Experience that matters
Navaro Medical Solutions, Inc. founder is Richard Navaro. In the late 1980’s and early 1990’s, Navaro was the owner and deeply involved in the day to day activities of an anesthesia billing service in Southern California. In this capacity, Navaro became intimately familiar with the needs of the billing community, especially for anesthesia billing. Navaro also was a software developer and developed an anesthesia billing software package for his billing service’s use. That software, ABA Software, was introduced to the market in 1991 to fill a void for quality anesthesia billing software. For the last 14 years Navaro has been developing, improving, selling and supporting ABA Software and EDI services. ABA Software became so well liked because Navaro understood what the billers needed. He talked to and listened to his customers across the country and combined his deep seated understanding of his customers needs with his expertise in software development to produce a superior practice management billing program. ABA Software was so well liked it sold almost entirely by word of mouth referrals and soon became Navaro’s only business. Today, ABA Software is one of the major anesthesia billing packages in the industry and used by anesthesia offices and billing service customers in over 40 states from Hawaii to Virginia. Navaro’s success has come from providing powerful software that meets the needs of his customers, combined with excellent support and a superior value for their investment.
While most practice managements software companies are run by individuals only interested in increasing the bottom line, Navaro operates from a passion to provide the best practice management software on the market and consistent with his history, provide it with excellent support and a superior value for the customers.
Today, Navaro holds Microsoft’s highest developer certification for the new .Net technology, the MCSD certification. Having been actively involved with .Net technology from its earliest beta versions, Navaro is also one of the most experienced .Net programmers in the country. He has hired a staff of skilled .Net certified software engineers to assist him and for the last 4 years has been leading the design and creation of the foundation for the most advanced practice management system in the country today.
That cutting edge practice management system is called ProSourceMD, and it is now available nationwide.
In its initial release, ProSourceMD will exceed the functionality of most practice management systems on the market today. However, ProSourceMD is not an end product, it is the foundation product for what will be an ever growing range of functionality and features that will continue to expand over the years to come. While most of the current practice management systems continue to fall further and further behind the technology curve, ProSourceMD will be at the forefront of the technology.
Cutting Edge Features
Online and Offline data entry capability. Because ProSourceMD is a hosted application, you can access your data in real time from anywhere with internet access.
Do not confuse ProSourceMD with ASP or Web applications.
ProSourceMD is a .Net Remoting Smart Client application and shares in all the benefits of a hosted application, primarily the 24x7 access from anywhere, but none of the drawbacks.
ProSourceMD differs from Web and ASP applications in 3 ways.
1) ProSourceMD can offer some offline functionality. While not all the functionality is available offline, ProSourceMD can allow you to still add, edit and delete certain kinds of data while off-line. Your data is re-synchronized when you regain your internet access. This functionality is achieved without the need for installing a local database. With Web and ASP applications you have no functionality when you are offline.
2) ProSourceMD runs on your workstation, so it has the primary benefit of a locally installed program- it runs fast. ASP and Web applications must download all the data and screen images to be displayed to your browser. This means constantly transferring huge amounts of data back and forth and all of it encrypted which slows it down even more. ProSourceMD only transmits data packets for the data it needs. ProSourceMD also employs very sophisticated caching mechanisms to further reduce the data requirement. While a Web or ASP program may require very expensive broadband internet connections, especially for multi-user access, ProSourceMD can run effectively even on minimal bandwidth.
3) All the processing power needed to run the application has to occur on the Web or ASP server. All users share the same processing system so during the peak of the business day, when you need it most, the Web or ASP program will be its slowest. ProSourceMD takes advantage of each user’s computer to handle the bulk of the processing.
Designed from the ground up around HIPAA requirements
There is a lot of misinformation from a lot of software developers who claim there software is ‘HIPAA Compliant’. Software cannot be compliant nor can it be non-compliant. Covered Entities, like medical providers, who fall under the jurisdiction of HIPAA requirements are compliant or non-compliant. A software package can help you comply with the regulations. Many existing programs that were designed before HIPAA do very little to help you meet your HIPAA obligations.
…a provider is required to maintain offsite backups of their patient data. ProSourceMD does this for you automatically.
… a program is required to automatically log you off if there is a period of inactivity. ProSourceMD does this for you.
…users must be able to be assigned access rights based on their need to know.
ProSourceMD allows very fine grain user access rights. A user can be given any combination of read, edit, delete options for one patient or one provider or one practice or all.
