save-money-on-bills1-300x194Billing insurance companies and keeping track of payments is a rather formidable challenge faced by all of us.  How to do this in the most effective way with the least expenditure of time and frustration is often a matter of preference.  The era of handwritten insurance bills is over and typed CMS 1500 forms are entering into the twilight as well. In fact, some insurers will not accept anything less than electronic submissions while others will only accept mailed CMS 1500 forms.

I would like to lay out the three basic choices we have for dealing with insurance billing.

The 1st choice which reflects the lowest tech involves you typing CMS 1500 forms and mailing them via US mail to the insurance company. I don’t need to go into the obvious challenge faced if we either increase the number of patients, or number of insurance companies.  The cost of postage, paper, and time should also be factored in.  We also lack the ability to track, gather data or keep a cohesive picture of the insurance
billing over months for any patient.

 

The 2nd choice involves paying somebody else to do everything related to insurance claims. There is an abundance of commercial billing services that will handle virtually every aspect of record keeping, filing claims and working with your insurance company to solicit payment of the bill. These services work on a percentage or a flat fee per claim and can be found locally and on a national basis. Generally you simply have to notify them of the dates of service and CPT billing code and they will handle the rest. The fees for set up, problem solving, resolution of unpaid claims and obtaining authorizations, are but a few issues that you would want to thoroughly investigate prior to engaging the services of a billing company.  Of course it goes without saying that you will need to have some sort of oversight to insure that your claims are being properly paid.

The 3rd choice is for those of you who would like to keep your billing in-house. This choice has two options as well. The first option involves utilizing software that exists in the cloud on the servers of an intermediary/clearinghouse. Historically, clearinghouses charged both the provider and the insurance companies per transaction. However in the past several years several electronic clearing houses  have taken a rather proactive approach where we as providers benefit. Specifically several of these services, including Office Ally (OfficeAlly.com) and Availity (http://www.availity.com) charge only the insurer for the filing of an insurance claim.  Further, Office Ally offers a free billing software that allows the individual practitioner to enter office visits on cloud software provided by the clearinghouse. This is probably the least expensive means to use an electronic intermediary and they can do everything for the clinician in terms of billing, payment and even notes.  However at this time the Office Ally “Practice software” is Windows based.  Use of Office Ally as an electronic intermediary though is available to you whether
you be a Windows PC or MAC OS person.

Another available option to electronic billing option is provided by many of the insurance companies who have their own electronic billing service that allows you to upload or use their website for insurance billing. The only difficulty here is that each insurance company has their own protocols, their own website and you would need to contact each insurance company separately to bill.

The second electronic option available to purchase dedicated billing software. Software varies from about $ 500.00 upwards and can be selected for individual or group practices with single or multiple office locations. There are various companies that provide software for both Windows and Mac operating systems. The cost vary and are dependent on whether the software is truly a robust product in terms of what it does and the level of customer service provided.

I’ve been using billing software in my practice for over 18 years. If you are looking for a bare-bones product, you can build one of your own in either FileMaker’s (www.Filemaker.com) or in Proview’s Panorama (www.Provue.com) flat file database software. Both of these products can be used cross-platform (Windows or Mac operating
system). It does take a fair amount of programming knowledge and expertise to
develop anything close to a sophisticated piece of software.

You also can buy software that has been developed for psychotherapists. The cautionary tale however is that you get what you pay for. I can tell you from experience, though I will not mention the name of one company in particular, that just because software is expensive does not mean that you get quality, decent customer service or software that is free of bugs or inherent design flaws. Having had that experience, I have spent a fair amount of time exploring the various software that is available. Regardless of what you spend, it is vital to have software that is robust (no bugs, user and computer friendly) provides timely upgrades, improvements and is built on trusted database platform (such as Filemaker).

I have listed several providers of billing software for psychotherapists.

Beaver Creek Software:  http://www.beaverlog.com

Delphi: http://www.delphipbs.com

eRecord: http://www.carepaths.com

Medisoft: http://www.medisoft.com

Practice Magic: http://www.practicemagic.com

PsyQuel: http://www.psyquel.com

TheraManager: http://www.theramanager.com/

Therapist Helper: http://www.helper.com

Theraquick: http://www.theraquick.com

TherapySoft: http://www.getphysicalsoftware.com/software/therapysoft/index.cfm

I would strongly recommend that you take the time to visit the software sites of the vendors that I’ve listed above and read about their software. Several companies allow demos that will give you the opportunity to practice and evaluate the software. Other companies will only sell you the software. Some have maintenance fees, upgrade fees, charges for technical support and other “hidden costs.”

