Lytec 2014 System Requirements

lytec 2014 sys requirements

Lytec 2014 Hardware and Software Requirements

This chapter identifies the hardware and software requirements for this release.

Lytec Single-User Hardware and Software

Requirements

Hardware – Minimum Required

CPU (Processor) Intel Pentium 4 2GHz or faster

 

RAM (Memory)

 

2GB

 

Storage Space available

 

4GB*

 

Optical Drive

 

DVD-ROM (required if install from CD)

 

Network Card (NIC)

 

100Mbps

 

Display Monitor

 

1024×768 (1280×800 for widescreen displays)

 

 

*The amount of storage space needed will increase as your practice database gets bigger.

FOR ADDITIONAL DETAILS ON SYSTEM REQUIREMENTS PLEASE CLICK ON THE FOLLOWING LINK: lytec 2014 system requirements

 

How to Run a List of Patients by Diagnosis

A common question in Medisoft Clinical and LytecMD is how to run a report of patients by diagnosis. In this example we will run an inquiry to find any patients that have Asthma (ICD-9 493.90) on their major problem list.

Step 1: Go to Reports/Patient Inquiry

pt list by dx 1

Step 2: When the Patient Inquiry window opens, hit the drop down for “Selection Criteria” and Choose “39. Problem Code #1”

pt list by dx 2

Step 3: Enter the ICD-9 you are searching for.

pt list by dx 3

Step 4: Select the operator value “equal to”

pt list by dx 4

Step 5: Enter Provider ID or leave it blank

pt list by dx 5

Step 6: The Patient Inquiry window should now display the item you are searching for. To add additional items to the inquiry, select either “And” or “Or” on the right hand side of the window under “Report Logic” and then hit the “Add” button at the bottom and repeat the process. (You can have up to 16 items per inquiry.) When all the selection criteria has been filled in, hit Run.

pt list by dx 6

Step 7: Enter a name for the report file and hit Open. (Make sure you browse to a location where you can find the report. We recommend making a folder on the P Drive called “Patient Inquiry.”) Note that you do not want to put an extension on the file name as the program will assign .sel also note that you cannot use any spaces in the file name.

 pt list by dx 7

Step 8: Depending on the size of your database and resources available on the computer you are running the report on, it may take some time to run. When the report has finished you will get a message indicating the number of patients that match the criteria, and the percent this represents of your entire practice.

pt list by dx 8

Step 9: Hit OK and it will print the report.  (This may also take a minute)

 

 

Meaningful Use Update: Immunization Registries and Syndromic Surveillance Public Health Agency Data Submission and Connectivity

McKesson released the following documentation today for Medisoft Clinical and LytecMD clients discussing the population health measure requirement for meaningful use objectives and the current status of Medisoft Clinical and LytecMD collecting and exchanging information with an immunization registry and/or providing syndromic surveillance data to a public health agency.

Meaningful Use Stage 1

In Meaningful use Stage 1, the menu set of meaningful use objectives require eligible professionals (EPs) to satisfy at least one measure related to population health. Specifically, EPs must attempt to exchange information with an immunization registry and/or provide syndromic surveillance date to a public health agency. 1

Meaningful Use Stage 2

In Meaningful use Stage 2, the Submission electronic data to a state immunization registry requirement has been moved from the menu set to the core set. Now, along with testing the submission, successful submission must be maintained for the entire reporting period.

An EP can be excluded from the population health measure:

Immunization Exclusions

(1) The EP, eligible hospital or CAH does not administer any of the immunizations to any of the populations for which data is collected by their jurisdiction’s immunization registry or immunization information system during the EHR reporting period;

(2) The EP, eligible hospital or CAH operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required for CEHRT at the start of their EHR reporting period;

(3) The EP, eligible hospital or CAH operates in a jurisdiction where no immunization registry or immunization information system provides information timely on capability to receive immunization data; or

(4) The EP, eligible hospital or CAH operates in a jurisdiction for which no immunization registry or immunization information system that is capable of accepting the specific standards required by CEHRT at the start of their EHR reporting period can enroll additional EPs, eligible hospitals or CAHs.

The second exclusion will not apply if an entity designated by the immunization registry or immunization information system can receive electronic immunization data submissions.

