Practice Management PC Software: QuicDoc® and Office Therapy™1
If I were to take a survey of mental health professionals and ask, “Name the two aspects of clinical practice you dislike the most,” I would guess that there would be a high degree of consistency across respondents. I would be surprised if the overwhelming answers were not: documentation and billing.
Having been in practice since 1979, I still vividly remember the time-consuming process of billing and filing insurance claims! It would take days for insurance claims to be types, reviewed, signed, and finally mailed, and there was an equally demanding ordeal associated with the monthly client billing process. Fortunately, personal computers (PCs) were on the horizon and today, practitioners can choose between many excellent computer-assisted billing and documentation programs.
First, let me address documentation programs. In March of 1998, I made the decision to leave group practice in favor of “going solo.” Perhaps one of the occupational hazards associated with being a mental health practitioner is that we may be acutely aware of our shortcomings, and I knew that my documentation procedures could use some work. While in group practice, I had relied on the hand written process note, or variations of the SOAP (subjective, objective, assessment, plan) or BIRP (behavior, intervention, response, plan) notes. Being actively involved in ethics and ethics education, I recognized that my documentation might not represent what I consider to be risk managed documentation. (For more on this topic, visit the “Members Section” of the Division 42 [Independent Practice] website where you will find many articles on documentation. Also, Gordon Herz, PhD, and I have recently written a book on risk managed documentation scheduled for release early in 2003 to be published by Professional Resource Press, www.prpress.com.) In fact, I remember giving a deposition and having trouble reading my notes, just one element that motivated me to find a documentation program!
I spent months looking for and using demos of documentation programs, none of which were, in my opinion, comprehensive. That is, I wanted a program that would not only generate a progress note, but would include a method of creating a detailed intake note, would generate those dreaded Outpatient Treatment Reports (OTRs) for insurance and managed care companies, would allow me to quickly, yet thoroughly, document missed appointments, telephone calls, and so on, and would save me time. And, I wanted a program that I could use to schedule appointments and keep track of my daily activities.
Beginning to believe that what I wanted did not exist, I remembered an old DOS based program that I had used, and in my search, learned that the psychologist developer of this program had designed a Windows-based documentation program and had started his own company, DocuTrac, Inc. (DTI; www.quicdoc.com). After using the demo program for a week or so, I took the plunge and purchased QuicDoc, and I am happy to say that was probably one of the best decisions I made as I started solo practice.
I wanted a program that would guide me through the intake documentation process, make creating subsequent progress notes a snap, and could generate treatment plans if needed for our friends in managed care or for some other reason. When in group practice I would take notes in the first session, and then dictate my initial evaluation. Having now learned so much more about risk managed documentation, I know today that even those dictated notes did not include the degree of information that can facilitate treatment if the client returns for treatment in the future, sees another therapist who requests information, and can protect a clinician in the event problems arise (e.g., complaints before licensing boards, ethics committees, or lawsuits). Using QuicDoc, the initial evaluation/intake report is far more comprehensive, and it honestly takes me much less time to enter the information into QuicDoc after the first meeting, generate the report, edit the report as needed, and print the final product than it did when I would dictate!
Doing progress notes takes less than 5 minutes to generate a note that covers session content, characteristics such as motivation, resistance, activity level, interventions used, response to interventions, “homework” assigned, the plan for future visits, and other information. There is incredible flexibility with the program so clinicians can add their own interventions, problems, and goals that are consistent with their orientation, approach, etc. And, all my notes are now legible!
Can’t print appointment for clients using a billing program? No problem with QuicDoc. When I first got the program and realized I could not print appointments, I called DocuTrac, an adjustment was made, and the fix was available and e-mailed to me soon after so I could print appointments! That’s service after the sale, and something that has consistently impressed me about the staff of DocuTrac, Inc. The scheduler within QuicDoc is highly refined, and users can find appointment slots, print daily or weekly schedules, and print appointments for clients.
Another very handy feature is the ability to track continuing education requirements. Once CEUs are completed, this information can be added allowing ready access to the number of hours completed and the remaining hours needed in order to complete the yearly requirements.
