9 Questions to Ask a Potential Billing Software Vendor

The consumer landscape has changed drastically over the last two decades, and the healthcare space is no exception. Technology has driven much of that change. The rapid pace of innovation has created a technological smorgasbord, meaning consumers can sift through dozens of products until they find the perfect match. This proliferation of options has yielded a fresh set of challenges—including the overwhelming nature of so much choice. Salespeople might be counting on you to make a quick—and not fully informed—decision in the interest of saving time. But this is not the time to be hasty; when you’re faced with a software decision that could make or break your practice’s financial health, knowing what you’re getting before you buy is a must. So, how do you protect yourself from getting suckered by a smooth sales pitch? The solution is simple: ask the right questions. Last week, I talked about pinpointing billing software software deal breakers. In this post, I’ve rounded up a list of questions you can ask a sales rep in order to suss out any deficiencies before they ever have a chance to break your heart—or your bank account.

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1. “Is it specific to rehab therapy?”

With so many medical billing programs on the market, there’s no reason to waste time and energy on an RCM system that doesn’t address the specific needs of a rehab therapy practice. Software that’s tailored to your speciality translates to fewer headaches for your biller, as it will provide built-in logic that supports therapy-specific coding—and thus, guards against claim denials. After all, your approach to caring for your patients is anything but generic—so why entrust your billing to a one-size-fits-all system?

2. “How well does it integrate with my EMR?”

As I mentioned in my last post, if your RCM software can’t communicate with your documentation platform, that’s an instant deal breaker. So, before you sign on the dotted line, make sure your billing software can integrate with your EMR. And remember: not all integrations are created equal, so dig for details. Find out how much manual data entry the end user must do. At the very least, the integration should make it possible to transmit the following information from your EMR to your billing software:

  • ICD-10 and CPT codes
  • Provider information
  • Patient demographics
  • Patient payments
  • Insurance profiles
  • Referring physicians

3. “What kind of reporting capabilities does it have?”

When an RCM program boasts robust reporting features, it gives the consumer a major business advantage. At minimum, a billing platform should allow you to easily and efficiently track any and all cash flow that cycles through your practice, from A/R to patient payments. Reports should also include a wide array of filters that allow you to gain insight on specific data elements. For example, it’s one thing to keep track of payments, but you should also be able to filter payments by patient, payment method, date, or CPT code.

Catch RCM Roadblocks

Additionally, any system you choose for your practice should have built-in reporting tools that make self-auditing a breeze—and help you catch inefficiencies in your practice (like lost patients and cancellations).

Stay Secure

Speaking of self-auditing, a HIPAA-compliant audit log is an absolute must. Not only will it help you ensure the safety of your patient’s private information, but it will also keep you covered in the event of a security incident.

Get Customized

Every practice is unique, and no RCM platform can anticipate every single user’s needs. So, to ensure you get the most out of your billing data, your software should allow you to create custom reports.

4. “Can it verify insurance eligibility and benefits?”

While this is still a relatively new function, many billing systems now offer the ability to verify benefits directly within the framework the program. This feature allows you to check eligibility in real time, instead of spending valuable time on the phone with the insurance company.

5. “Can it keep up with industry changes?”

Let’s face it: when it comes to health care, the rules of the game never stop changing. Whether it be the industry-wide transition from ICD-9 to ICD-10, the implementation of new eval CPT codes, or the introduction of MIPS, health care is constantly evolving. If your RCM system can’t adapt to these changes, you can bet it’ll go the way of the dinosaurs. And when that happens, you’ll be back to shopping for a new billing platform.

6. “Will it keep up with my growing practice?”

As with any strong partnership, your business and your software should grow together. If you have more than one practice—or you’re thinking about opening up additional locations—be sure your billing software can support multiple tax IDs. Verify that the program can maintain its speed and usability as you enter more and more data. Find out the size of the vendor’s average customer, and ask for case studies or testimonials from practices of all different sizes. That way, you can be sure it’ll function optimally no matter how big your business gets.

7. “How often do updates occur?”

Security is one of the main reasons so many practices turn to tech for their data storage needs. Regular software updates are vital to ensuring the safety of your sensitive patient data. In addition to adding safeguards that protect against cybersecurity threats, many updates are implemented to maintain—or increase—system speed, prevent crashes, and catch software bugs before they bigger issues. When you ask about the regularity of program updates, you should also confirm that the company notifies its customers of any downtime in advance.

8. “Do you offer training for new customers?”

When you make a commitment as weighty as implementing a new software, you want to make sure you—and the individual handling your cash flow—actually know how it works. Otherwise, you’ll end up saddled with a big expense that’ll never pay off. Find out how many training sessions you’ll get, and be wary of hidden fees for initial training services. The cost of new-customer training should be included in your initial setup amount. If that’s not the case, you can be sure training fees won’t be the only surprise expense.

9. “Is there an extra cost for tech support?”

Some companies offer minimal tech support—or no support at all—unless you’re willing to pay extra. I don’t know about you, but when I have to shell out extra money for a service that should be free in the first place, I start to wonder if the company even cares about me as a customer. Ultimately, your success with the software is directly tied to the success of the company that develops it. So, a company offering free resources to ensure your success is truly a no-brainer. On the flipside, if the company expects you to pay for access to these resources, that’s a concern.

It’s one thing to buy a new jacket without trying it on first, but buying a software for your therapy practice is a whole different ballgame. Savvy consumers know a sales demo should never be a one-sided conversation. It’s an opportunity to ask questions and investigate whether the system is truly a good fit for your practice. And asking the right questions will empower you to get the most out of whatever billing software you choose


Still wondering how to find the right system for your practice? Download your free copy of the Physical Therapy Software Buyer’s Guide for more information on software must-haves and tips for making your transition to a new platform as seamless as possible.


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