Syndromic Surveillance Exclusions

Any EP, eligible hospital or CAH that meets one or more of the following criteria may be excluded from this objective:

(1) The EP is not in a category of providers that collect ambulatory syndromic surveillance information on their patients during the EHR reporting period;

(2) The eligible hospital or CAH does not have an emergency or urgent care department;

(3) The EP, eligible hospital, or CAH operates in a jurisdiction for which no public health agency is capable of receiving electronic syndromic surveillance data in the specific standards required by CEHRT at the start of their EHR reporting period;

(4) The EP, eligible hospital or CAH operates in a jurisdiction where no public health agency provides information timely on capability to receive syndromic surveillance data; or

(5) The EP, eligible hospital or CAH operates in a jurisdiction for which no public health agency that is capable of accepting the specific standards required by CEHRT at the start of their EHR reporting period can enroll additional EPs, eligible hospitals or CAHs.

Note: HL7 v2.3.1 has been removed as an acceptable message type. However, if an EP began using HL7 v2.3.1 in Stage 1 and the IIS continues to accept it, the EP fulfills its Stage 2 objective using this version.

Registry Availability

Not all states have implemented electronic submission to their immunization registries or public health agencies. Additionally, some larger metropolitan areas have multiple registries.

In some cases a registry does accept electronic submission, but does not support the government mandated standards. In these cases, submission of data is not required to successfully meet the meaningful use objective.

Thus, McKesson will not develop non-standard interfaces to those registries. If the customer wants to request the development of a non-standard interface, McKesson will evaluate the customer’s need and may provide customization or services packages to enable transmission.

Caveats

Uni-directional vs. bi-directional interfaces

Some registries (North Carolina, Kansas, Pennsylvania and Tennessee) require the use of bi-directional interfaces in order to allow electronic submissions to occur. This requirement exceeds the requirements for the demonstration of meaningful use, which is a uni-directional interface. Medisoft Clinical and LytecMD do not currently support a bi-directional communication pathway.

Additional information required by registries

Registries may require information that Medisoft Clinical and LytecMD may not be able to collect. As with bi-directional interfaces, from a compliance perspective eligible professionals in these locales will meet the requirements and thus be incentive eligible, even though the submission “failed” due to local registry/PHA policies. The client will be provided documentation of the failed attempt, which will be adequate proof of meeting the objective.

1 The rule states the EP must perform at least one test of a certified EHR technology¡¦s capacity to submit electronic data to an immunization registry and/or provide electronic syndromic surveillance data to public health agencies, and follow up submission if the test is successful (unless none of the immunization registries or public health agencies to which the EP submits such information have the capacity to receive the information electronically), except where prohibited.
Disclaimer: AZCOMP Technologies, Inc, (AZCOMP) is providing this material as an informational reference for eligible professionals. Although every reasonable effort has been made to assure the accuracy of the information within these pages at the time of posting, the Medicare program is constantly changing, and it is the responsibility of each provider to remain abreast of the Medicare program requirements.

Revenue Management (EDI) Common Rejections and Fixes

PATIENT MUST BE THE SUBSCRIBER – For this insurance, relationship to insured MUST be S – Self. Spouses of the insured will have their own insurance card and a different member number.

INVALID PATIENT RELATIONSHIP – 3 places to check. 1 and 2. Go to patient, billing tab, confirm relationship to guarantor and relationship to insured is correct. 3. Pull up the claim line item on the ledger, click detail in the top right hand corner, then click on More Detail – correct relationship code on right if needed.

MISSING PRIOR PAYMENT AMOUNT – This was transmitted to the secondary insurance before the primary insurance’s payment was attached to the claim. This will almost always show up with INVALID OTHER SUB ADJ OR PMT DT.

INVALID OTHER SUB ADJ OR PMT DT – Could be a typo in the date of the primary insurance payment, or it is missing altogether.

MISSING PAYER CLAIM CONTRL NUMB – There is a valid Freq Type code being used, but the insurance cannot replace the old claim unless it has the claim control number assigned to it. This will be entered in the first field below the freq type field, and can be found on the Acknowledgement report from the transmission the claim was paid on. (Ex, Pt comes in 01/06/12, gets keyed, but there is a typo in the procedure, so it’s entered as a 99212 instead of 99213… claim goes through and gets paid. While posting payments you catch that the wrong code was used, so you want to resubmit it. Go pull the Acknowledgement report on the claim when it was paid and grab the “TSH CLAIM ID:” for this claim. It’s always a long number starting with 12. looks like this: 1207316105933097972.)