…A major flaw of most practice management programs is that while they may log and protect access of data through their program, they don’t protect the data in the database, allowing access to the data through Access, Excel or other unlogged, unrestricted programs. Data administrators and others can see, print or change this protected health information (PHI) at will. ProSourceMD prevents this in two ways. First, the database is kept on our site away from 3rd party programs and prying eyes. Second, ProSourceMD encrypts PHI in the database. Each customer has their own private encryption key. The only way to view the data is through the customers program where user access is controlled and logged.
…Data access and change logs must be created. All accesses, adds, edits and deletes are logged by ProSourceMD. Each log record is stamped with the date, time, user and workstation where the changes occurred. Data can be viewed before and after the change. All history of a record, including patient records can be extracted from the point of adding to its current state. All user activity is logged showing login time, logout time and all activity for that user during that time period. Log reports can also be useful for productivity analysis.
Failed Logon Alerts, Celebrity Aliases, Need to Know design and much more is built into the ProSourceMD program to help you achieve HIPAA compliance.
…Many programs claim and are able to produce a HIPAA compliant EDI transaction, but they are not all the same. Many programs EDI functionality consist of creating a HCFA (CMS) 1500 form print image and transmitting this to a clearinghouse where it is translated into a HIPAA compliant EDI transaction. For this process to work, the clearinghouse has to fill your claim with default values they’ve set up for you. These default values may or may not represent the true nature of your claim. Furthermore, while a HIPAA transaction has thousands of potential values; the print image versions created by many software packages only allow input into a couple hundred basic fields, at most. Other programs on the market may offer a more robust EDI component, but if they were designed before HIPAA, it is unlikely they offer anywhere near the full component of options available under HIPAA. In contrast, ProSourceMD has built its data structure around the full set of HIPAA transactions. We have worked to give you the ability to enter any field in the transaction set, with any value permitted under HIPAA. We also designed our system so that if HIPAA added or removed values, those changes would be reflected immediately in your progam.
ProSourceMD will create a full HIPAA 837, it will read an 835 EOB with automatic posting of payments to the proper accounts. It will create a 270 Eligibility request and read a 271 Eligibility response, posting the response to the insured account.
All EDI transactions go through a thorough 997 validation prior to transmission. In addition, all claims data is extensively validated with thousands of edits, including carrier specific requirements, CCI validations, age-sex edits, valid code edits and more.
Navaro’s approach to EDI transactions, whenever possible, is for the customer to transmit their encrypted data over an encrypted connection, directly to the carrier’s computers. This eliminates a number of potential problems that can occur when a 3rd party is involved in the process. ProSourceMD makes this process easy by automating the entire communication process. A couple times a day claims that are ready to be transmitted are batched up, and transmitted to the carriers servers for processing. This all happens without user intervention. This frees up time for users to handle other more important tasks and assures that the claims are in process for payment as soon as possible. Reports are automatically downloaded, processed and available for review. Program alerts are set for identifiable problem areas.
Pre-loaded Data Updates
ProSourceMD includes over 40 pre-loaded database tables that are automatically included in your program and kept up-to-date for you.
These include, the annual CPT codes and descriptions, ICD9 codes and descriptions, National Medicare Fee Schedule Tables, CCI edits, Age-Sex edits for CPT codes and ICD9 codes, National Zip Code database, Insurance Carrier List, ASA Anesthesia Code RVU list, CPT/ASA crosswalk, Medicare Anesthesia Conversion Values by Carrier,CPT/ICD9 crosswalk, ICD9/CPT crosswalk, Modifier List, National Drug List, ASC Codes and Charges, Taxonomy Codes, All HIPAA approved field values and much more. Most of these codes change on a quarterly or annual basis and are automatically updated in the ProSourceMD program for you.
Automatic Software Updates
The ProSourceMD program automatically checks for newer components and automatically installs those components. This means that if we need to make a change to the program those changes can be implemented fast and without inconveniencing the user.
Automated Fee Calculations
The ProSourceMD program includes the full Medicare fee schedule along with the proper conversion factors for every zip code in the country. To assure accuracy, each Medicare base fee is calculated based on the zip code of where the service was performed and the date the service was performed.
Specialty, modifier, location adjustments are all handled automatically.
Non medicare fees can be configured to be calculated based on a percentage of the medicare rate or a flat rate can be associated with each code. A separate fee schedule can be associated with any practice/insurance carrier combination to reflect exact contract terms.
In addition to the billed fee, an expected fee is calculated for each individual charge. If a payment is less then the expected payment, an alert is created to prompt review. The expected payments also can be displayed on reports to give a better representation of accounts receivable.
Anesthesia fee calculations are discussed in the Anesthesia features section.
