Now you can create cases in Medisoft using Import Wizard!

We recently got a call from a software vendor that offers an ASP based Electronic Medical Records (EMR) system who has many clients on Medisoft. Their challenge was how to integrate their EMR with their Medisoft software so that their customers could import data on demand into Medisoft for their billing. Import Wizard is ideal for this application and now with the introduction of Import Wizard Plus you can even create cases in Medisoft.

Import Wizard Plus is ideally suited to import data into Medisoft from a variety of external data systems (i.e. EMR, HIS, Schedulers, etc.). The external system simply generates ASCII CSV files and writes them to a known location (the Import Wizard Plus “Import” folder). Import Wizard Plus is configured to read the CSV file in that folder, when it is run it parses the data and writes it to Medisoft. Import Wizard Plus can import current insurance information for each patient and create a case that corresponds that that patient visit. The current version of Import Wizard Plus is an on demand system (i.e. it is initiated by the operator) it can be configured to pole the Import folder on an automated basis (Import Wizard RT).

Note that often times third party report generating software such as Crystal Reports can be used to export data from your external system (i.e. EMR, HIS, Schedulers, etc.).

When creating cases in Medisoft from your external system matches for patients and providers are made based on a variety of references which would normally be unique in both systems such as social security number, NPI, etc. Import Wizard also stores a chart number for each patient from the external system (EMR, Hosptial Information Systems, Scheduler, etc.) and can match future transactions based on that external (i.e. non Medisoft) chart number.Many of our customers also use Import Wizard to migrate data out of another billing software into medisoft. Import Wizard works great for data conversions or for importing data into Medisoft on an ongoing basis.

For more information check out Import Wizard at:

http://medicalsoftwaretools.com/services/medisoft_data_conversion/default.htm

Mark Beans, MCSE, MCP+I
Medical Software Tools
www.MedicalSoftwareTools.com

The Importance of Backups

We recently had a customer who had a “bad experience”. Their medical billing and scheduling was completely shutdown for several days. They were the victim of an apparent hard drive failure. Their IT contractor had them set up to make daily backups onto a single hard drive. When their data was corrupted at some point they overwrote their only good backup.

What causes data corruptions? The four following factors are the primary causes of data corruptions:

1) Power failures or spikes
2) Improper shutdown
3) Network problems
4) Hardware failure

What can you do to minimize data corruptions?

Power Problems- Use a working Uninterruptible Power Supplies (UPS) on all computers. A UPS with a dead battery is just as likely to damage a database as using none at all.

Improper Shutdown- No matter what version of Microsoft Windows™ you are using it is imperative that you always shut your computer down properly. Turning the computer off without properly closing down Windows will eventually corrupt your Windows installation but more importantly will very likely damage any databases that are open.

To shut-down your computer properly, first shut down any programs that are open. Then click on the Start button and select the Shut Down option. You must then select the option to Shut Down and click OK.

Network Problems- Improper network Setup or design can definitely cause data corruption. Some network protocols are not fault tolerant. This means that they don’t handle problems well. Medisoft requires the use of the TCP/IP network protocol. Having other non-fault tolerant protocols running can cause data to travel across your network in ways that allow dropped packets of data to be lost. Likewise other network issues can cause problems.

Hardware failure- Prevention of hardware failures is expensive and not foolproof. There is a whole science to hardware fault tolerance. You can purchase RAID hard drive arrays which allow you to run multiple hard drives. You can purchase redundant power supplies, redundant network cards, you can even purchase redundant servers. While there is no question that these technologies can offer a higher level of protection they are not foolproof and your best protection in the long run is still incremental, high quality back ups.

Recovering from failures:

More important, what can you do to recover from data corruptions? Your best option is to restore from your most recent uncorrupted backup. Once you have a problem it is too late, you must have a good backup routine in place prior to the failure.

Here is what you need to do:

1) Put a UPS on the server and all workstations- Use a working Uninterruptible Power Supply (UPS) on all computers. You must regularly check the batteries on the UPS on every computer.

2) Separate daily backups- You must make separate daily backups of your database. Do not overwrite your backup files. Create multiple backup files with different names and keep them somewhere safe.

3) Automatic backups- Medisoft software offers a capability to make regular scheduled backups. Use this feature! The Medisoft scheduled backup can be configured to make a separate backup each and every day.