In Medical Billing, go to Ledger > Edit Charge > Additional > Additional 1 tab, enter the claim reference number in the appropriate Claim REF# field as follows:

Claim Ref # (1)  – Enter the claim reference number when resubmitting a prior claim for the primary carrier (as specified in the charge billing order).

Claim Ref # (2) – Enter the claim reference number when resubmitting a prior claim for the secondary carrier (as specified in the charge billing order).

Claim Ref # (3) – Enter the claim reference number when resubmitting a prior claim for the tertiary carrier (as specified in the charge billing order).

NOTE: When claim frequency type code is 7 or 8,  the claim control number should be sent in <OriginalRefNumber>123456789012</OriginalRefNumber> (HCFA > ClaimCore > Item > OriginalRefNumber) to populate Loop 2300 REF (Example: 2300  REF~F8~123456789012).

INCORRECT CLAIM FREQ TYPE CODE – In the line item of the claim, go to the Additional button. the Type Code box will be in the top right hand corner. This carrier does not like the choice that is in there. This field should only be used after an insurance has made a payment and something was keyed incorrectly on the claim. This allows you to re-submit the claim with the corrections.
**A corrected claim is a claim that was originally submitted with incorrect information and is being resubmitted.
When submitting a corrected claim electronically, update the Claim Frequency Code with:
7 = Replacement (replacement of prior claim).
8 = Void (void/cancel of prior claim).
The Explanation of Benefits (EOB), Explanation of Payment (EOP) or Claim Control number of the claim being disputed.
Reason why you are disputing the claim.  Claim will be rejected if Claim Control number is missing, too.

MISSING/INV DIAGNOSIS CODE POINTER – Usually a diagnosis code was listed twice. I advise reviewing the claim and removing the duplicate. If that fails, re-enter  the claim and then bill it.

MISSING PRIMARY DIAGNOSIS CODE POINTER – Make sure there is at least one diagnosis. probably just a typo when keying the charge initially.

MISSING SUBSCRIBER GROUP NAME –  The 2000B SBR04 is missing for the carrier’s group name.
1. Make sure that the carrier plan name was filled in.
2. The plan name needs to be entered into the insurance carriers profile
3. Create a new insurance account plan on the patients account in order to select the account plan name.

MISSING SUBSCRIBER GROUP NUMBER – Pull up the patient, then click on the insurance button at the top. In the top left corner, there is the group number.

INVALID AMT/COB OUT OF BALANCE – This just means the math does not add up. Usually this is because the adjustment code (Maintenance – Configuration – Definitions- Adjustment) is missing a Group Code X12 or a Reason Code X12. If these are both present, this can be corrected by deleting and re-keying the adjustment on the claim.

INVALID SL PAID AMOUNT – This is almost always with the INVALID AMT/COB OUT OF BALANCE. Correcting one will correct the other, IF NOT  Claim core > ServiceLine2 > ProfessionalService > AdjudicationInfo > ClaimLevelAdjustments > ClaimLevelAdjustment > Quantity. – Hardcode a 1 for the payor specified

INVALID ACTIVE SUB MEMBER ID – The Payor ID (CPID) found under Insurance – Billing Tab – Advanced Claims Tab is not a valid number. The active numbers can be found here.

INVALID INSURED ID NUMBER – The insurance member/plan number entered for the patient is not an active number – usually this is caused by billing an insurance that the patient did not have coverage through at the time of service.

INVALID ADJUSTMENT GROUP CODE – (Maintenance – Configuration – Definitions) The Group Code X12 selected for the adjustment on this claim is not valid for this type of adjustment and needs to be changed.

SERVICE NPI SAME AS BILLING NPI 
1. If this claim is for Place of Service 11 or 12, remove the facility.
2. If this is not at PoS 11 or 12, then compare the practice and facility names and addresses. They must be character for character identical for RH to scrub out the NPI.
3. The facility may have the wrong NPI.