For Medicare claims, the medicare anesthesia base units are used and the conversion factor is based on the zip code of the service and the date of service. This assures that the anesthesia rate being billed is based on current Medicare fee schedules. The actual amount billed can be 100% or a higher percentage of the Medicare fee schedule rate.
Claims can be entered with either the CPT surgery code or the anesthesia code. The program will automatically crosswalk the surgery code to the anesthesia code for you.
A lookup is available showing all the most common surgery to anesthesia crosswalk codes and another lookup is available showing the common links between a diagnosis code and surgery code.
Medicare time units are calculated in exactly the same manner as Medicare calculates them.
Base unit, Modifier units and Time units are all calculated automatically.
The program allows for an unlimited number of split anesthesia start and stop times per procedure and allows for multiple rendering providers. The program will properly calculate the billed time and the proper rendering provider to use.
ProSourceMD checks for overlapping times for a rendering provider, before the claim is saved. This helps to eliminate errors before they happen.
The type of anesthesia used can be saved with the claim and notes or scanned charts can be saved with the claim.
The program will automatically calculate concurrency modifiers for anesthesia claims, append the proper modifier to the claim, adjust charges as appropriate and create a second claim for supervised claims, when needed. This process is fully automated and includes a Gantt chart display of all related claims. The concurrency process can be run to show the potential results before it saves the changes, allowing for the claims to be modified first if an error has been found.
Concurrency rules for CRNA’s, Residents, AA’s and SRNA’s are all handled properly.
A concurrency report can be generated showing all cases and the parties involved.
Additional units are automatically billed when Physical status modifiers with additional units are billed.
For special requirements, individual insurance carrier settings can be made, as needed, to
1) customize printing the anesthesia information on the claim form
2) transmitting the data in an 837 file
3) Concurrency rules
4) Time Unit Calculation rules
5) Base unit charges and/or Fees
6) Modifier charges and behavior
Detailed anesthesia reports allow for a detailed analysis of procedures, time and units.
Payments and Adjustments
Payments are applied at the service line level. This permits fine level reporting and analysis.
The payment process is as fast and easy as it can be done.
Payments and adjustments are associated with a Financial class id and associated adjustment codes for fine grain reporting and analysis.
Electronic payments via an 835 are electronically applied at the claim and service line level, depending on the information received from the carrier. The default application of these automated payments can be overwritten manually, if needed.
Guarantor and Practice charges and payments
ProSourceMD allows for automated charging of interest to past due accounts. These fees are posted to a Guarantor general account. Other fees, like copying charges can also be posted to the Guarantor general account. Likewise, payments from guarantors can be posted to a general account, being automatically posted to the oldest charges first.
General Practice charges and payments can also be entered and are sometimes needed to balance a payment. For example, if an insurance carrier pays interest or a bonus to the practice, that payment can’t be posted directly to a claim but must be posted to the general practice account.
Program can be accessed through the internet anytime and from anywhere
Why this makes a difference – this allows your staff to work from home, from multiple offices, the hospital etc and everyone always works with real-time data.
Cutting Edge Technology
ProSourceMD has been designed and written from the ground up using C#/.Net programming language and tools. This language builds on the .Net framework which is the cornerstone of Microsoft’s future technology. All of the programmers involved in writing ProSourceMD are certified by Microsoft in .Net technology.
Many existing windows practice management systems are written in languages that are now dead languages. This means that there will be no future upgrades to those languages. Further, these programs cannot be ‘upgraded’ to .Net. These programs will continue to ‘run’ for several years, but they will constantly fall further and further behind in their technological capabilities.
While these programs fall further and further behind the technological curve, ProSourceMD is riding the crest of the wave into the future. Any new technological advance can be easily incorporated into our program. We are poised for growth.
Be wary of vendor double-talk on this issue. Many are inventing their own terms to mis-lead prospective customers. Some say they are ‘.Net compatible’. That is a bit like a bag of sugar boasting it is ‘fat free’. Almost every program including DOS programs are .Net compatible, that does not make their technology any less antiquated.
No Server Required
A large part of the expense of running an in-house practice management system is the requirement of maintaining a robust server.
By eliminating the need for a server, you save money on hardware, software licensing, network technical support, security, back-ups and the obvious inability to work with the data unless you are physically connected to the network.
With ProSourceMD, we use the latest server technology, hosted in Level 3 data centers for hardware and data security and reliability. All data is backed up daily and redundant copies of the data are stored offsite.
Advanced features of ProSourceMD include either real-time read-only replication of your data to your servers. This advanced functionality permits you to have a full copy of your data on your site at all time.
