Electronic Data Interchange (EDI)
Enrollment
Guidelines
- Provider Guidelines for choosing a vendor
- Vendor Selection
- Evaluating Proposals
- Negotiating with Vendors
Provider Guidelines for Choosing a Vendor
Before selecting a vendor, you must examine your business needs to identify the services needed from a vendor. Consider what services you want to provide from internal operations and what services you wish provided by a vendor.
To receive better vendor proposals, create a written description of components of your practice that need vendor support and a description of a support needed. Requirements to consider include the following:
- Future growth of the practice
- Workload
- Payer analysis
- Referral tracking
- Fee schedules
- Appointment scheduling
- Medical records
- Interconnections with physicians/hospitals and other networks
- Word processing needs
- Electronic billing (formats and versions supported)
- HIPAA compliance
- Multiple practices/locations
- High volume/low volume billing
- Specific bill types
- Management reporting
- Hardware/software requirements/compatibility with existing equipment
- Data storage needs
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Vendor Selection
Once you have determined your goals and requirements, begin the vendor selection process. Selecting a vendor must be as objective and quantitative as possible. Areas to be evaluated should include technical functionality, flexibility, and customer service.
These steps may be used as guidelines for providers to start the vendor selection process:
| A. | Develop a list of potential vendors: Ask other providers of comparable size/specialties: what vendors they use for what services how satisfied they are Ask a consultant Attend standards conferences Follow trade magazines Investigate Web pages |
| B. | Call or write the vendors selected/recommended to discuss the organization’s needs and request a proposal. |
| C. | Tell the vendors how the proposals should be structured so that the various proposals can be more easily compared. |
| D. | Attend demonstrations of at least 2-3 vendors and pay close attention to: How individual requirements will be met? Ease of understanding Ease of features – data entry, search features, editing/compliance-checking features, help features, error correction features. Security disaster recovery plans, controls and audits Daily procedures Reporting/Tracking features |
| E. | Check vendor references and ask specific questions such as: How long has the business been in operation? How long has the system been in place? What is the quality of the training and ongoing support: Is there a user’s group in place? What formats are used/supported? Have you experienced any problems with the system? Have you experienced any problems with the vendor? How long it takes to get up and running? Are you happy with the system/vendor and would you recommend it/them today? Is there anything else I should know or ask before making my decision? |
| F. | Make site visits to the vendor as well as other clients of similar size and bill mix that has been running the system for some time. |
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Evaluating Proposals
Vendor proposals should be evaluated on several levels including company reputation/history, system functionality, flexibility, overall costs, and support provided.
Providers should create a checklist that compares the vendor proposals against their original requirements by assigning a relative weight to each requirement and then rating the vendor’s ability to meet each requirement based on their written proposals. Although some aspects of each checklist will be highly individual, the following are some of the elements that should be considered:
OVERALL COST:
- Software cost
- Hardware cost (types as well as quality)
- Licensing fees
- Training cost
- Installation costs
- Upgrade Charge
- Cabling
- Phone Lines (leased line/toll charges)
- Remodeling/Furniture
- Forms
- Conversion costs
- Electricity costs
- Supply costs (diskettes, CD’s, tapes, paper, and printer ink)
- Annual hardware maintenance
- Annual software maintenance
- Cost of custom program changes
- Cost of continuous software support
- Evaluate hardware differences
- Evaluate quality of training and support
- Evaluate system documentation
- Consider the staff size of the vendor
Determine overall system convenience including hours of customer service, technical support and connection times.
Assess future risks and the vendor mitigation of such risks through system trial periods and source codes placed in escrow
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Negotiating with vendors
Once a vendor has been selected, the provider must negotiate the final costs, services, and implementation dates to be provided by the vendor. All agreements reached between the two parties should be obtained in writing.
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