One of the biggest annoyances when dealing with insurance companies and managed care companies (MCOs) is generating the required treatment plans. Built into QuicDoc is a component called QuicForms™. Enter the necessary information when doing the initial intake, and then QuicDoc intelligently fills in your treatment plan form. Most of the major MCO forms are included. The software prints both the form and the data. (If a treatment plan form is not included, DocuTrac encourages providers to send a copy so one can be developed and posted online.) While I have developed my own treatment plan formats using ScanSoft’s OmniForm 5.0™, when I did use QuicForms, I was impressed. The ability to generate a quick treatment plan is also nice if you are about to speak with a MCO reviewer. You can “wow” them with your thorough approach, and of course get lots of referrals from them in the future - just kidding.
Another impressive feature is the report capability within QuicDoc. Reports can be generated that cover quality assessment, diagnoses, contact hours, medications, etc. Outcome measures and satisfaction scales are also included, and these can be printed for clients to complete, and these data are then entered into QuicDoc to track progress. If these scales are used on a routine basis, any questions asked about outcome, satisfaction, etc., can likely be answered after clicking on a few buttons.
If one prefers, there is the option of using the SOAP format for progress notes. The intake note includes one of the most comprehensive psychosocial histories I have seen in a program which is especially helpful for child clinical psychologists. The chances of overlooking important areas in the treatment/intake documentation process such as risk factors are minimized if the clinician follows the logically based process included in QuicDoc.
When using the built-in word processor, there is mail merge feature which can be very handy. One day when I had some cancellations and no shows, and I used this feature to create a “Happy New Year” and follow-up letter for some of the clients I had not seen in some time. To create and generate the letters (about 30) only took 15 minutes. The letters then resulted in several clients calling to schedule “booster sessions” which almost covered the purchase price of the version I bought in 1998. Now that’s return on investment!
QuicDoc also offers “add-ons” including the Lexi-Comp Drug Reference Database.™ This valuable tool allows me to click on the Lexi-Comp icon and pull up current information on over 4000 medications a client may be taking.
While a clinical information/documentation program was high on my list, I also needed a billing program since I had no intention of typing insurance forms, statements, and so on. Initially, I selected Therapist Helper (www.helper.com) and was very pleased with the program (for more information, see the other review I wrote in this section of the Division 42 website:TherHelpQDoc.html. However, one of my fantasies was to be able to use a software program that provided seamless integration between billing and documentation, and some dreams actually come true! In 2002, DTI added to its product line, Office Therapy, a comprehensive billing program, and included some integration with QuicDoc with the plan to eventually have the two fully merged. But, regardless of the degree of integration of these programs, billing software needs certain features. From my perspective, billing programs should allow clinicians to work smarter, not harder. Ease of use should be a top priority with a logical process of entering new client information, insurance information, charges, payments, and learning to use the program should be easy and straightforward. Next, the actual process of generating insurance claims should be simple and require minimal time. Also important, is the ability to generate needed reports, such as demographic information about clients, referral statistics, and financial data such as clients with outstanding balances, insurance companies who have not paid, and so on. The program should also be affordable. And as already mentioned, if a client information, treatment planning, and/or documentation program is used, information should flow seamlessly between the two programs.
Office Therapy is “all that” and more. For me, one of the biggest benefits of using integrated practice management software is the ability to “work smarter.” For example, after entering client information in QuicDoc, this information is painlessly imported into Office Therapy, saving a considerable amount of time. Another highly efficient and timesaving component is the actual process of posting services, payments, and printing insurance forms and/or statements. Each morning, it takes me less than five minutes to click on “Charge Client,” and then “File Insurance.” Viola! Insurance forms are printed and ready to be placed in either left or right window envelopes (the user chooses when printing insurance forms) and mailed. Likewise posting payments and generating client statements - just point, click, print, and mail. Each month, I run an “Aging Detail” report, and then simply select the clients to whom I want to send a statement. As with the daily entry, this process is quick and easy, and takes very little time. If adjustments are applied (e.g., MCO write-offs, courtesy adjustments, etc.), Office Therapy also makes this process painless, and the reports that can be generated provide specific information on the adjustments (along with charges, client payments, insurance payments, refunds, and other important information included in the Provider Earnings reports).
