Practice Management System Vendor Survey Please check the appropriate boxes below to indicate whether your practice management system offering provides the following criteria as a standard or optional feature or does not provide that feature. Complete a separate vendor survey for each product offering. You can place additional clarifying comments or dates when an upgrade will become available in the comment section following each of the criteria. Please ensure the accuracy of the information provided. Any company that provides inaccurate information may be withdrawn from consideration. S = Standard

S O NP

O = Optional

NP = Does Not Provide

Appointment scheduling

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Appointment scheduling system permitting “double booking”

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Resource scheduling, such as procedure rooms

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Patient reminder notices

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Basic patient information)

registration

(including

demographic

and

insurance

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Electronic health identification card reader interface

Comments: ____________________________________________________________________________ ____________________________________________________________________________ RFP NO. 2015-144 – ATTACHMENT C Page 1 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Maintain patient insurance eligibility verification information

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to generate, send and receive batch eligibility requests and responses from payers using: S O NP

HIPAA ASC X12N 005010 A1 270 and 271

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to generate, send and receive real-time or nearly real-time eligibility requests and responses from payers using: S O NP

HIPAA ASC X12N 005010 A1 270 and 271

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Council for Affordable Quality Healthcare (CAQH) Committee for Operating Rules of Information Exchange (CORE) Phase 1 certified

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

CAQH CORE Phase 2 certified

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 2 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

Claims Management S O NP

Claims generation using the CMS 1500 claim form

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Batch claims generation using the CMS 1500 claim form

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Claims generation using the UB 04 claim form

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Batch claims generation using the UB 04

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to generate and send batch claims processing using: S O NP

HIPAA ASC X12N 005010 A1 837P

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to receive and process batch claims acknowledgments using: S O NP

ASC X12N 005010 277CA

S O NP

ASC X12N 005010 999

S O NP

Proprietary claim acknowledgments

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 3 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

Ability to generate real-time or nearly real-time electronic claims submission using: S O NP

HIPAA ASC X12N 005010 A1 837P

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to receive and process real-time or nearly real-time electronic claims submission acknowledgments using: S O NP

ASC X12N 005010 277CA

S O NP

ASC X12N 005010 999

S O NP

HIPAA ASC X12N 005010 835

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Manual referral and authorization management

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to send real-time or nearly real-time claim acknowledgments using: S O NP

123

ASC X12N 005010 277CA

S O NP

123

ASC X12 005010 999

S O NP

1 2 3 HIPAA ASC X12N 005010 835 response

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to generate, send and receive batch referral and authorization management requests to and responses from payers using: S O NP

HIPAA ASC X12N 005010 278

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 4 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

Ability to generate, send and receive real-time or nearly real-time referral and authorization management requests to and responses from payers using: S O NP

HIPAA ASC X12N 005010 278

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Maintain list of referring physicians

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Maintain list of referring laboratories and testing facilities

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Maintain list of local hospitals

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Claims scrubbing for Current Procedural Terminology (CPT®) format compliance

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Maintain list of payers including individual payer products and associated contracted fee schedules

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Automatic upload of multiple payer fee schedules by product type

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 5 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

Ability to generate, send and receive batch claim status inquiry and response from payers using the standard transaction: S O NP

HIPAA ASC X12N 005010 276 and 277

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to generate and receive real-time or near real-time claim status inquiry and response from payers using the standard transaction: S O NP

HIPAA ASC X12N 005010 276 and 277

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to generate and send claims attachments to payers using: S O NP

HIPAA ASC X12N 005010 275

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to receive and process claims attachments requests from payers using: S O NP

HIPPA ASC X12N 005010 277

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Ability to generate and send first report of injury to payers using: S O NP

HIPAA ASC X12N 005010 148

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 6 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

Clinical Documentation and Interface S O NP

Patient summary generation: paper

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Patient summary generation: electronic (e.g., CD-ROM, USB drive)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

HL7 electronic lab interface

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

EHR interface

Comments: ____________________________________________________________________________ ____________________________________________________________________________

Billing and Collections Ability to receive batch claim payment/remittance advice using: S O NP

HIPAA ASC X12N 005010 A1 835

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Maintain physician practice retail fee schedule (charge entry)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Creation of finance charge for claims in the system (should be able to apply finance charges automatically to overdue patient balances from the finance charge configuration window)

