eClinicalWorks vs. Tebra Billing & Payments

eClinicalWorks should be used in most medical situations. The program generally speaking works the way it should keeping track of patient records and the like. They have recently added an inpatient module for ASCs. Seems to work pretty well for smaller practices that don't require a lot of additional features or integrations.

Incentivized

In my experience, problems with them adding incorrect fees to pad their bills coupled with their unethical business practices such as locking you out from accessing your EMR at the drop of a hat prevent me from recommending Kareo to any practice. Reliability is paramount. Kareo's use of unethical business practices (locking you out from your EMR or disabling your EMR all together) can result in a physician being sanctioned by the medical board (inappropriate medical record keeping) or financially destroy a small practice leaving them with NO ACCESS to their ERAs/patient billing accounts etc leads me to NOT reccomend their products or doing business with them.

• One of the strengths of ECW can also be a weakness depending on the user's perception. ECW has a lot of redundancies. There are multiple pathways to perform a task. It can be appealing to advanced computer users because of the versatility. I have found that it tends to confuse lesser experienced computer users.
• The creation of templates is very easy and any provider in our system can create one. It definitely makes documentation more efficient. By creating a set of templates for the clinic, we are able to standardize the orders/procedures along established guidelines.
• We have converted our scheduling to open access. ECW allows us to set the follow up time and the end of the visit and then an alert is created. Front office staff can run the report and schedule patients closer to the actual time. It has improved our no show/cancellation rates.

Incentivized

• Kareo stays up to date on insurance changes which allow for smooth transitions.
• Kareo asks for feedback and has a place to go and request changes or additions that would make our job easier.
• I love that you can submit a help ticket or call, if you prefer, with any questions or problems that you may have. They are always very prompt with their follow up.

• Meaningful Use Reports should be capturing data in real time and generated fairly quickly instead of the MAQ dashboard extraction process.
• Their support teams are not very helpful at certain topics such as the definition/logic of Meaningful Use calculations. These are generally difficult to determine but several cases in regards to Meaningful Use take several days before it gets addressed.
• Training videos would be helpful on their support website.

Incentivized

• Where to start...for one, during my start-up with a "success coach" and trust me, I use that term broadly, I had to f/u on every single issue that came up. I was told she was taking care of my electronic lab enrollment, after waiting 3 months and reaching out to my success coach, Kayli, countless times, I only was told when contacted by management that my Quest lab access had been denied after 2 weeks because I was never told to independently create my own account with Kareo- after asking/emailing/calling multiple times trying to figure out the process. So needless to say, I have NO electronic lab access 4 months after signing with Kareo and they are now just starting the process.
• Prescriptions- I had reached out to Kareo, no exaggeration, over 10 times to figure out why I wasn't receiving prescription refills. Spent countless hours on the phone with "support line" that could never give me an answer- to any question. And never f/u either until I directly insisted to my salesperson to have management contact me directly. I had a patient go to the hospital due to not having their medications because apparently their pharmacy had sent refill prescriptions over 3 times which I never received. Only after talking to management, did they look into further and then inform me that I had 3 locations in the system (?? I have ONE location). They were all prior addresses of offices, one from over 4 years ago. To date, again, 4 months after paying a year up front, I can't receive refill requests. And the solution proposed to me by management was to call my prior EHR and request they delete my prior addresses. And I cannot contact my prior EHR because I was in a large group that restricted the account to only 2 individuals in a group of 18 doctors to even have access to talk to them. So I can't resolve the issue, Kareo after 4 months instructs me to call them myself, and the prior EHR doesn't even recognize I had an account with them because it was under a group practice name.
• Online booking- I thought this would be an amazingly efficient add-on. What they don't tell you is you can only designate "increments" of appointment times. Kareo will tell you it syncs with your existing schedule so that online bookings are only in vacant time slots. I had new patients selecting a time increment of 15 minutes, existing patients selecting 45 minutes (with a deductible) and any increment over 15 minutes (which the patient can select at their own will, being if you choose 15 min increments, it will offer appointment length for 15 min, 30 min, 45 min, 60 min etc with no outline of the appropriate time length) will over-book your schedule. So if you have a 10-10:15 slot, the patient can select a 45 minute appointment that starts at 10 (Because that 15 minute slot is open). But then will overbook the patients at 10:15 and 10:30.
• It created utter chaos in my practice. My office manager spent more time calling patients to inform them they had booked an inappropriate time increment, they can't book a new appointment for 15 minutes, we don't accept their insurance...the list goes on.
• There is no way to restrict the increments or who can book an appointment.
• Messaging- I can't view what incoming messages from patients are sent to whom. And neither can my office manager. And the patient gets to select who to sent the message to, either the "provider" or "location." And 9 times out of 10 they send to the "provider." So as a physician, I am inundated with patient messages simply wanting to book a new appointment or reschedule. As a physician, obviously prioritizing my time is important and my office manager can't view these messages.
• The list goes on, unfortunately. "A/R" reports only allow them to calculate a theoretical A/R based on your self-pay rates to patients, not individual contracted rates with insurances. So my A/R has an inflated number, which I can't even quantify by how much, because the A/R is based as if every insurance patient paid as a self-pay patient. Seriously, no one thought this through?
• Can't send multiple controlled scripts at once electronically. Have to enter, go to separate site, enter code, be redirected back to KAreo then re-enter another med, be redirected to separate site, enter code, be redirected...Any other EHR I've ever used (and I've used around 6 between residency and private practice) you could enter multiple Rx, but then check the meds you wanted to send and then enter ONE code for, say, 2 controlled scripts. Kareo, you must enter separate codes one by one.
• I could go on but will choose to hope for all reading, you get the general point...