The reports included are extremely powerful. I like to know exactly how much of what I did, that is, for a period of time, how many initial evaluations, individual therapy sessions, family therapy, etc. were provided. That information is provided in the Client Activity Reports. Reports can also be generated regarding referrals, payment tracking (to make sure those insurance companies are paying and those who need a friendly reminder), managed care reports (number of sessions authorized and number used), and many other useful reports. One I find particularly helpful is a “Day Sheet” which allows me to print a report for specific period of time (day, week, month), and the last page is a “deposit slip” that I can use to make sure the deposit slip that my bank requires includes all the funds (cash and checks) to be deposited. Without this report, there would have been many times that I would have included a check that was not properly entered on the bank’s deposit slip.
As with QuicDoc, Office Therapy also includes a “Perform Mail Merge” feature. Since switching to Office Therapy, I use this frequently to send follow-up letters to clients I have not seen in a while, to send past due notices, and appointment reminders (if needed). I have created many of these templates myself, and the process is easy - even for a person who rarely uses Microsoft® Word!
As noted, the integration of the two programs is a tremendous plus, even at this early stage. For example, while I am working in QuicDoc I can click on an icon and be immediately presented with the Office Therapy ledger letting me know what the outstanding balance is, if there is one. (Detailed information is available, but not who owes what, and I suspect this will be included as the integration process continues.) The import/export capabilities between the two programs also save time. As I have mentioned, it is my understanding that DTI plans to eventually have complete integration so that users are able to work within one program rather than switching back and forth between billing and documentation, and I look forward to that day.
Recently, DTI has offered an add-on for Office Therapy - Office-To-Go, a Palm application which allows users to view and update information when away from the computer.
And, what about costs? As with anything, prices change, so I encourage readers to visit www.quicdoc.com or call DocuTrac, Inc. (800-850-8510) for more information. My experience with clinical practice software has been that there is a yearly maintenance fee. In some cases, I have paid my money, and in my opinion, gotten nothing in return. One of the reasons I have always been a DTI fan (and long before I joined the team) is that “service after the sale.” The developers and staff of DocuTrac are not content to rest on their laurels. Rather, I found that for both products frequent updates or upgrades are offered. If there are any “bugs” (and frankly I haven’t found but one in over five years), they are fixed almost immediately, and the staff is always open to ideas for improvement and these suggestions are often incorporated in future updates. And what if there are problems using the software? From my experience, the technical support available from DTI is excellent, and there is also a forum (www.quicdoc.com/Forums) in which questions, ideas, etc. can be posted, and if answers are needed, they appear quickly.
I recommend downloading the programs or requesting a fully functioning demo CD. There is always some learning curve with software, but I found the curve to be very gentle, requiring little time to become proficient, and taking a weekend to work with the program can let you know just how powerful QuicDoc and Office Therapy are.
Some readers may be prone to discount my enthusiasm as biased since I do now have a relationship with DTI. Rest assured that my passion when it comes to QuicDoc and Office Therapy is related to my use of the programs in my practice, and that I was singing the praises of DocuTrac, Inc., its staff, and products long before “signing on” as a member of the team. I believe that if use the products, you’ll really understand why I am as passionate as I am.
1 As discussed in this article, I have used QuicDoc for many years, and Office Therapy since early 2002. As a very satisfied end user of these products, I would often call and speak with staff and the developer with comments, ideas, and suggestions, and over time, got to know the “key players” well. I shared with them my love of computers and software, and one thing lead to another, and in September of 2000, I joined the DocuTrac (DTI) team as Executive Director, Enterprise Division. My commitment to software developed by DTI is based on my years as a end-user, but with my commitment to “truth in packaging” (aka ethical/professional practice), I think it is important to disclose that I am not only a very satisfied user but also a DTI team member. The Division 42 website encourages readers and members to submit articles on other professional practice software including articles that might present opposing opinions. (return to top)