhouseCoopers in Portland, Ore.

When it comes to investing in a practice management (PM) system, practice managers want to see gains in efficiency and fatter bottom lines. Even if they choose a PM system that’s coupled with an electronic medical record (EMR), their primary goal is to boost their practices’ efficiency through more accurate and speedier billing, resulting in faster reimbursements from payers. To achieve these goals, a growing number of practices, large and small, are deinstalling their old practice management systems and replacing them with systems that include integrated EMRs.

While many of these PM systems are still quite healthy and have been kept updated, installing a truly integrated system from a single vendor appears to provide physicians with faster access to clinical data and better documentation, while ensuring that all the pertinent data necessary for billing of patients encounters is quickly entered into the billing cycle.

“I am a big believer in EMRs because you can achieve a lot in the middle segment of the practice management process by using EMRs,” says Bill Bysinger, director of Mercer Health Systems in Macon, Ga. “But I approach EMRs from a purely business perspective. How can I make not just the physician more productive, but the whole practice more productive? To really get a return on investment, a physician group must have this as an underlying goal.