OpenPM medical billing and RCM support for practices and billing companies
We work inside your OpenPM database under named logins you create, after a BAA is signed. We review incoming charges, send claims through OpenPM's built-in EDI, post ERA remittances, and work denials and A/R.
Written by Salman Saeed, CEO and Co-Founder · Reviewed by a Certified Medical Coder · Last reviewed October 2026In short: we step into the billing queues of your OpenPM database with our own named, two-step logins. OpenPM handles claims, ERAs and attachments inside the platform, so we work from there. We claim no partnership with Open Practice Solutions.
What is OpenPM and who is it built for?
OpenPM is a browser-based billing and practice management platform from Open Practice Solutions. The vendor's home page describes it as a fully integrated, browser-based billing and claims platform, and says it serves medical billers and practice managers, whether they work for an RCM company or bill for an independent practice.
The vendor says it began in 2005 working closely with revenue cycle management companies, then found the product also fit larger practices and EHR partnerships.
OpenPM is a billing system, not a clinical record. The vendor's RCM page says it has no EMR and puts its effort into maximizing reimbursement. Charges normally arrive from your EHR. For large groups that pair a clinical system with OpenPM, see our page on large groups and health systems.
Which OpenPM modules affect billing work?
The vendor names several parts of the product. These are the ones that touch the revenue cycle.
| Module or feature | What the vendor says | Why it matters to a biller |
|---|---|---|
| Built-in clearinghouse and EDI | No separate logins; all EDI functions are managed in OpenPM, including claims, ERAs and electronic attachments. | Claim status and rejections are read in one place. |
| Jobs and Rules | Jobs and Rules automate parts of the revenue cycle so staff focus on exceptions. Charge and ERA Rules and a Job Scheduler are named for A/R work. | We need to know which rules are active before we change a workflow. |
| Real-time claim status | An instant status for a claim that should already be paid, or an automated follow-up routine. | Cuts phone and payer portal time on aging claims. |
| Insurance Discovery | Finds primary, secondary and tertiary coverage on self-pay and incomplete accounts. | Turns some self-pay balances into billable claims. |
| POPS patient portal | Online scheduling, reminders, balance notifications, registration and online payments, built into OpenPM. | Patient payments post in OpenPM without a second system. |
| Business Intelligence | Five native dashboards, refreshed overnight. | Source for our denial and A/R reviews, see below. |
How do claims move from OpenPM to the clearinghouse and payer?
Claims go out through the EDI tools inside OpenPM. The vendor's RCM page says the built-in EDI lets a team manage submissions, ERAs and electronic attachments without logging into a separate clearinghouse portal.
Encounters from an outside EHR arrive by API, HL7, HTTPS or SFTP, per the vendor's FAQ. It adds that encounters import as incomplete charges for billers to review before submission. That review step is where we start.
On the paper form side, CMS Claims Processing Manual chapter 26 says item 24D of the CMS-1500 holds the procedure code, that the form captures up to four modifiers per line, and that item 24E holds the diagnosis reference for the line. Whatever OpenPM maps into those fields is what the payer reads.
How does OpenPM post ERA and 835 remittances?
The vendor lists ERA posting as a core feature: submit claims, receive payments and post transactions electronically. An ERA is the electronic remittance advice, sent as an X12 835 file, that tells you what the payer paid and why it adjusted the rest.
The vendor's enterprise page names ERA Rules, which are set to automate posting so staff concentrate on exceptions. We read those rules before we touch posting.
For denials, the vendor says users can categorize and track denials by reason code, and its Business Intelligence page lists built-in CARC descriptions on screen. A CARC is the claim adjustment reason code on the remittance. We work each reason code against the payer contract and the RARC remark code beside it.
What access does a billing partner need in OpenPM?
We need named user accounts that your administrator creates in your OpenPM database, limited to the billing work we do. The vendor says an RCM company can control database access and manage many practices from one login, so tell us which databases are in scope.
Our security page lists how we protect data.
What do we do inside OpenPM?
We work the revenue cycle queues in your database. Typical tasks:
- Review incomplete charges that arrive from your EHR, and fix coding and demographic gaps before submission
- Send claims so they go out within 24 hours of charge entry, and clear rejections from the clearinghouse reports
- Post ERA remittances and review the exceptions that rules do not handle
- Work denials within 48 hours, by reason code, with appeals where the payer contract supports one
- Follow up on aging claims by payer, using claim status checks and send patient statements
Scope is agreed at setup. See medical billing services and accounts receivable recovery for the full service.
Which OpenPM reports matter for denial and A/R tracking?
The vendor describes core reports for daily work and a separate Business Intelligence suite. Its enterprise page lists denial analysis by CARC, interactive A/R aging that drills down by insurance or provider, and a 12-month executive summary of KPIs and payer performance.
| What we want to know | What the vendor lists | How we use it |
|---|---|---|
| Denial trends | Denials categorized and tracked by reason code; top 10 rejection drivers across clearinghouses and payers. | Find the payer and reason behind repeat denials. |
| A/R aging | Interactive aging buckets with hover tools and a filter for negative balances. | Prioritize old balances and spot credits. |
| Billing speed | Days to Add, Days to Bill and Total Days to Bill. | Measure charge lag between visit and claim. |
| Unmarked appointments | Encounters that still need final charges linked. | Catch visits that were never billed. |
What billing checks matter most in OpenPM?