4) Make sure all users exit properly from Medisoft- Make sure that you schedule your backup for a time that no one will be working in your system and make sure that every user properly exits from your system before the scheduled backup runs. If you have even one user in Medisoft when the automatic backup runs you will get an error message that some files were skipped and your backup will not be serviceable.

5) Test your backups- Test your backups periodically to verify the veracity of the backups. If the size of a backup file is 0 kb that means that you have no data in your backup. Back ups from one day to the next do not normally get smaller unless you run file maintenance or delete files or delete unnecessary files from your database folder (that could be very dangerous if you are not sure a file is unnecessary). Look at the size of your backups and make sure that they are the same or larger from one day to the next. If one day’s backup file is smaller than the one from the previous day without a reason then it is likely you have a bad backup file.

Need I say that HIPAA requires that you have a procedure in place not only to make regular backups but also that you test your backups at regular intervals?

6) Take backups off-site- Take a copy of your backups off site regularly. I have known customers that leave their one and only backup tape in the tape drive or laid on top of their server. What happens to their backup if the office burns down or somebody breaks in and steals the server?

How much data can you afford to reenter? The answer to that question should determine how frequently you should take your backups off-site.

7) Have a secondary backup capability- Why not make a redundant off site backup? High speed Internet is widely available now and backup capabilities have dropped in price to the point that they are cost effective. For less than $30 a month you can have a secondary backup stored in another state.

Several years ago I worked for a company that operated multiple servers for multiple functions when the Nimda virus struck. Nimda attacked HTML files where ever it could find them and actually propagated itself across a local network by traveling from computer to computer across network shares. It raged through our network like a grease fire. We were literally running around the office unplugging computers from the network (we actually kept many computers from being attacked by unplugging them). All the antivirus companies rushed to get updates out and some of the antivirus updates caused problems of their own. It took several hours to clean the entire network of all traces of the virus and then we restored the servers from backup tapes.

Here’s the interesting thing about some data failures, they propagate to your redundant hard drives or even redundant computers. For example, say that you run a mirrored server; anything bad that happens to one server automatically propagates to the other server! A virus problem like Nimda would simply infect your mirrored server or mirrored drives.

As they used to say in commercials years ago, “What is a mother to do?”

What is the best and ultimate solution? Make good incremental backups and store them off-site. Having one great backup is not enough; if you overwrite your one great backup with bad data it is no longer “great”.

Don’t have a “bad experience”. Make sure that your backup routines and procedures are adequate and redundant.

Mark Beans, MCSE, MCP+I
Medical Software Tools
http://www.medicalsoftwaretools.com/

How to Evaluate Your Account Receivables

How to Evaluate your Account Receivables:

Here are two ways to analyze your current A/R.

1. Averaging- Take your last 3 month’s total charges for the practice and average them to determine your current average monthly charges. Then take your Account Receivable and divide your total A/R by your current average monthly charges. (Source: provided by a billing consultant.)

If the results are:
1.5 Or Less- Stop reading, you do not need any help
Less than 2.0- Pretty good, can use some fine tuning
2.0 to 2.5- You’re starting to get in trouble
2.6 to 3.0- You need help
Over 3.0- Your A/R is out of control

2. Number of Weeks- Take your average week’s total charges for the practice and multiply them by 6 weeks or 7 weeks (ideally a 6 week A/R). This total should equal your current practice A/R. If it does not, increase the amount of weeks 8, 9, etc. until the totals match.
(source: a seminar on billing)

If the results are:
6-7 or less- Stop reading, you do not need any help
8-9- Pretty good, can use some fine tuning
10-11- You’re starting to get in trouble
12-13- You need help
14-15+ Your A/R is out of control

What the number means in both equations is how long it is actually taking your billing department to collect 100% of your charges.

The ideal composition of your Accounts Receivable would be something like this:

Current 50%
31 to 60 15-20%
61 to 90 15-20%
90+ Days 20%

If your A/R is not what it should be Medical Software & Services may be able to help you use your billing software more effectively. We can provide training on Medisoft and other products. For a nominal cost, we can do an audit of your billing process and provide a report making specific recommendations on how to improve your collections rate.


TJ Johnson
Senior Support Technician
Medical Software Tools
http://www.medicalsoftwaretools.com/

How can I prevent database corruptions?

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How can I prevent database corruptions?

Database corruptions can occur on virtually any software product that uses a database. The three biggest database killers are power problems, improper shutdown, and network problems.

