It seems like just yesterday, as the CEO of a multi-provider ophthalmology center and ambulatory surgery center, I was faced with the challenges of finding a new practice management system and implementing electronic medical records into our organization's processes. Though there were many decisions and choices to be made, the one decision I didn’t make was the claims clearinghouse we would use. At the time, no one told me I had a choice and because of that decision many hours of lost productivity and revenue cycle management issues were encountered.