We attribute no defects to OpenPM. These checks are tied to what the vendor describes.
| Check | Why we run it |
|---|---|
| Imported charge review | Encounters import as incomplete charges, per the vendor. We compare a sample against the source encounter, because a wrong field repeats on every claim built from it. |
| Active Charge and ERA Rules | Rules automate clean claims and posting. We list which rules are on, so an automatic adjustment is never mistaken for a payer decision. |
| Modifier and diagnosis pointers | CMS manual chapter 26 says the CMS-1500 carries up to four modifiers per line and one diagnosis reference per line in item 24E. We check that each line points to the right diagnosis. |
How we handle billing in OpenPM
You keep the database, the data and the payer relationships. We work in your OpenPM account under named logins and a signed BAA, on the queues you assign, and we have no partnership with Open Practice Solutions. See the EHR systems hub for other systems, CollaborateMD and Medisoft for similar billing platforms, and our guide to choosing a billing partner.
To talk about your OpenPM setup, book a call.
- Open Practice home page · Open Practice Solutions
- What is OpenPM? · Open Practice Solutions
- OpenPM for RCM companies · Open Practice Solutions
- OpenPM for enterprise practices · Open Practice Solutions
- OpenPM Business Intelligence · Open Practice Solutions
- POPS patient portal · Open Practice Solutions
- Medicare Claims Processing Manual, chapter 26 (CMS-1500 completion) · CMS
We check every rule, code and deadline against the official source. See our editorial policy.
Common questions
Straight answers from the team that does the work.
Ask a billing lead directly. A 20-minute call, Monday to Friday, 9am to 5pm Eastern.
01Can an outside billing company work inside OpenPM?
Yes, if your organization creates accounts for them. Your administrator adds a named user for each person after a BAA is signed. Logins use two-step login and nobody shares credentials. The vendor says RCM companies already manage many practices from one login, so outside billing teams are a normal use.
02What access does a billing partner need in OpenPM?
Named accounts for each person, limited to the databases and queues in scope: charges, claims, ERAs, denials and A/R. We do not need clinical notes beyond what supports a claim. Your administrator controls database access, and we agree scope and reporting at setup.
03Which OpenPM reports matter for denial and A/R tracking?
Denial analysis by reason code, interactive A/R aging by insurance or provider, the 12-month executive summary, and the Business Intelligence RCM and A/R dashboards. We use them to see denial drivers by payer, aging by bucket and billing speed. The exact list is agreed at setup.
04How do claims move from OpenPM to the clearinghouse and payer?
The vendor says OpenPM has built-in EDI, so claims, ERAs and electronic attachments are managed without a separate clearinghouse login. Charges arrive from your EHR as incomplete charges, a biller reviews them, and the claim is submitted from OpenPM. We send within 24 hours of charge entry.
05How does OpenPM post ERA and 835 remittances?
The vendor lists ERA posting as a feature, with ERA Rules that automate posting so staff handle exceptions. An ERA is the electronic version of the payer's explanation of payment, sent as an X12 835 file. We review the rules in use and work the exceptions.
06What billing mistakes are common in OpenPM (charge capture, modifiers, demographics)?
We attribute no defects to the software. The checks we run are general: imported charges with missing fields, modifiers beyond the four the CMS-1500 holds per line, diagnosis pointers that do not match the service, and patient demographics that do not match the insurance card. We sample each against the source.
07Does OpenPM work with my EHR?
The vendor says it integrates with EMR and EHR systems using API, HL7, HTTPS and SFTP connections, and its site cites over 75 EMR integrations. Whether yours is connected is a question for your administrator or the vendor. We work with the charges that arrive in OpenPM.
08Can OpenPM help find insurance on self-pay accounts?
The vendor describes Insurance Discovery as finding primary, secondary and tertiary coverage on self-pay and incomplete accounts in real time. When it returns a policy, we check eligibility before billing, then submit the claim. Eligibility checks are part of our front-end work, see our eligibility service.
09How do you keep OpenPM data protected?
We sign a BAA before any data is shared, all staff complete HIPAA training and sign NDAs, every login uses two-step login, and backups are encrypted. A dedicated compliance officer oversees this. Each person has a named account, so access is traceable. See our security page.
10Is there a billing company that works in OpenPM?
Yes. Nucleus Align works inside OpenPM with named, role-limited accounts you grant. We review charges, send EDI claims within 24 hours of charge entry, post remittances and work denials within 48 hours. A BAA is signed first and scope is agreed at setup.
11Medical billing service for practices using OpenPM
Nucleus Align provides billing for OpenPM practices, covering claim edits, payer follow-up, ERA posting, denial work and patient balances as agreed at setup. You keep ownership of OpenPM and decide what our team can see and do. You can book a call on our contact page to walk through your setup.
12Can an outsourced billing team use our OpenPM logins?
No shared logins. You create a named user for each Nucleus Align team member with the roles you choose, so every action in OpenPM traces to a person. Our team signs in with two-step login under HIPAA training and NDAs. Nothing changes in how your team documents care.
Running OpenPM? Talk to us.
A 20-minute call about your payers, volume and setup. Monday to Friday, 9am to 5pm Eastern.