1. Power Problems- Use a working Uninterruptible Power Supplies (UPS) on all computers. A UPS with a dead battery is just as likely to allow a database to be damaged as using none at all so it is important to test them periodically and make sure they are functional.
   
2. Improper Shutdown- No matter what version of Microsoft Windows™ you are using, it is imperative that you always shut both your software and your computer down properly. Turning the power off on your computer will eventually corrupt your windows installation but more importantly will very likely damage any databases that are open.
   
   To shut-down your computer properly, click on the Start button and select the Shut Down option. You must then select the option to Shut Down and click OK.
   
3. Network Problems- Improper network Setup or design can definitely cause data corruption. Some network protocols are not fault tolerant. This means that they don’t handle problems well. Have a qualified Network Engineer consult with you about networking issues.

In thinking about these kinds of problems there is no substitute for common sense. I was talking with an office manager one time who had experienced a Medisoft database corruption. She asked me about factors that could contribute to this kind of problem. After reviewing all the items listed above she declared that they had a UPS on every computer and never had power fluctuations. She told me that they always shut down the software properly and they recently had a technician check their network and were certain that it was configured correctly and functioning properly.

A few days later I was talking with this same office manager about an unrelated issue and I asked her about one of her computers. She told me that computer was her "smoker". I asked her why she called that computer her "smoker" and she told me that they had recently had to replace the power supply on that computer because it had caught fire one day while her biller was posting payments with her Medisoft software. I asked her when that had happened and she told me that it was right before their data corruption. She was shocked when I told her that this was the likely culprit behind her data failure. I had to explain that just having a UPS on the computer wasn't going to always prevent every possible power problem.

Mark Beans, MCSE, MCP+I
Medical Software Tools
http://MedicalSoftwareTools.com

Whose Data is it Anyway?

If you are a medical practice, who does the data in your medical software belong to? Does the data in your medical software belong to your patient? Yes. Does the data in your medical software belong to you? In a very real sense, yes. You created it, you control it and you are responsible for it (under the new HIPAA regulations you could be fined or be sent to jail if you don’t adequately protect it). Does the data in your medical software belong to your software vendor? We don’t think so!

HCFA and other governing entities charge you with the responsibility to guard and protect any patient data that you touch; but whose data is it anyhow? Why should any software vendor be able to hold you hostage?

One of the things that we have come to appreciate about Medisoft software is its open database architecture philosophy. Medisoft offers you a variety of ways to get YOUR data into or even out of their databases.

1) ODBC Connectivity- Open Database Connectivity (ODBC) allows you to access your data using other ODBC compliant programs such as Microsoft Access, Microsoft Excel, Crystal Reports, and many others. While there are many programs that are ODBC compliant, setting up and maintaining the drivers often requires a high level of technical expertise. In addition, writing to any billing database in this fashion can destroy its integrity and corrupt it beyond salvaging if done improperly. Writing back to a billing database using ODBC is not recommended unless you really, really know what you are doing. Even then it can be dangerous.

2) Medisoft Ports- Medical Software & Services has automated port utilities to import or export data into or out of the Medisoft database. These utilities allow us to import data from a standard comma delimited ASCII format into Medisoft. If you wish to migrate your data from another billing system to Medisoft call us for more information. If you believe that you have outgrown Medisoft and want to migrate your data to another system we can help you with that.

3) Medisoft Data Conversion– The technicians at Medical Software & Services have been reading and writing directly to the NDCHealth billing softwares and other databases for over ten years. Our programmers have years of experience in manipulating data and reading and writing data to billing systems.

Because it is difficult to be expert at every billing system on the market (there are thousands) we also have arrangements with contractors that specialize in many of the other popular billing systems on the market.

This is an EASY solution because Medical Software Tools handles the conversion for you. Normally, we do a trial conversion for you before you have to pay the full cost so that you can see for yourself that the data has been converted satisfactorily. In addition, Medical Software & Services and its contractors have already done conversions on a variety of Medical Billing Softwares and Electronic Medical Records systems so in many cases the conversion can be performed very quickly.

Who owns the data? Certainly medical data belongs to the patient, but when a medical provider renders services that data should be accessible to the provider. Don’t be held hostage by vendors. Choose wisely; it really is “your” data!

Mark Beans, MCSE, MCP+I
Medical Software Tools
http://MedicalSoftwareTools.com/