Intelligent Electronic Medical Billing and SOAP Notes Software Requirements

Doctors and therapists must produce clinicalmedications ordered, treatments performed (e.g.,
documentation in ever increasing volumes andminor surgery procedure), patient referrals
detail to ensure best healthcare, get medical(sending patient to a specialist), patient disposition
claims paid in full and on time, and protect the(e.g., home care, bed rest, short-term, long-term
practice from post-payment audits and unfairdisability, days excused from work, admission to
litigation.hospital), patient directions and follow-up directions
But visit documentation speed conflicts withfor the patient.
documentation accuracy and thoroughness. ForNext, each one of the four key SOAP stages
insurance companies, patient visit documentationconsists of templates reflecting multiple possibilities
must be precise and comprehensive. If the qualityfor each stage. Templates, organized according to
of documentation is high, the medical billing appealsSOAP order, ensure comprehensive coverage and
on unpaid claims are paid faster and at a higherallow the doctor simply check multiple selection
rate. Otherwise, appeals are denied and theboxes on the screen driven by a computer
practice becomes vulnerable to post-paymentprogram.
audits, refunds, and penalties.Templates have attracted two-fold criticism both
Insurance companies do not care how long does itfrom the provider and the payer sides. The
take to produce good documentation. But forproviders dislike the lack of built-in intelligence to
provider, slow documentation impedes practicereflect individual doctor's preferences to treat
profitability and wastes valuable time. The doctorpatients. The payers often suspect
must be done with visit documentation by thetemplate-generated notes of low quality and poor
time the patient leaves the office.reflection of true patient state and treatment
To ensure comprehensive note coverage,progress because template susceptibility to
healthcare industry adopted a two-prongedmechanical clicking and difficulty of interpretation.
structured approach. First, the doctor uses SOAPThe challenge is to combine the advantages of
notes format, which reflects four key stages oftemplate and verbose formats without their
patient care, starting from Subjectiveshortcomings to describe precise patient condition,
observations, to Objective symptoms, toensure productive medical billing, prepare for
diagnostic Assessment, and culminating withregulatory scrutiny, and improve practice
treatment Plan:productivity. To overcome the perception of
mechanically generated notes while saving the
1. SUBJECTIVE: The initial portion of the SOAPdoctor the time to type, some vendors have
note format consists of subjective observations.created specialized products that use randomized
These are symptoms typically expressed verballywording for each template. Such automatically
by the patient. They include the patient'sgenerated notes include sentence structures,
descriptions of pain or discomfort, the presencewhich closely resemble natural speech patterns.
of nausea or dizziness or other descriptions ofFlexibility and integration must be key design
dysfunction.features of SOAP notes. In the opening section,
2. OBJECTIVE: The next part of the formatfor example, you create new patient files that
include symptoms actually be measured, seen,grow organically with each visit or treatment.
heard, touched, felt, or smelled. Included inBuilt-in intelligence allows you to customize a
objective observations are vital signs such asdocument to your own preferences and observe
temperature, pulse, respiration, skin color, swellingthe entire patient progress history in a single
and the results of diagnostic tests.screen. Native system integration with medical
3. ASSESSMENT: Assessment is the diagnosis ofbilling systems, enable automated claim generation,
the patient's condition based on Subjectivevalidation, and submission to payers for payment.
observations and Objective symptoms. In someSOAP notes must not merely emulate the paper
cases the diagnosis may be a simplefolder that every doctor has for every patient.
determination while in other cases it may includeThey must use computer technology to help
multiple diagnosis possibilities.automate routine tasks and create a faster,
4. PLAN: The last part of the SOAP note is theeasier, and error free process to increase practice
treatment plan, which may include laboratory andprofitability and reduce its audit risks.
or radiological tests ordered for the patient,