DESTINATION PAYER MUST BE PRIMARY – Whatever insurance this was being sent to (in this case, Mutual of Omaha) has to be the primary insurance in order to receive payment.

INVALID ZIP CODE – Three places that could cause this. Check for a country code of USA and a 9-digit zip-code.  Note: If you find that one of the zip code fields requires the full 9 digit zip code then you can find it by entering the 5 digit code into the USPS Zip Code Lookup Tool – http://www.usps.com/zip4/
1. The Practice Information
2. The Provider Profile
3. The Facility

Loop   –   Segment    –   Description   –   Zip Code Length
2010AA – N403 – Billing Provider Name – 9
2010AB – N403 – Pay-To Address Name – 5
2010AC – N403 – Pay-To Plan Name – 5
2010BA – N403 – Subscriber Name – 5
2010BB – N403 – Payer Name – 5
2010CA – N403 – Patient Name – 5
2310C – N403 – Service Facility Location Name – 9
2310E – N403 – Ambulance Pick-up Location – 5
2310F – N403 – Ambulance Drop-Off Location – 5
2330A – N403 – Other Subscriber Name – 5
2330B – N403 – Other Payer Name – 5
2420C – N403 – Service Facility Location Name – 9
2420E – N403 – Ordering Provider Name – 5
2420G – N403 – Ambulance Pick-Up Location – 5
2420H – N403 – Ambulance Drop-Off Location – 5

MISSING OTHER SUBSCRIBER INFORMATION – When re-billing the charge (print, print/review insurance claim), set the BYPASS PAYMENTS/ADJUSTMENTS (bottom option) to Y, to bypass that payment/adjustment

INVALID SERVICE LINE DESC – There is usually an invalid character in the Procedure Description. More often than not, it is a > or < to designate a shot for children under or over a certain age.

INVALID SL THROUGH DATE  – There was a typo in one of the dates on this claim.

INVALID ADJ ADJUSTMENTS QTY  – Claim core > ServiceLine2 > ProfessionalService > AdjudicationInfo > ClaimLevelAdjustments > ClaimLevelAdjustment > Quantity. – Hardcode a 1 for the payor specified

MISSING INSURANCE TYPE CODE  – Claim Core > OtherSubscriber > OtherInsuranceTypeCode and OtherInsuranceTypeCodeSpecified. – Unsuppress.

INVALID SL ADJUD OTHER PAYER ID – This is usually because the 2ndary or tertiary insurance has a bad CPID in the advanced claims tab.

SL PRIOR PAY NOT ALLOWED – This is happening when sending a primary claim after the patient has made a payment and it has been attached to the charge line. There IS a setting to suppress Pt. payments when sending to the primary (Maintenance – Configuration – Settings – Insurance) If this is already turned on, resend the claim after making sure there are no insurance payments on it.

MISSING CLIA NUMBER – 

Open the ClaimConfigurationUtility in PPART. Under ClaimCore > Item > ClaimSupplimentalInfo > CLIANumber
Select the option that says Practice User Defined CLIA.
Verify that in Practice Maintenance, Other Data Tab that the PCLIA ID id present and populated with the CLIA number.

Solution: Unable to connect to McKesson for product authorization

Problem or Issue

McKesson cannot authenticate the serial number of the product for networked versions of Medisoft of Lytec. These include:
• Medisoft Network Professional
• Lytec Client/Server

Cause

There are two possible causes:
• Medisoft or Lytec cannot reach the authentication server using the Internet, or
• Medisoft or Lytec cannot authenticate within a certain timeframe due to high Internet usage or network usage.

Solution

1.  Download the following file and extract to your desktop: PHConnectionTest

2.  PHConnectionTest.exe can be run from any location on either the server machine, or any client workstation connected to the application’s data server.

Note: Complete this process on each workstation that has Medisoft or Lytec installed if they experience similar problems in the future.

