Datamedic: A Computer Billing System
I suppose there are a lot of orthodontists who, like myself, have recognized the need for some form of automated billing system. The problem is in finding the one that is right for a particular practice. In my case, what I wanted most was simplicity and flexibility. I didn't want to be forced into conforming to the framework of a system. I wanted the system to fit me. I wanted a maximum of control over my own billing.
I had been using a copying machine system for billing, which meant that the office personnel no longer had to type statements, nor make ledger entries. They typed one line on a ledger card, reproduced it for the patient, inserted it in a window envelope, and out it went. The procedure was repeated every month and this was the system that prevailed in my office while I searched for the automated system that would satisfy me.
Other Methods Investigated
One of the early methods that I investigated involved making out daily reports in my office, either typed or in pen and ink, which had to be mailed to a center in the Midwest. Anyone can imagine the potential for problems when your control is over a thousand miles away.
I considered a system employing a touch-tone telephone. Although this firm had its center in the middle of the country, the telephone offered speedy contact. In theory it worked, but no one could guarantee that we could get through to the computer when we wanted to. This could mean hanging around in the evening for circuits to open up, or carrying the work over to the next morning to call the information through. Naturally, the work could pile up, causing more and more opportunity for error.
The copying machine system was crude compared to what I now have and open to all kinds of inefficiencies, but hardly less effective than mailing information to a computer halfway across the country or competing with the rest of the world in trying to get an open phone line to Chicago or New York City.
The Datamedic System
In the Fall of 1972, Datamedic (154 Plandome Road, Manhasset, New York 11030) opened an Operations Center less than half a mile from my office and the computer billing system I had searched for found me.
Datamedic is based on the same kind of time-sharing arrangement your local banking office uses. Many banks use the same central computer, but each has its own input terminal right at its own office. It is an on-line system with individual programming tailored to the functions of each
subscriber on the line. It employs a computer terminal into which data are fed, offering absolute control in the office and immediate contact with the central computer. In the Datamedic system, a Computer Center must always be within thirty miles of a subscribing practice. This means that information, advice and servicing are never more than one hour away.
Operation of the System
I have a terminal in my own office, operated by auxiliary personnel. Datamedic trains personnel in the use of the equipment and, if the trained assistant is out sick, they send a trained operator to handle the work.
Data is entered into the terminal in our office in a prescribed fashion. Immediately after pushing the "Send" button, the operator gets a printout of what she has sent. It is expressed in a code, which the operator learns to read as you and I would read a book. If an incorrect entry is made, it can be corrected right away. The printout also can be checked against the copy we get at the end of the month, which is one more way of guarding against error. In addition, we keep a daily log of what we are going to send, so we have still another check on the data. The advantage of having these checks is in the opportunity to correct a mistake before it is presented to the patient. If an error has occurred, the operator enters a message that says-- "Remove the entry that was in error". Then she sends it correctly. It's that simple.
Datamedic Computer Billing System consists of a terminal (1), located in the orthodontist's office, into which the Family Account Card (2) is inserted when account information is sent. At the same time, a copy of what is sent is printed (3) as a record and for checking against error. The information goes to the main computer center (4) at Datamedic Central Computer Center, where it is stored in a tape storage bank (5). To retrieve and use taped information, the tape is placed in a Tape Drive Unit (6) and a printout is made on a Hi-Speed Printer (7). Fictitious samples of a typical bill (8) and a typical Monthly Practice Analysis (9) are shown.
Report of Aging of Accounts
An additional feature of the Datamedic system is a report of aging of accounts. Without such a system, I rarely noticed an account getting behind until it was four or five months overdue. Now if someone gets sixty days behind, the computer picks it up and sends a gentle message-- "YOUR ACCOUNT IS PAST DUE AND WE WOULD APPRECIATE YOUR REMITTANCE". Each thirty days thereafter, another message is sent, the wording getting stronger each month. I use Datamedic's recommended wording, but I can select my own if I desire. If an account gets beyond 150 days, we have to take action on our own.
The system goes after the late account as soon as it gets late. It is easier to collect closer to the date the debt was incurred, than to try to collect payment six or eight months later.
Family Account Card
The heart of the billing system is not only the computer, but also the Family Account Card, which is inserted into the terminal each time we send data for that family. This card rules out error in charging or crediting the wrong family, short of our putting in the wrong card. Barring that, it's foolproof. It doesn't involve punching in a certain number for identification. You just insert the card in the terminal. If this is compared to the touch-tone telephone system, for example, picture having to punch Account Number 5236 into the telephone. The assistant would have to touch four keys. If she touches a wrong digit, a wrong account number is recorded and you may not know it until you get a call from an irate patient.
Each family has an account card. Let's say that there are three patients in a family. One is under active treatment and two are under observation waiting to start treatment. Each family member goes on the card with an identifying number. For example, Number 1 would be Mary; Number 2, John; Number 3, Charlie.
Number 1, Mary, involves regular contact with the office. Debits and credits are rendered in her favor and a definite billing pattern is established with the computer. Number 2 is John who is recalled to the office every four months. When I see John, I write on his recall card when I want to see him next. My operator puts the family card into the terminal and punches out a code indicating this. If there was a charge for John's office visit, that is put in too. In just a few seconds, we have automatically arranged to have John recalled in four months and we have had the charge for the occasional visit put on the family's statement for the following month.
If Charlie is to be seen again in two or three months, we enter that recall too, and forget about it. It will be taken care of automatically.
The Datamedic system is extremely versatile. The account is billed once a month and everything is listed-- regular payments due, additional charges for occasional visits, x-rays, recall reminders, contract status, everything.
The computer not only sends bills, it sends helpful messages. I get a bit peeved at failed appointments. When a child doesn't show up for an appointment, I could charge for it because the original contract provides for this. But, I never do. It tends to create a bad relationship. However, we do put the Family Account Card into the terminal and punch out FAILED APPOINTMENT. This puts the youngster on the spot with his folks who are paying his way. It's a little like the school telling you that your child has been playing hookey. I like these little pluses in the system.
At the end of the month, the computer sends me a list of the services I have performed. It tells me how many kinds of x-rays I've done, how many different types of appliances, repairs, models, etc. I expect to develop a production versus time expended readout.
The computer organizes our billing so that we are current every single day. When the day is over, if the office were to close down for the rest of the month, the bills would still go out automatically.
At the end of the day, all office visits and charges are recorded. You don't stop and ask yourself, "Should I send them a bill?" If there was a service rendered, it is entered. Too often in the past, we overlooked sending a bill because we waited until the end of the week or month to send out the bills all at once. If you are billing from a book, you can miss a whole page. If you use little slips of paper, they can get lost. This system records on the day the work is done and that's the end of it.
When we instituted this system, everything was put on microfilm. Datamedic sent a technician who filmed all our ledger cards. Since some of our recall patients didn't have ledger cards, they photographed our recall cards too. From these, they printed all the Family Account Cards. Then they trained one of our assistants to operate the terminal in our office under actual operating conditions.
Advantages of the Datamedic System