- 1 Physical Space
- 2 Set Up Billing Workflow
Opening a new practice is a complex process. One important element is selecting the EHR and Practice Management System you want to use, but, before your practice can open its doors, certain things must be in place.
Your practice location is of critical importance. Selecting a location, signing a lease or purchasing a property, and interior fit-up take time.
Certificate of Occupancy:
Before you can begin seeing patients, you must receive a Certificate of Occupancy from your state or local government to certify that your physical space meets building code requirements.
Having a connection with enough bandwidth to support your patient volume and practice operations is critical. Before you can start using your EHR, the right internet connection needs to be up and running, provided by the local internet service provider (ISP) of your choice. PCC strongly recommends fiber or business-class cable for internet. Your PCC representative will provide specific requirements and review your current or planned internet connection.
Will your practice host your data locally, in a physical server on the premises, or in the cloud? PCC provides both solutions, and can work with your practice to decide on the best choice. We also provide network equipment to practices that need them, such as a firewall, UPS battery, and network switch.
If you will have a server running locally on the premises, or if you use PCC to supply and manage your network equipment, PCC requires that this equipment have adequate space, power, and ventilation. Many pediatric practices use a ventilated closet or storage room, one that is not used for other storage needs. To ensure that proper security is maintained, this equipment should be locked when not attended.
Your office must have network cables to connect hardware throughout your practice. Speak to your PCC representative for help determining what kind of cabling will work for your practice. Please note that PCC does not do premise cabling and cannot cut holes in your walls, ceilings, or furniture for cabling. You are responsible for arranging such work to be completed before the PCC Server is installed.
A floor plan of your physical space allows you to determine how many exam rooms you will have, where your front desk will be, where to house your PCC equipment, and where to place wireless network access points.
Before you can go live with PCC, you’ll need to set up the printers, scanners, and workstations to support your practice. Clinical, front desk and billing staff will need workstations that meet PCC’s hardware requirements.
Set Up Billing Workflow
One of the biggest challenges for new practices is ensuring that their billing and collections are up and running from day one. Your billing is your revenue stream, and without proper coding, claims processing, and followup, your practice will have a difficult time getting paid fairly and on time. We recommend the following as a minimum to help you build a healthy billing workflow.
Get Your Providers Credentialed Properly
Without the right credentials, your providers can’t see patients, or bill for services. Identify who is responsible for getting the right paperwork completed to ensure that your providers can see patients and submit claims before you open your doors.
Hire an Experienced Biller or Billing Service
Billing is an incredibly detailed and complex process. It may sound straightforward, but insurance companies, coding practices and changing regulations require a great deal of attention. Hiring the right person will help you build strong billing practices from the start, saving you from potential trouble down the line. If you’d prefer to use a billing service, PCC has experience working with billing services.
Identify Claim Posting and Followup Responsibilities
Determining who posts charges, who follows up on personal balances, and who follows up with insurance companies is vital. Make sure each person understands and can handle their responsibilities.
Plan Out Your Front Desk and Encounter Workflow
Your patients and families need to quickly check in at your front desk, register for their visit, and pay their copays. When you start a new practice, you’ll be collecting a lot of information – names, addresses, insurance cards – and your front desk will be set up for success if they have clear responsibilities and proper workflow in place. How will your practice manage the flow of patients from check in, to the waiting room, to the exam room?
The best way to prepare for your go-live is to visit a pediatric practice in your area already using PCC. We’re happy to provide you a list of PCC clients near you. Visiting another office allows you to see how they have chosen to set up their system, observing their workflow and asking questions about what works best for them. This hands-on experience will give you an idea of how you’d like your practice to work and can help you make informed decisions as you go through the PCC online process.
Set Your Prices
Your practice needs to determine how much to charge for its services. This includes all of the different procedures and office visits you do, as well as lab tests, school forms, and other ancillary services. PCC has reporting tools you can use as a guide when making pricing decisions, but, your practice must decide how much to charge for each service you provide.
Determine Your Coding Practices
Pediatric billing is complicated, and your practice needs to become familiar with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) coding. Use resources about pediatric coding to decide which CPT and ICD codes you will use and how your visits should be coded. Make sure this information is communicated clearly with staff members who are responsible for charting.