3.  Prior to running the PHConnectionTest.exe, close any running instances of Medisoft or Lytec on the workstation.

4.  Double-click PHConnectionTest.exe to start the PHConnectionTest application.

5.  Click the Start Connection Test button to allow the PHConnectionTest application to perform some quick network diagnostics. The results will appear indicating whether the connection tests have passed or failed. This will aid Support in troubleshooting network connectivity issues.

phconnect test6.   Click the Make sure CheckActive2 Is Installed button. A confirmation screen appears. All installations of Medisoft and Lytec on the workstation will be identified, and, if currently running, will be closed. In addition, all installations of Medisoft and Lytec will be updated.

phconnect27.  Click the Yes button. The Update Succeeded screen appears. In the screen sample below, both instances of Medisoft and Lytec were updated.

phconnect3

8.  Click the OK button to complete the process.

9.  If the application still cannot authenticate the serial number, you will see the McKesson Product Authentication screen.

phconnect4

Note: This screen sample is for Lytec. A similar screen for Medisoft will appear with a unique link for Medisoft.

10.  Follow the directions on this screen to unlock the application for 90 days. If necessary, connect to the indicated URL by a different machine that has Internet access. This can be any workstation, tablet, smart phone, and so on

11.  On the Product Authentication screen, enter the challenge code and click Retrieve PIN. Enter the five-digit PIN into the Product Authentication screen within Medisoft/Lytec

phconnect5

 

 

Rx Fill History & Recording Patient Consent

Use The Rx Fill History with e-Prescribing in Medisoft Clinical or Lytec MD

The Rx Fill History tab under the Rx/Medications section of the patient’s chart is a valuable tool that is designed to help physicians reconcile medication in order to prevent adverse drug interactions or overdose.

Note: The Rx Fill History tab is only available to providers enrolled in ePrescribing.

The Rx Fill History tab displays pharmacy fill events downloaded to your system from the patient’s Pharmacy Benefits Manager. This feature allows you to see details of what medications your patient is actually obtaining from pharmacies, whether they were prescribed by you or another physician.

You can obtain or refresh the fill history by clicking the Update Fill Hx button, which will initiate a live download of data from the patient’s Pharmacy Benefits Manager. (This feature is limited to what the Pharmacy Benefits Manager provides. It may not contain a complete list of all medications for any particular patient, and it may not be available for all patients.)

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Once data has been downloaded you can view detailed information about a prescription by selecting the prescription from the list and clicking the Show Detail button. The Medication Fill History Detail screen will appear with detailed information about the prescription.

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You can use the Fill History to update the Current Medications list by clicking the Add to Current Meds button.

Considerations Regarding Patient Privacy& Practice Liability:

It is up to the practice to make sure they are gaining patient consent before accessing a patient’s medication history through their e-prescribing/EMR software system. Surescripts does not provide any sort of form/template for gaining patient consent. As a network, Surescripts does not mandate how a prescriber obtains consent-whether this is done orally or in writing (although the prescriber must act in accordance with the applicable law where they are practicing).

Sample wording for a signed consent:

“I understand that performing a medication reconciliation in order to prevent adverse drug interactions and overdose is a critical component to my care. By signing this form I authorize my provider to query and review my medication fill history including drug, dose, form, strength, prescribing provider, and pharmacy.”

Optional Security Settings:

Access Levels can be used to limit access to the Rx Fill History features to only those users that should have access. Your system administrator grants or denies access to these features by going to Maintenance/Setup/Access Levels, selecting the access level and hitting the Edit button.

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On the Records tab the “Rx Fill History Request” should only be checked for users that should have the ability to request the fill history information. And “Rx Fill History” should be checked for users that should have access to view the Rx Fill History tab of the Medications Screen.

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By default the system is setup with the assumption that either a written or oral consent has been obtained, however there is a feature that can be enabled to require users to record in the patient record that consent has been obtained. This would prevent the download of fill history data for any patients that had no indication that consent had been obtained.

To set this feature up the Administrator must edit the ppart.ini file (Found in the ppart directory on the server), changing the current setting of “RxFillHxCheckConsent=OFF” to “RxFillHxCheckConsent=ON

The next step is to create a new question under the patient demographics screen. The “Other Data” tab in the patient’s chart is a place where you can create custom fields to record information on a patient that is not otherwise tracked in the chart. We will setup a question on this tab to indicate whether or not the patient has given consent to obtain Rx Fill History.

Select Maintenance/Configuration/Define Other Data/Patient

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When the Patient Define Other Data Select screen appears, click on the New button.

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Enter Rx Fill Hx OK? in the Label field, select Text from the Type drop-down list, and select 1 Character from the Length drop-down list. Enter a Description and hit OK.

