Many of you, and many EMR companies, have asked us for our recommendation for EMR or practice management software. We are also often asked which integrated system we prefer (an all-in-one system that has all the practice management functions plus EMR). We have spent several years now experiencing different platforms and products, and asking for demonstrations from various companies.

What is the difference between practice management systems and EMRs? Practice management programs typically include functions like scheduling, billing, claims processing, and claims tracking. They work with a clearinghouse to send your electronic claims. On the other hand, EMRs automate the documentation, storage and retrieval of patient records.

Obviously, our top choice for practice management software is CollaborateMD, which is why we continue to use it year after year. If customers come to us with a different preferred program, we are happy to work in their software as well.

Unfortunately, we have not yet found an EMR that we feel we can reasonably recommend. This is mostly because we work with such a diverse group of providers and practices. Some of you are required to utilize electronic charting; some are not, but enjoy the convenience of these programs.

Because of your diverse needs, we are committed to working within whichever EMR or practice management system you choose to use. There are nearly limitless choices, and LBS can work with you in any of them.

A warning about integrated systems: There are all-in-one programs out there that charge a percentage and promise billing and follow-up along with the use of their software. Please be careful! These programs offer very little in the way of customer service, and what they don’t tell you is that you still need to have in-house staff or a billing service doing your billing, coding, and follow-up.

Here are some helpful tips when choosing an EMR:

  • Consider your growth potential. For example, if you do (or you think you may in the future) accept Medicaid or Medicare clients, then invest in a system that is approved by CMS for this purpose. It is difficult enough to navigate those governmental systems; don’t put yourself through learning a new charting system at the same time!
  • Consider your budget. There are products that range from free to thousands of dollars; they generally accomplish the same things, but some are more specialized than others, and some simply look a little better than others.
  • Consider security. HIPAA and HITECH security is an absolute must in any system. If you have a web-based program, what do they offer you for security? Does their agreement completely indemnify them? If so, that’s not good for you. Do they have a significant amount of documentation and paperwork explaining how they secure your clients’ Protected Health Information? Are they willing to sign a Business Associate Agreement to share liability in the case of a breach?
  • Consider data. What happens to your chart info (which you are required to store for 50 YEARS after the death of the patient) if you leave the company or change programs? Will you have to pay to get your data? In what format can you receive it?
  • Consider ease of use and access points. Do you have to pay per computer or ISP that accesses the system? Do you have to pay extra per staff/user? Do they offer training to you and your staff? Can you easily train new staff how to use the system once established? If the system is not web-based, then how will you submit electronic chart notes, and how will your biller access the system? If the EMR downloads to your phone or iPad, what happens if you lose it? Is there a process from the program provider to clear your device for you and absolutely prevent the loss of Protected Health Information?
  • Consider billing functions. EMRs do not send out insurance billing. They can produce an invoice and/or a superbill, but you must still have a practice management software program (like CollaborateMD) to actually submit and track your claims. EMRs can automate or support your responsibility to choose codes and set pricing, but they do not replace the work of a biller or billing service to properly submit those codes to insurance payers, nor do they indicate processing information or collect payment.
  • Consider benefits functions. Some EMRs have the ability to ‘check benefits’. Our billing software also has this function, and for a few cents a one-line report comes back usually stating the general in-network percentage and deductible. These automated reports will not tell you anything about out-of-hospital birth coverage, midwifery coverage, newborn claims coverage under the mother, preventative services covered under the Affordable Care Act, out-of-network coverage, family deductibles etc. We have found that they are rarely useful to our customers at all.

As with so many issues in our industry, we sincerely wish that the answer was simple. It costs close to one million dollars to create a decent EMR (which is why we haven’t built our own), so they are often just not specialized enough to meet your every need. And some of those that seem the most user-friendly have fatal flaws in the way of security.
That being said; Collaborate MD has a list of EMRs with which they are able to interface. This could create for you the most seamless charting-to-billing system, and it is assured that with those options, CMD has done some of the work for you in regard to HIPAA, HITECH, access and billing.

You can access this list at

Questions about EMRs, billing tools, and how LBS can work within your chosen system can be posted in the comments section right here on our blog. We will respond to you!