Medical Practice Management Software

• Appointment scheduling dashboard with configurable presets for different specialties and patient groups, adjustable time increments, tags, color coding, and other customizations.
• Scheduling appointments across multiple locations.
• Flagging appointment conflicts.
• Real-time waiting lists to fill up canceled slots.
• AI-powered recommendations for appointment dates and times to improve schedule utilization.
• Sending automated appointment reminders (via SMS, email, voice messages, or messengers according to a patient’s preference).

• Template-based and custom intake forms for patient demographic data, essential medical information, and insurance details.
• Sending requests to insurers' systems to verify patient eligibility and benefits.
• Sending automated prior authorization requests for medical procedures to insurers and tracking the status of requests.
• Generation of explanations of benefits (EOB) and estimation of out-of-pocket costs (copays, deductibles, or coinsurance).

• A workspace for medical coders to assign and verify medical codes for diagnoses and procedures (according to ICD, CPT, and HCPCS).
• Automatic extraction of diagnoses and procedures from medical records.
• Search for codes across an electronic catalog of specialty-related medical coding standards.
• Automated updating of the standards to the latest versions.
• Smart search capabilities, including autocorrection of misspelled words and search by different parameters and keywords (e.g., by specialty, diagnosis, number, abbreviation, acronym).
• Built-in automatic code error checks.
• Rule-based or AI-powered automated coding suggestions for diagnoses and procedures.
• Tracking assigned medical codes as well as all the changes made to them and generating relevant reports for coding compliance audits.

• Claim generation based on medical codes and auto-population of claims with data from patient profiles and invoices.
• Automatic claim scrubbing against payer-specific rules and clearinghouse standards to reduce denials.
• Claim status tracking and alerting staff when follow-ups are needed (e.g., providing additional information).
• Claim denial prioritization based on claim value and urgency, plus categorization by denial reason (e.g., medical necessity issues, non-covered services, or lack of prior authorization).
• Automatic assignment of tasks related to managing claim denials to the responsible staff.
• Template-based appeal generation.
• Payment tracking and reconciliation.
• Automated staff notifications on outstanding balances, payment due dates, and overdue payments.
• Automated patient billing with options for e-statements, payments via patient portals, and installment plans.

• Financial analytics: tracking revenue and profitability metrics, claim rejections, denials, and reimbursement rates.
• Operational analytics: tracking patient flow, provider workload, workflow efficiency, staff productivity, and utilization of facilities and resources.
• Patient engagement and satisfaction analytics: survey-based satisfaction scores and rates for overdue payments, canceled visits, no-shows, skipped medical procedures, etc.
• Dashboards supporting data filtering (e.g., by period, patient group, insurer), drilling up and down, and ad hoc and scheduled report generation.

Advanced analytics powered by AI and machine learning:

• Revenue cycle forecasting: predicting future revenue, reimbursement timelines, and potential cash flow issues based on billing patterns, payment cycles, claim denials, and payer contracts.
• Operational optimization: identifying bottlenecks in patient throughput and suggesting optimal appointment schedules, staffing levels, and room assignments to enhance efficiency.
• Fraud detection: flagging suspicious billing practices, such as upcoding, unnecessary testing, or billing for no-shows and undocumented treatments.

(Available via a patient portal or a mobile app)

• Access to personal data, visit history, lab results, and physician recommendations via the app.
• Independent appointment scheduling for patients.
• Uploading insurance and identification information via a personal profile in the app.
• Appointment registration forms with auto-population of fields with patient data that is already in the system.
• Pre-visit screening questionnaires with electronic signing of consent forms and privacy notices.
• Notifications on completing different steps of online pre-visit registration (e.g., validation of patient registration data, appointment confirmation).
• Contactless check-in when a patient arrives for an appointment.
• Paying bills online and linking payment cards for quick out-of-pocket payments during or after visits.
• Enabling automatic billing, customizing payment amounts, and setting repayment periods.
• Requesting prescription refills.

Advanced:

• An AI chatbot for patient assistance (FAQs, scheduling), with an option to contact healthcare facility staff directly.

• Role-based access controls and action permissions for healthcare practice executives, physicians, medical coders, admins, etc.
• Multi-factor authentication (MFA).
• Encryption of all data at rest and in transit.
• Audit trail mechanisms for recording all user activities.
• Compliance with patient data privacy regulations (HIPAA, HITECH, GDPR) and payment security standards (PCI DSS).