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The Rx Fill Hx OK? field will now appear on the Other Data tab of the Patient screen.

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You will need to establish a workflow where patients (or, for minor patients, their guardian) are informed that their pharmacy benefits provider provides information about the medications they have had filled at retail and mail-order pharmacies, and asked for their consent to request that data for medications prescribed by all providers, providers at your site, or not at all. You can enter the following values in the Rx Fill Hx OK? field based on the patient’s response:

– Enter “Y” if the patient gives consent for all providers.

– Enter “P” if the patient gives consent for providers at your site.

– Enter “N” if the patient does not give consent.

Note: The response must be entered in as a single character and must be in uppercase for the feature to work.

Closing Screen Clinical

 

ICD-10 Makes Paper Superbills Obsolete

Why Paper Superbills Won’t Survive ICD-10 And What To Do About It.

ICD-10 Superbill Template for Family PracticeOne of the many steps practices will need to take in order to be ready for ICD-10 is updating their superbill. Codes are drastically increasing and that is definitely reflected in a paper superbill. What once was 2 pages has turned into 9 pages! At AZCOMP we just don’t see that as practical.

“Paper superbills with diagnosis codes on the back are about to become a thing of the past,” says Kim Pollock, RN,  “Using the same charge capture tool you used for ICD-9 just won’t be sustainable with ICD-10.”

Check out this Sample ICD-10 Superbill Template. You’ll quickly recognize that a giant superbill is more than impractical.

Now Is The Time To Switch From The Paper World To Electronic

Not only because of the sheer increase in paper- but because of the higher level of documentation required. Payers will need to see much more documentation and that will be extremely hard to meet with paper documentation.

2 Easy Options For Electronic Superbills

#1 – Go Mobile

For a fast way to take your superbill electronic, start using the Mobile Application available in both Medisoft and Lytec. This instantly alleviates the problem of massive paper work- but it has several other cool benefits as well.

On the Mobile App, providers enter charges on their iPad. Superbills that the doctor did in the hopsital won’t get lost. All superbills are available immediately for billing- and since the biller won’t have to rekey all the information, then the claims will go out sooner and providers will get paid faster.

Check out this quick Mobile App demo

#2 – Make The Switch To EMR

Of course if you want to go electronic the best long term solution is Electronic Medical Records. EMR is already known to get rid of the down-coding problem rampant among paper chart providers. You can stop down-coding because you can easily prove what was done, and that will be the same with the new level of detail required with ICD-10. And, with EMR costing as little as $349 a month- EMR is more affordable than ever!

Call for a consultation!

Find out more about the available mobile apps, and also our EMR options we have for your practice. We can set up a demo, get you pricing and answer questions. Call us at (888) 799-4777.

 

What is the best way to sent patient statements?

Most Widely Used Add-on for Medisoft and Lytec

EVERYONE HAS TO SEND PATIENT STATEMENTS- BUT WHAT IS THE BEST WAY?

Check out this short video and you will quickly see why Billflash is by far the most widely used and loved add-on for Medisoft and Lytec users. 

What once took days to do, can now be done in a few clicks without ever leaving your medisoft or lytec billing software.

McKesson Practice Choice EMR Implementation & Training

McKesson Practice Choice EMR Implementation & Training

Implementing EMR has never been easier or quicker thanks to Practice Choice. This EMR & PM Software is so intuitive and easy to use- you’ll love how quickly you’re up and running on this system.

For a Limited Time Only- Absolutely FREE Implementation & Training on Practice Choice EMR! Why pay $4,100 when you can get it for FREE??? Call 888-799-4777 for Details.

Practice Choice Implementation & Training Hours and Prices:

Quoted per Provider based on Subscription Package Selected

  • Standard Package 1st Provider, 24 Hours- $4,100
  • Connect Package 1st Provider, 26 Hours- $4,400
  • Premium Package 1st Provider, 28 Hours- $4,700
  • Additional Provider any Package, 8 Hours- $1,450

All Training & Implementation Packages are currently FREE! Limited Licenses Available. Call 888-799-4777 For More Information.

The implementation for Practice Choice is all done remotely via Microsoft Live Meeting or McKesson’s support portal. Also, during the implementation, practices will have access to online training videos.