CMS Pub. 100-04, ch. 24, § 40.2.4.7.1

Before selecting a vendor, the provider must examine its business needs to identify the

EDI, practice management, or other services that the provider is interested in obtaining

from a vendor. The provider should consider what services could be easily performed by

their in-house staff and which might be more cost effective to obtain through a vendor.

The provider should create a written description of the components of its practice that

need vendor support and a description of support needed so prospective vendors can

design their proposals to best meet the provider’s needs. Requirements to consider

include the following:

• Future Growth of the Practice;

• Workload;

• Payer Analysis;

• Referral Tracking;

• Fee Schedules;

• Appointment Scheduling;

• Medical Records;

• Interconnections with Physicians/Hospitals and other Networks;

• Word Processing Needs;

• Electronic Billing (formats and versions supported);

• Multiple Practices/Locations;

• High Volume/Low Volume Billing;

• Specific Bill Types;

• Management Reporting;

• Hardware/Software Requirements/compatibility with existing equipment; and

• Data Storage needs.