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 7 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Manual payment posting and reconciliation of paper explanation of benefits (EOB)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Manual payment posting and reconciliation of electronic remittance advice

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Automatic payment posting and reconciliation of electronic remittance advice: S O NP

HIPAA ASC X12N 005010 835

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Patient financial statement generation

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Printing practice’s patient financial statements and other correspondence

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Generating and e-mailing encrypted practice patient financial statements and other correspondence

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Interface with third-party patient statement printing companies

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 8 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Generation of claims aging reports

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Printing of encounter-specific superbills

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Integrated credit card processing

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Scanning of superbills

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Automatic upload of guarantor statements

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Patient encounter reconciliation

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Patient collection tools

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Recording and posting of claims payments, refunds and adjustments

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 9 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Maintain payer and product-specific claim edits and payment rules

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Ability to define payer specific automatic payment posting and reconciliation exceptions for electronic remittance advice

Comments: ____________________________________________________________________________ ____________________________________________________________________________ Electronic funds transfer and electronic remittance advice management using: S O NP

HIPAA ASC X12N 005010 835

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Management of rejected claims

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Automatic posting of capitation payments

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Automated posting of performance bonus (e.g., PQRI, gain sharing, ePrescribing)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Automated posting of bundled payments

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 10 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Automated claims appeals process

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP Automated tracking of overpayment recovery by health plans Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Manual entry of overpayment recovery notification letter information

Comments: ____________________________________________________________________________ ____________________________________________________________________________

Reporting S O NP

Extraction of detailed data on practice financial performance and financial histories

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Extraction of detailed data on practice patient financial histories

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Basic reporting (predefined, such as: claim age by payer, days in accounts receivable by payer, collection percentage by payer, open slots for appointments by provider by location)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Data dictionary available to licensee

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 11 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Financial decision support module

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Database is open database compliant (ODBC)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

End-user customizable reporting

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

End-user customizable dashboard templates

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP End-user ad-hoc query reporting Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Ability to interface with business intelligence software tools that create reports and analytics

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Advanced reporting (e.g., dashboard in real-time or nearly real-time)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Ability to save reports in Microsoft_______________________________

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 12 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Reports automatically generated in Microsoft Excel

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Non-proprietary open relational database (e.g., Oracle_______________

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Non-proprietary open connectivity with any clearinghouse, payer or portal

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Ability to select and switch clearinghouses or other vendors with relative ease at no cost

Comments: ____________________________________________________________________________ ____________________________________________________________________________

Technical Specifications S O NP

Graphical user interface (GUI) (Microsoft Windows_________________ or DOSbased)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Integration of user interface tools such as Microsoft .Net

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

On-site client/server or remote data center host compatible (if remote data center host compatible, software has been optimized to operate as a Web service or “software as a service”)

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 13 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

Modern and widely supported relational database for the underlying data structure (e.g., Microsoft SQL Server, Oracle, MySQL®, etc.)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Open interface to receive third-party patient registration data (kiosk, tablet, etc.)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Role-based and facility-based security (e.g., secure passwords, audit logs, etc.)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Ability to encrypt either the entire database or protected health information without system performance compromise

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Data back-up/disaster recovery system that meets the HIPAA Security Rule requirements

Comments: ____________________________________________________________________________ ____________________________________________________________________________

Vendor Support S O NP

Installation cost included (e.g., cabling, labor and travel, if applicable)

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Initial and ongoing staff training for upgrades and features included

Comments: ____________________________________________________________________________ ____________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 14 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.

S O NP

After-hours or emergency vendor service hotline included

Comments: ____________________________________________________________________________ ___________________________________________________________________________ S O NP

Notification about new upgrades and services and installation of new upgrades and services to comply with all federal and state mandates and with the HIPAA Privacy and Security Rules and the HIPAA Transactions and Code Sets Rule

Comments: ____________________________________________________________________________ ____________________________________________________________________________ S O NP

Transition to current or new clearinghouse, as needed

Comments: ____________________________________________________________________________ ___________________________________________________________________________

RFP NO. 2015-144 – ATTACHMENT C Page 15 This resource was developed through a cooperative effort between the American Medical Association and the Medical Group Management Association. Copyright 2010–2013 American Medical Association. All rights reserved.