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20 pts.
 3rd party billing vs built-in EMR
When building an EMR, better to build your own billing system or integrate with 3rd party?
ASKED: April 19, 2010  2:46 PM
UPDATED: June 24, 2010  3:55 am

Answer Wiki:
Neither :) My first recommendation would be an electronixc health system that includes practice management, billing, and clinical functionality. I realize that there are only a few vendors today that can offer such an integrated system and the higher price point may be more than what a small or mid size practice or hospital can swallow. Think about it this way: You need some integration between clinical and billing systems anyways. The most logical and easiest way is to have them integrated right out of the box. Everything else requires electronic interfaces and data communication that add to the cost of the implementation and can potentially limit functionality (because you're always settling on the capabilities of the weakest link in the chain). Best Regards, Florian Twitter: <a href="http://twitter.com/florianbecker">@florianbecker</a> Blog: <a href="http://searchhealthit.techtarget.com/healthitexchange/virtualizationpulse/">Virtualization Pulse</a> Considering that both suggested answers are right, one has to look into where should your resources be inverted into. From a business stand point the biggest moving target we can strongly predict is the EHR peice. In most cases the PMS has not seen a major adjustments. I have worked with client still using very succesffuly legacy systems and their AR is incredible. I do agree that there are probably some nice additions (auto posting, elegibility check, claim adjudication..), but the reality is that the resources you will need to put toward recreating something that maynot really give you the edge over a competitor because most billing systems have the same base functionality. But if you can acquire another company (There are plenty of examples out there to review), you will be able to continue to focus your current resources and talent into adding functionality and benifits to your EHR to ensure that it contains enough differantiators to compete with. As stated in this discussion, sometimes large volume of transactions a day may create some performance and interfacing issues, and rightfully so that should be a concern. It is also important to recognize that many vendors have been able to overcome some of those challanges but making interface/intergration adjustments to the system to overcome that.
Last Wiki Answer Submitted:  June 24, 2010  3:55 am  by  FlorianB   195 pts.
All Answer Wiki Contributors:  FlorianB   195 pts.
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It depends – it’s typical build vs buy decision, you have to consider lots of parameters.
I’ll give some more details, that may help you decide to build or go with 3rd party.

If your transaction volume is higher than 10,000 /day it is better to go with your own. Building your own will change the business model also. You have to maintain few staff members to look after the solution. The regulation changes the rules every 3 to 6 months.So, you have to change the rule engine and update with the latest regulation. This is the pain point.

In case you have less transaction volume, you have to do a financial calculation – as the 3rd party billing vendors charge by transactions and the total cost / year becomes high – if you can bargain, that may tilt the balance.

 200 pts.

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