Another advanced feature is the ability for our servers to merge replicate with your servers. This would allow you to have your users logon locally to your server or logon to our servers through the internet. Both servers are kept in synch through merge replication.
Automatic Software Updates
Each time you start the program, ProSourceMD checks for software updates. If there are updates, it automatically downloads and installs the latest version. This advanced functionality allows you to always have the latest features, and any bug fixes and it is easy on you.
Automatic Code Updates
The ProSourceMD program comes loaded with all the current ICD9 codes, CPT codes, Anesthesia Codes, Modifiers, HCPCS codes, Medicare Fee Schedules, National Zip Code list, Master List of Insurance Carriers, plus many more list like current quarter CCI edits, acceptable codes for all the HIPAA code sets,
Age/sex edits, insurance carrier requirements, etc. These codes and list and more are pre-installed in your program. The tedious task of keeping these code sets up to date and installed in your program is handled by our staff.
Many software packages claim to be HIPAA compliant. The fact is that software cannot be HIPAA compliant or noncompliant. It is the Provider or other Covered Entity that is compliant or non-compliant. Software can only aid you in becoming compliant. ProSourceMD helps you not only meet the minimum requirements for compliance; it helps you meet the stringent application of the requirements. The real challenge is not meeting the requirements for compliance, that is pretty easy. The real challenge is in actually protecting your confidential data – and that is where ProSourceMD rises above the crowd.
Mail and Document Manager
ProSourceMD has an enhanced internal email and document managing system.
The internal email system works between users of the program. Write a message, attach documents and send it to one or more users. When a user has new messages, an indicator light brightens on their main screen alerting them to the fact they have mail.
You can also schedule your messages. By setting a future date and sending it to yourself and/or others, it serves as a reminder system.
The document features allow you to have a paperless office. Scan and save any document in your program. Once there, it is stored in your database and available from anywhere, instantly.
All kind of files can be saved in the program; scanned documents, other image files, sound files, text files, Microsoft Word document files, pdf files etc.
Best of all, all messages and documents can be linked to a patient record or claim, doctor, practice, insurance or other type entity. When viewing that entity’s record, you will have access to all the documents associated with that entity.
So, when viewing your bank deposit, you can view a scanned copy of all the checks. Scan lab reports and link them to a patient record, save dictation files with a patient visit.
The possibilities go on and on.
Under HIPAA, one of the primary goals of the laws is to protect confidential information. If someone is going to get sued under HIPAA laws, it is not likely going to be because they are not compliant. It is more likely going to be because confidential data in their safeguard was not protected, information got out, that person found out and sued the provider. Almost all practice management software packages fail miserably at protecting confidential data or restricting access to those who have a need to know. Does your program drop down unfiltered list of patient names, print patient names on reports that can be viewed by anyone, allow database access by unrestricted programs like Access or Excel, store confidential data unencrypted in the database? Many of these things might be considered desirable features in pre-HIPAA days, now these same features are just setting you up for a lawsuit.
ProSourceMD meets all the minor requirements of HIPAA security, like passwords, restricted access rights, automatic screen closing, failed logon alerts, celebrity accounts etc. But, we also have designed the program with a conscious effort to only show confidential data to those who need to see it. All transmissions of data are encrypted and confidential data is stored encrypted in the database. The only time confidential data is unencrypted is to authorized users in the ProSourceMD program.
Automatic uploading of error messages
Most program errors are automatically sent to our support staff giving us insight to fix problems. This helps speed up our process of creating and maintaining a totally bug free program and giving you helpful support.
Out with the old technology, in with the new.
Most practice management software on the market today is written with Microsoft Windows technology. Almost all Microsoft windows software written more then 1 year ago, or written with the older technology, is going down a dead end road. In the last year and a half, Microsoft released an entirely new software development platform called .Net and Microsoft has announced it will not provide continuing upgrades or support for the older technology. Just like the older DOS programs could not be upgraded to the Window technology, Windows programs cannot be effectively upgraded to the new .Net technology; there are just too many fundamental differences. Most practice management vendors do not have the trained staff, time or resources to completely re-write their programs in the new technology and will continue to fall further and further behind in providing current technology features and benefits to their customers.
ProSourceMD has been in design since the early beta stages of the .Net technology.
Navaro Medical Solutions, Inc. is a Microsoft Gold Certified ISV Vendor and has had its .Net software tested and approved by 3rd party testing facilities.
Please contact us if you would like more information about our anesthesia billing software, practice management software, or any other services.