Medical PracticesServing Dallas-Fort Worth

Staff says the EHR is down. The EHR is fine, and something it depends on is not.

We trace the connections behind missing results and failed transactions, and manage the equipment your staff depends on.

When three vendors say it is somebody else's problem, we get on the phone with them.

Ask one IT question

The record moved to the cloud. The practice did not.

The check-in desk of a small practice: a monitor showing an indistinct schedule grid, a card reader, a printed day sheet on the counter and a wall of colour-tabbed chart folders behind.

A result does not post. A prescription will not transmit. An eligibility check times out with a patient standing at the counter. To everybody in the building the EHR is down, and the EHR vendor's status page is green, because from where they sit nothing is broken.

Each of those interfaces has a vendor at both ends and a connection in the middle that often belongs to a third.

So the call goes in a circle. The EHR blames the lab, the lab blames the interface, and the interface belongs to a third company nobody in your office has a number for. We make those calls instead of you. Your practice manager has a job already.

We work for you.

Our managed IT has no long-term contract. There is no separate onboarding fee either.

We resell nothing and take no vendor commissions. Nobody pays us to recommend their product.

Billy Dunn designs and supervises the technical work. He founded this company in 1989, and the same family has owned and run it ever since.

Within our scope, we document what your business controls. That means the domains and the administrative accounts. The documentation is yours whenever you want a copy, including when you leave.

Three that come up in almost every practice

Interfaces

The EHR is up and the results are not arriving

Orders and results move over HL7 as ORM and ORU messages, and a result can carry only a report or a link rather than the images themselves. When that channel stalls, the chart just looks empty.

Staff start phoning the lab for faxes, which is how results end up back on paper.

The building

A hosted EHR moves the server out, not the office

Scanners, label printers, card readers, check-in tablets, the network, the Wi-Fi and every workstation are still yours, and any one of them can stop a visit.

None of it becomes somebody else's job because the record is hosted.

The money

Nobody here can name the route a claim takes

Aetna's own vendor list reads Optum (formerly Change Healthcare), Waystar (formerly NaviCure and ZirMed), TriZetto Provider Solutions (formerly Gateway EDI).

The practice knows which button it clicks. That is not the same as knowing who carries the claim.

When the fault sits between two companies, chasing it is our job, not your practice manager's.

The EHR is only part of the practice

Charting, orders, results, prescribing, eligibility, claims, referrals, imaging and patient messaging all run on connected systems. The record may be hosted somewhere else, but the interfaces between those systems, and the equipment in your building, are still somebody's job.

The systems your medical practice runs on

The record and practice management

athenaOne, eClinicalWorks, NextGen Office and NextGen Enterprise, Tebra (Kareo and PatientPop before the rename), AdvancedMD, Elation, Greenway Intergy and Prime Suite, Veradigm (Allscripts Professional before it), Practice Fusion, CareCloud, RXNT, CharmHealth, PrognoCIS, CureMD, Azalea

Specialty systems that are not a generic EHR

ModMed EMA in dermatology, ophthalmology and orthopedics; gGastro for endoscopy; Nextech and Compulink in ophthalmology; ChiroTouch; WebPT, Raintree and Prompt in physical therapy; SimplePractice and TherapyNotes in behavioral health

The interfaces nobody sees until they stop

lab orders and results over HL7, e-prescribing, eligibility, the imaging launch, the HIE, the portal, and whatever single sign-on sits in front of all of it

Claims, eligibility and remittance

Optum, Waystar, Availity, TriZetto Provider Solutions, Office Ally, Claim.MD, Veradigm Payerpath. Several answer to an older name, which may be the one in your setup notes

Patient access and messaging

Phreesia, Klara, Luma Health, Relatient Dash, Artera, Updox, healow, InteliChart, Clearwave. Each one holding another copy of your patient list

Everything your staff touches

network, Wi-Fi, scanners, label printers, card readers, email, phones, accounts. Yours, whatever the EHR vendor hosts

When one piece fails the front desk backs up, clinical staff start inventing workarounds, and the waiting room gets a front-row seat. We manage everything around the record, and we take it up with the vendor when the fault sits between companies.