Features you would want to have in software regardless of cost.

– An easy to learn interface. You shouldn’t have to be a computer programmer to understand how to use the software.

– The Software of choice has been thoroughly tested and is free of bugs and flaws.

– Technical support is readily available and the personnel are knowledgeable, friendly and able to immediately address your concern/problem.

– Software must be easily upgraded with little effort on your part. (The corollary is that software is regularly updated as quality improvement is an ongoing process).

– Software must be stable and robust.  For example, even if your software corrupts due to a malfunction of your computer, power failure or software crash, your data is never compromised.

– Flexibility- Your software has all the services you need built in, e.g. email, note taking, HIPPA compliance, forms, patient billing,data input, CPT codes, DSM diagnostic codes, credit card processing, report functions, batch preparation, and batch download information from the clearinghouses, custom forms (to name a few features).

There is fairly unsophisticated software available for billing that simply fills in the CMS 1500 form.  This type of software is limited to little more than form completion.  On the other side of the spectrum, the most sophisticated of the software out there not only produces billing for your clients, but also bills all of your insurance companies in a single batch. In addition the better software has the ability to take credit card payments, checks, send letters, and keep your billing and insurance payments organized.  Calendars that allow you to enter the office visit and payment if made by the client are also included that automatically set up the insurance billing, etc.  Basically, the best software makes for an easier task in billing, note taking and insurance reimbursement processing.

I can tell you from my experience that I could not efficiently run my practice without the benefit of quality software that is supported by exemplary technical support.  I can effectively run my entire month of patient and insurance billing (multiple companies) in about 1 hour.

While it would be inappropriate for me to recommend a single software product or service over another in this article, if you contact me directly, I can talk to you about the software I use and believe to be the best choice of the lot.

Depending on the complexity of your practice and your level of expertise and interest in using the computer, the solution to billing insurance companies and patients comes down to individual preference.  At the end of the day we all want to spend as little time as possible in pursuit of reimbursement.

By A. Scott Greer, Ph.D.

Chair of Academic Programs


  • Jennifer Carlin-Mathis

    Dear Dr. Greer,
    Thanks for this post. I am looking for billing software for my private practice. I am a psychologist. I am a sole practitioner and see about 20 patients a week. All patients pay me upfront. I’m looking for software which is compatible with my mac desktop and laptop. I want it to be simple, generate bills which I can print and have the capacity to submit claims electronically. I am not particularly tech savvy and want the easiest and most user friendly program that fits my needs. I keep my calendar on ical. Thanks in advance, Jennifer Mathis

    • Susan Jacobs-Backlund

      Dear Dr. Greer,
      I am looking for billing software for my private practice. I am a master’s-level psychotherapist and a sole practitioner. At this time I see close to 20 patients a week, and expanding. I am looking for software compatible with my mac. I need electronic billing to companies (in batches) and patient billing. I need a high-quality, no-bugs, simple to use program that allows for me to keep billing and insurance payments organized, plenty of good tech support. Guess this means I need the best of everything (!). Thank you! Susan

  • Leslie Bartolf Glass

    Hello Dr. Greer,
    I just had a hard drive crash after 15 or so years of using a billing software that was developed for Macs. It was the original program for Macs, and it has been surpassed by bigger companies. So in a google search looking to get a new program, I came across your very helpful article and wondered if you would be so kind to share with me your preference in programs. Thank you in advance!
    Leslie Bartolf Glass

  • Anonymous

    Dr. Greer,

    I would appreciate help sifting through the billing software options. I feel a need to change what i am using. Please forgive the lack of a name in the post – i prefer privacy, but it is embedded in the email address. Thank you for your assistance, i appreciate your article. Private Practitioner.

  • Breena Yeh

    Hello I am interested in finding the best software to use mainly for billing and financials of running a psychotherapy practice. We use quickbooks mainly, however not efficiently. Any insight you have would be appreciated. As of now, clients pay upfront, and we send out Superbills to those clients that need them at the end of the month.

  • I would be very grateful to see your preferences on billing software for macs. I have been using Sumtime happily for years, but its not upgraded for OSX.
    Thanks very much.
    David

  • Bill Milford

    Dr. Greer,

    Can you tell me which software you found to be the best, the one you chose. I am a bit leery of electronic billing and storing records on the cloud. Guess that’s years of using paper and pen and protecting information in a locked file cabinet.

    Thanks
    Bill

  • Susan Radant, Ph.D.

    Dear Dr. Greer,
    I am interested in learning what software you would recommend for a PC. My current vendor is retiring and won’t be able to provide technical support. So I would like to switch over to another billing software which has electronic billing capability.

