Taking a Second Look at Practice Management Software

Larry D. Rosen, Ph.D.

The National Psychologist

September/October 2000

Four years ago Dr. Michelle Weil and I tested and rated 24 software packages to manage office finances, for inclusion in our book The Mental Health Technology Bible (Wiley, 1997). Programs varied, but most included components that allowed insurance billing, reports, managed care tracking, scheduling, electronic billing and more. Using sales estimates supplied by companies, we calculated that approximately 13% of practitioners were using billing software as of spring 1996.

Given the changes in technology over the past four years, it seemed time for an update, so I contacted the five companies recently whose products we recommended highly and took a second look.

First, using sales estimates from the top companies, it is clear that billing software usage has more than doubled. Today, one-third of all practitioners are using an office management program.

Second, the top five companies are all still solvent. In today’s business world, this is an amazing testimony to the increased interest from practitioners and ability of the companies to attract new users. These companies have prospered for an average of 12 years when most software companies have long since disappeared.

To avoid prejudicing the reader, I am providing updates in alphabetical order. For each product I downloaded a demonstration version and also interviewed a key person at the company.

Delphi Psychotherapy Billing System (PC Consulting; 800-847-8446; http://www.delphipbs.com/) is still very popular with practitioners. It is only one of two on our preferred list that provides a complete purchase package including upgrades and lifetime support. As of this writing, it is still a DOS program, although that has not discouraged 5,400 therapists from purchasing, using and liking it. I recently previewed the upcoming Windows version and it retains the simplicity and user friendliness of its predecessor. Just a few keystrokes and weekly billing is done. Delphi's program includes all components for a single price.

The combination of Office Manager and Case Manager (SOS; 352-242-9100; http://www.sosoft.com/) form perhaps the most sophisticated and most costly of the programs. Recently rewritten with an SQL Database, Office Manager, the financial package, is now geared toward groups and agencies. It is powerful and is able to produce the complex reports needed for multiple practitioner settings. Case Manager, the computerized clinical record that meets complex insurance guidelines, integrates clinical information with billing information providing a complete financial and tracking system.

ShrinkRapt (Saner Software; 630-513-5599; http://www.shrinkrapt.com/) was one of only two recommended packages that worked on both Mac and Windows computers. Now being used with over 3,000 practitioners, ShrinkRapt is a comprehensive program that provides both billing and patient clinical information. Like Delphi, ShrinkRapt offers free lifetime support for its product. An upgrade to version 4.0 complete with a full client server version for networked groups is due later this year. Mike Johnson, President of Saner Software, promises that ShrinkRapt users will enjoy additional flexibility and ease of use in this upgrade which includes a free scheduler.

SumTime (Rudd, Inc.; 888-821-0771; http://www.sumtime.com/) is another package for both Windows and Mac computers. Although company representatives did not respond to my e-mail and phone messages, I did download the latest Windows version and gave it a "test drive." Again, I was impressed with its "look and feel" which is very picture oriented. Adding and billing new patients is still straightforward. SumTime does have a limit of 1,200 active patients, which might make it impractical for some large groups. SumTime's technical support is an additional cost per year.

Therapist Helper (Brand Software; 800-343-5737; http://www.helper.com/) is the best selling among all the programs with 10,000 installations, according to Cheney Brand, creator of the product a decade ago. Therapist Helper offers a comprehensive program plus plug-in modules that provide electronic claims, credit card processing and even integrate client and schedule information with a Palm Pilot or Handspring Visor handheld computer (see my review of the Visor in the May/June 2000 issue of this magazine). Next year, Brand Software will introduce a more robust client server version for use with four or more workstations. Therapist Helper also charges annually for product support and plug-in modules are available at an additional cost.

I also asked each of the company principals for their perspective on how therapists have changed in their attitudes toward practice technology. Cheney Brand still sees psychologists as resisting change and sees Therapist Helper's biggest competition with those still using paper-and-pencil accounting. Mike Johnson (ShrinkRapt) felt that therapists were getting more comfortable with technology in general, which made it easier to get up and running more quickly.

Kathy Peres, Ph.D. of SOS has seen practitioners feeling more "tired" and frustrated due to their increased workload and reduced income due to shrinking insurance pay structures. This, she feels, makes the therapist's job doubly difficult. Finally, Will Pardy, creator of Delphi, finds therapists are getting more technologically savvy and having an easier time with the sometimes complex world of Windows.

Both Johnson and Pardy, who developed and support their programs, talked with me about their loyal following and how referrals from other users are a major source of new customers. Pardy also noted that many of his referrals come from therapists who are unhappy with paying extra from support that they have difficulty obtaining. They complain about phone calls never returned, being planced on hold for an eternity and having support staff who don't really understand their problems. He told me that when therapists find out that he returns calls promptly, they breathe a sigh of relief.

So, how do you select a billing program? First, go to the five websites and get a feel for the product through lists of features and other options. Select a maximum of two and download the demos or call the company who will mail a CD-ROM demo. Load one demo at a time and enter 5-10 of your patients. Now, bill for a month of sessions and see how the program "feels."

Your job is to balance program features and cost, cost and availability of support and upgrades, and the program's "look and feel" in making your decision. It is a personal decision and one that only you can make. If staff members or other therapists will be responsible for entering data, have them try the program, too.

In my opinion, all of these programs will make the financial aspects of your practice more streamlined. Don't expect miracles, but over a few months expect to see your time spent doing billing and record keeping DECREASING and your collectables INCREASING.

Copyright, 2000, The National Psychologist. Reprinted with permission. The National Psychologist is a privately-owned bimonthly newspaper which may be purchased for $30 a year. Write or call: TNP, 6100 Channingway Blvd., Suite 303, Columbus, OH 43232; telephone: 614.861.1999 or fax with Visa or MC to 614.861.1996.