If we had an option to easily switch to another EMR product we would. However, an EMR keeps you invested solidly in it - once you've started you're then going to be stuck with it. The investment into the data in the system are such that you have no real option to back out of what you are in and move into something else. Again, if we could, we would immediately move to another EMR. The ability to use it and be supported by the vendor has decreased nearly to the point of inability to use.

Incentivized

[In my opinion] the features allowed by the system are not designed for providers. [I think] the systems are inefficient, and new features tend to be "bolt on" features either as products purchased and added from other providers or simply a module created and strapped onto the software. There doesn't seem to be much idea around making things easier for the provider, though they like to state that provider burnout is something they are working on.

Incentivized

Kareo Medical Billing is very user friendly and the support they provide allows users to get their questions answered quickly and efficiently. The wait time to receive help is usually pretty good and most of the time we can ger our questions answered. We have found that is the tech help is unable to answer our question, they will attempt to find a colleague who is able to help!

Incentivized

I often cannot assign a proper diagnosis under the assessment section; and as mentioned, sometimes (about once a month) the dictation just freezes because "the request has timed out" (even restarting the iPhone/ laptop does not help).

You put in support cases through a support portal. [I believe] for no apparent reason, the company decided that their support cannot have access to actual patient records and as a result, it's required that they have to connect remotely to a computer system in our network, and log in as one of our users to do anything. This also entails that they are completely incapable of diagnosing problems and require significant amounts of user input and time to try and begin any sort of work on the problems. [In my opinion] this takes away from patient care and other concerns. Also, while you can put in as detailed a ticket as you want, when you are called, you have to go over the ticket again, as they don't seem to read or care what you put in, as it's more important to them to go over everything in painful detail. Often times you must explain to the tech how the process works. In the past month, we were upgraded overnight with zero warning, which caused issues the following day as we had to update every single computer in our network (over 300) and it requires administrative privileges so couldn't be done by a user. This also doesn't update any information in the programs list, so there's no way to tell whether the update happened or not.

Incentivized

Paid for training, did not help. They trained prior to go-live, but it was so long ahead that users weren't able to function well when it actually happened, they seemed unable to provide adequate support. [In my experience] further support is typically very boilerplate, and is thus not useful, and has additional cost.

Incentivized

It's very important to limit your schedule during the weeks after go live but it is equally important to have a resource that is the lead at the practice that ensures that milestones are met leading up to the go-live date. Someone must be the point person at the practice otherwise milestones will be missed and the implementation will run into problems.

Incentivized

I was attracted by the final note format of ECW. I said then and still say that most EMR's clinical notes are terrible to try to read and follow in orderly fashion by comparison...BUT the devil is in the data entry and that is where "you live" as a clinician. Incredibly frustrating software because of inflexibility and restrictions of multi level data fields that can only be opened one at a time (i.e. no "toggling" between windows... ooen read and close...then reopen other data entry window....then close and repeat if you need to refer back to original window of data. This applies throughout the software and is due to its reliance on SQL architecture from what I have been told). Kills productivity.

We have used several Practice Management programs which our doctors have chosen. Kareo is far above those in ease of use, efficiency and reporting. Training takes very little time as the program is intuitive. Licensing cost is reasonable. Our doctors enjoy the integration with the Kareo EHR and our staff appreciates the integration from the EHR to the practice management. It makes their job easier.

Incentivized

• I will just share one area that our organization saw the ROI in a very short time period. That is the elimination of a dictation service for most of our specialty group doctors when we introducec Dragon Medical. This functionality brought a tangible benefit and a significant ROI in a short time period.

Incentivized

• Kareo had an overall low return on investment.
• Despite the software being active at our company, we were forced to transition to a different solution within 6-months of implementation.
• The time spent attempting to reconcile the system to itself was rather wasteful.

Incentivized