I don’t know about you, but for me, it’s hard to put a price on a good cup of coffee. For some, it’s not merely a beverage to be sipped with eggs and toast—it’s an integral part of a morning ritual. For these folks, the difference between a stellar cup of joe and a subpar one can mean the difference between a productive day and one they struggle to push through.

Much like a hot cup of java can make or break a coffee aficionado’s mood, a billing system can make or break a practice’s productivity. It’s the backbone of your revenue cycle management (RCM) process—so if it doesn’t fit with your practice, it can cause serious damage to your billing cycle. But, tracking down the right system doesn’t have to be a guessing game. To avoid a devastating blow to your bottom line, consider these RCM software deal breakers as you shop around for the right solution.

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1. Integrating with your EMR is out of the question.

Let’s say you’ve found it—after months of weighing your options, you’ve finally settled on a billing program for your practice, and it seems like the perfect fit for your needs. There’s just one problem: it doesn’t integrate with your documentation system.

This should be an immediate red flag. Using a billing software that doesn’t connect to your documentation platform not only puts your practice’s current success in jeopardy, but also hinders your ability to hop on the interoperability train in the future. When you have integrated RCM and EMR solutions, on the other hand, it helps streamline communication between providers and billers, thus eliminating the risk of costly data-entry oversights.

2. It isn’t tailored to the needs of your region or specialty.

What a world it would be if billing rules were the same for all specialties in all states! Unfortunately, this is far from reality, but does your RCM system know that? Your billing software should be able to assess and adapt to your needs, whether that be the inclusion of a regional Medicare fee schedule or customized reporting modules. You’ve chosen your specialty because health care isn’t “one size fits all,”and your billing software shouldn’t be, either.

3. The reporting functionality leaves something to be desired.

If you frequently find yourself having to crunch numbers manually, that’s not a great sign. Any RCM solution worth its salt—and your business—should offer robust reporting capabilities. Speaking of reports, here are some things to consider:

  • Are they easy to use?
  • Can they be customized?
  • Do they help you catch RCM issues before they snowball into RCM crises?

Whether you’re looking for info on aging claims, A/R, or payment averages, there’s a whole lot of data churning through your billing software. And you should be able to use it to your practice’s advantage.

4. It struggles to keep up with compliance changes.

Maybe your billing software isn’t perfect—but at least it keeps up with major compliance changes, right? If not, then Houston, we have a problem. Between the industry-wide push toward a pay-per-performance payment environment, constantly changing Medicare requirements, and the introduction of MIPS, the healthcare landscape is always evolving—and your software should be on the same evolutionary path. If it’s not, you can expect to receive denials and rejections for minor things your software should definitely catch in the first place.

5. The lack of training leaves you out in the cold.

So, your new RCM software has all kinds of bells and whistles—hey, maybe it even integrates with your EMR! Having a ton of cool features is great, but how useful will they be if you don’t know how to use them? That’s where training enters the equation.

During your initial foray into a new RCM system—or any new software, for that matter—having a helping hand to onboard your practice can make a huge difference. Instead of leaving you to muddle your way through vague user guides or dry, outdated training videos, the company you’ve chosen to work with should be eager to guide you through the setup process. Afterall, your RCM vendor’s success is dependant on your success.

6. The help articles are anything but helpful.

After digging into all the learning materials, you’ve managed to get a grasp on your new software’s features, and you’re shipping out HCFA forms like a lean, mean, claim-generating machine. But, learning a new program is an ongoing process, and you’re bound to hit a bump in the road at some point or another. So, it’s comforting to know you’ve got a go-to resource when you need one. And while your software company should definitely offer free phone and email support, the real key to minimizing the impact of any software hiccups is a robust—and well organized—knowledge base. After all, your day is busy enough without having to spend time chatting with a support rep. When finding a solution to your issue is as easy as Googling “Chinese food near me,” you’ll be back up and running in a flash.

7. The support is lackluster.

If and when you do need to speak to a real human, you want the voice on the other end of the line to be knowledgeable and friendly—and you shouldn’t have to pay extra for it. If you dread reaching out to your billing software’s technical support team—or the cost of assistance comes at a premium—it might be time to reconsider your options.


As any coffee addict knows, it’s easy to throw out a bad brew and replace it with one you know and love. But, if your billing system is throwing a wrench in your business processes, switching to a new software isn’t quite as easy as hitting up the next closest café. While many systems may claim to be the best solution to your billing quandaries, a good portion of them are likely guilty of one or more of these system shortcomings.

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