    Many thanks,
    Susan

  • Dear Dr. Greer,

    I am the director of a counseling center with 7 therapists (most part time). Our office manager does a great job of keeping details together, however, it is all on ledger sheets in notebooks for each therapist. As you can gather, losing track of a client who may have forgotten to make their copay one week can easily happen, and we would like to do a program that would allow weekly or monthly reports of accounts. We do have some insurance billing as well. We are hoping to purchase something outright, as opposed to a monthly fee, but would be certainly interested in your recommendation.

    Many thanks,
    Ms. Chris M. Bassett, LMFT

    • You might try Timetotrack. Here’s a recent email sent to me and I investigated it though it is a monthly fee but low enough that your interns could afford it.

      Thank you for taking time to speak with me about how Time2Track can serve your behavioral health students, clinical supervisors, and program administrators in tracking and monitoring quality of clinical training. I have confirmed with Maggie Wilkerson, President of Time2Track, and we are available to meet with you via GoToMeeting webinar this Thursday, March 6th at 11:00 am PDT, 2:00 pm EDT. Maggie will send you a webinar invitation shortly.

      Here is the link for you to review additional information about Time2Track:

      http://time2track.com/time2track-for-institutions

      In addition, here is the link to access more specific information about the Institutional Analytics Reporting.

      http://time2track.com/time2track-analytics-announcement
      Please scroll down towards the end of the page, and you will see a link to access a sample student aggregate report. I think you will find the information and data displayed as very useful in monitoring quality of training, as well as in facilitating your internal and external reporting requirements.

      Maggie and I look forward to walking you through all the features of this comprehensive data tracking software on Thursday. At that time, we will also demonstrate how the Supervisor Online Approval feature works, and how user friendly it is, saving everyone time and resources. At about $30/student/year, this is an amazing value to students and programs.

      So thanks again for your time, and talk with you this Thursday.

      Regards,

      Teresa

  • I have Therapist Helper from 2011 (version 7.6). I now have to make some adaptation to provide for the transition to ICD-10 codes. I notice that instead of inserting 296.32 in the diagnosis box I could insert F33.1. The only problem is the description (Major depressive disorder, recurrent, moderate) won’t print out on a form if I have to drop the claim to paper … which I do have to do in some instances. Do you have any idea how I might be able to keep this version of TH yet still comply with ICD-10?

  • Denise

    i am part of a group of 13 mental health professionals looking to move to a billing software system in the cloud or buying outright. Would love your suggestions.

  • Karin Romp

    Dear Dr. Greer, I would love to hear your recommendations as I have been stuck with bad options for some time. I also need office help. I am in Burbank, CA

  • Fbfriedman

    Dear Dr. Greer,
    Thanks for this post. I am looking for billing software for my private practice. I am a psychologist. I am a sole practitioner and see about 20 patients a week. All patients pay me upfront. I’m looking for software which is compatible with my mac desktop and laptop. I want it to be simple, generate bills which I can print and have the capacity to submit claims electronically. I am not particularly tech savvy and want the easiest and most user friendly program that fits my needs. I keep my calendar on ical. Thanks in advance, Jennifer Mathis

    REPLY
    Dear Dr. Greer,
    I am looking for billing software for my private practice. I am a Ph.D level psychotherapist and a sole practitioner.. For years, I’ve used a free lance billing person, but there have been problems. Colleagues say it’s do-able without huge hassles and the right program. At this time I see close to 30 patients a week. I can go Mac or PC. I need electronic billing to companies (in batches) and patient billing. I need a high-quality, no-bugs, simple to use program that allows for me to keep billing and insurance payments organized, with plenty of good tech support. Thank you very much for your suggestion and guidance.

    REPLY

  • Bill Martin

    I have used therapist helper since it was a DOS based program in the late 1990’s. I checked out Office Ally, but decided to remain with Helper. I really like the program. However, it is costly each year and I was wondering if anyone on this list knows the basic differences between Helper and Office Ally?

  • Bill Martin

    How about ZOCDOC? Anyone have any experience with them?

  • Jennifer Palmano

    Dr. Greer,
    I am the office manager of a busy private practice. We currently have 3 full time therapists and 1 part time. We are in the process of transitioning to a wellness center and we hope to add a nurse practitioner, a nutritionist and possibly a chiropractor to the mix. I have been using Beaver Creek’s TherapistEZ for the past 10 years. I am looking for something similar, but something that is able to support electronic claims. Are any of the softwares you mentioned comparable to what I have been using? And would they all cover my needs for the broad spectrum of specialties I would now be billing for?
    Thank you for any insight you can give.
    Jennifer

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