Protected health information needs sensible boundaries

Patient information turns up in email, scanned forms, shared drives, exported reports, billing attachments, the fax archive, voicemail and whatever device happens to be on the counter. Give staff the access their jobs need, take it back the day they leave, and do not let one shared login become office tradition.

We configure and manage Microsoft 365 or Google Workspace, multi-factor authentication, permissions, device security and secure sharing. Those controls help protect patient information. They do not certify compliance, and we will not pretend otherwise: the policies, the risk analysis, the training and the regulatory decisions stay with the practice.

An outage you did not cause can still stop your cash flow

In February 2024 an attack on Change Healthcare stopped claims moving across the country. Practices could not submit, could not verify eligibility, and could not say when money would arrive. None of them had done anything wrong. They were simply downstream of something they had never had to think about.

Nothing in your office broke, so nothing in your office fixes it. What helps is having the route written down beforehand. We record which clearinghouse carries your claims, which enrollments exist and what a second way to submit would take, so the question "can we bill at all this week" has an answer before the week it matters.

Closer to home, monitoring runs around the clock through a staffed security operations center. Phishing simulation and training help people spot a fake document share, password reset or payment request, including one that looks like it came from the practice manager.

Security has to fit how the practice actually works. Anything that blocks a routine task just breeds shortcuts around it.

Your EHR vendor backs up the EHR. Check what else is in that contract

That is the whole trap in a hosted practice. The record is covered. The scanned documents on the file server, the fax archive, the images on the modality workstation and the spreadsheet your biller actually runs the month on very often are not, and nobody goes looking until one of them is gone.

A backup sitting next to the system it protects gets encrypted along with it. We keep backups separate, and we run the restore rather than reading the report. A green checkmark is not a recovery plan.

Agree on the recovery order while the schedule is still running. Start with these questions:

  • How will patients reach us?
  • How will we see today's schedule?
  • Can clinicians reach the chart?
  • Can the desk still verify eligibility?
  • When do claims have to start moving again?
  • What else can wait?

Ask one IT question

Pick the thing about your practice's IT that has been nagging at you and send it over. You will get a straight answer, at no charge, with nothing to sit through afterward. If the honest answer is that somebody has to look at it, we will say so.

Send one question

Email it or pick up the phone. No form to fill in first and no meeting to sit through.

Get a straight answer

At no charge. If it can be answered honestly from the outside, we answer it. If it cannot, we say that instead.

Decide what happens next

Nothing follows automatically. If a closer look would help, we will tell you, and it is still your call.

Before you send it

We already have somebody doing our IT

Ask anyway. If your person has it handled, that is what you will hear, and it will have cost you one email. We are not trying to talk you out of somebody who is doing the job.

What is this going to cost

The answer to a question costs nothing. Anything past that is scoped and priced in writing first, and you approve it before anyone touches a system.

We are in the middle of a contract with someone

Nothing here asks you to break an agreement. A straight answer to one question is not a switch, and plenty of people ask us something years before anything changes.

The free answer, and any separate review

  • An answer to a question, not troubleshooting, system access or ongoing support.
  • Some questions cannot be answered honestly from the outside.
  • If a closer look would help, we may offer a read-only review as a separate engagement, with a written summary of what we found and what we would do about it.
  • Before anyone touches a system, both sides confirm in writing the scope, the sample, who authorizes the access, the date and any fee.
  • Asking does not book a review, and printed material does not reserve an appointment.
  • Reviews take real hours, so they are subject to availability. One per practice.

A review is a point-in-time sample of the systems named in the written scope. Items outside that scope are not evaluated and have not passed. It is a limited IT safeguard review, not a HIPAA audit, compliance determination, certification, penetration test or legal opinion.

What has your staff quietly learned to work around?

An interface that fails every Monday, a report nobody trusts, a claim nobody can trace. Send us whichever one it is.

Call (817) 265-5000 or email [email protected].

Ask one IT question