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Obtenez l'un des meilleurs logiciels pour ostéopathes pour 299 $ par mois ou gratuitement avec le service de facturation et de recouvrement d'assurance-maladie ACOM.

En savoir plus sur RAPID

Avantages :

Rapid is so easy to use for our busy chiropractic office. It makes filing claims, scheduling patients, printing statements, and running reports easy for all of my employees.

Inconvénients :

That a patient cannot have 3 different types of accounts within their main acct. Insurance, Auto accident and Cash accts.

RAPID - Notes

Note moyenne

Facilité d'utilisation
4,3
Service client
4,4
Fonctionnalités
4,3
Rapport qualité-prix
4,4

Probabilité de recommander le produit

8,4/10

RAPID a reçu une note globale de 4,4 étoiles sur 5 d'après 153 avis d'utilisateurs publiés sur Capterra.

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Filtrer les avis (153)

Joan
É.-U.
Temps d'utilisation du logiciel : Non fourni
Source de l'avis
Source : SoftwareAdvice
5,0 il y a 11 ans

Commentaires : I am a relative old-timer, in practice 32 years. I work part time and currently run a pretty low key, solo practice out of my home. I have no employees, and in a great week will see 60 patients. I've been using one computer program or another to run the business side of my practice since the dinosaur age (I bought my first computer in 1982 - a Digital Rainbow which loaded the operating system using two 5 1/4 inch floppy discs - and I wrote the first accounting programs myself). I finally bought an 'official' program and used it for years. In 2006 I realized that I needed to do something more than travel cards and buy a program to help me with my charting. I looked around, and chose BestNotes (which, by the way, is a great stand alone program for doing notes). Though the program was great, I tried to make my note a faithful reflection of what I did and talked about during the visit, couldn’t do that in a timely manner, and so was chronically behind in charting. It got to the point that the only patients who had more than a line or two of history in their charts were the ones who 'had' to have notes sent - personal injury, worker's comps - and those who had notes requested for one reason or the other (those requests sometimes took weeks to fulfill). This behavior finally caught up with me. I was unable to produce charts on three patients out of the 30 requested during an 'in-house' audit, and had to return lots of money. I decided that I had learned my lesson. I was going to do notes on every patient every time, using the system I already had in place. Within six months, I was so far behind I could not possibly catch up once again. I decided I needed a different system, one that integrated notes with practice management, so that I could not bill unless the note was finished. I also had to give up being perfect at notes, and realize that I was writing the note for the insurance company, not for the patient. It took me four or five months to test drive all of the different programs out there, and once I had, I chose ACOM/Rapid. I took a deep breath, put myself into debt, and bought both the practice management and charting systems in April 2011. I was told that it would take me several months to ‘go live’ but I knew better! I thought of myself as very computer savvy, had already programmed lots of language into my BestNotes system that I thought I could just transfer over, and was sure I didn't need as long as ACOM predicted to put the system in place. Turns out that they were right (and they usually are) - it did take what felt like a very long time to educate myself and get everything I needed into the system. Turns out it really is a process, and can't happen overnight. ACOM has the process part down pat - all I had to do was follow the plan. I didn't actually go live until August 1, 2011, and I can't say even that was glitch free, but what I can say is that I have never called tech support and had them unable to find/fix or teach me how to avoid whatever problem I encountered. I got real chummy with some of the techs - and every experience was positive. Lots of time has passed since then. I don't remember what version I started with, but I'm at v3.7.7 of the practice management, and v7.1 R3.0 of Rapid Documentation, and every time a new version comes out, the program is easier to use. I haven't actually changed my spots - I still get behind on notes - but I haven't billed for one service that doesn't have documentation to support it since August 1, 2011. I no longer live in fear of an audit and I find it amazingly satisfying to get a request for a chart and be able to fulfill the request the same day. I can do my notes, post the charges, send the insurance, print statements, and be done with it, all with these two integrated programs (and, no staff!).

mark
Doctor (É.-U.)
Cabinets médicaux
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

The most customizable system available.

5,0 il y a 8 ans

Avantages :

I have been a chiropractor for over 30 years and in the middle of my career I spent 10 years , full time, designing, installing and selling home theater audio-video equipment. Because of my experience in both fields, I believe I am unusually qualified to review this software. First of all the software is extremely well laid out with respect to setting it up. There are tutorials that are short, to the point and shows you everything you need to know to set it up. Phone support is necessary to me and Acom's support is quick and available when you need it. I am a diplomate of addiction and compulsive disorders and do a lot of other work like neuro-biofeedback, positive motivational therapy and the like. Acom is the ONLY company that is available that allows me to customize the program the way I need to use it..... and I checked out them all. Plus, the cost, after taking into consideration the initial layout and yearly subscription monies, is very affordable compared to the other competitive companies. The use is straight forward and quick. I can do most daily notes in just a few minutes. You can use an in house server, but I use my system on the cloud. That way there is no cost of maintenance or down time for hardware..... and I can use the system from anywhere I work. There is also no cost for other doctors and staff who use the system. Very good for multiple doctor/staff practices. I could go on and on, and there are a lot of questions many of you will have..... but I recommend you check out this system.

Inconvénients :

If your looking for free software or a cheap application, then this is not the software for you. But, that type of software will not let you customize it, and typically it will not offer clearinghouse compatibility and/or accommodate billing, scheduling and office notes all in one program. All in all this program is very well designed.

Liz
É.-U.
Cabinets médicaux
Temps d'utilisation du logiciel : Non fourni
Source de l'avis
Source : SoftwareAdvice

Good but could be better

3,0 il y a 11 ans

Avantages :

In general, the product is nice. RAPID Doc is easy to use and very customizable. I am constantly training interns (pre-chiropractic students) on how to use it, and they can learn quickly. It is frustrating how everything in the patient's symptoms (and what they fill out on the KIOSK) is all about pain, but hey, that's an insurance thing so what can we do. The vendor was great to work with as we investigated the software.

Inconvénients :

Customer service. I get really frustrated with the customer service. I realize that others have had better experiences, and I am sad that has not been the experience we have had. Customer service is hard to get a hold of. I have often left messages on voicemails for people to contact me regarding an issue and didn't get calls back. I have left email messages with tech support when they are unavailable and have asked them to get back to me regarding certain issues and again received no return email or call. It can be so frustrating that something I am working on comes to a grinding halt and remains halted for days or weeks until I am finally able to get a hold of someone. The other issue is nothing is truly simple in the RAPID PM portion of the software. Entering a payment takes five clicks of the mouse and a few keyboard strokes. Posting a patient payment to a bill takes seven clicks and a few keystrokes. Many of these tasks could easily be made a bit more simple. Seven clicks is time wasted to me if they could set the system up to get it done in three or four. Signing a patient into the office and assigning them to a kiosk takes seven clicks as well; it could be done in less steps. The extra steps are great in making sure that a lot of unnecessary errors are made but it's a bit much. Just my two cents. (I am the office manager and have been for 10.5 years in this practice; I come at this from the side of the non-medical staff using the product). The practice has been around for 34 years. We won't change systems for the PM side of things simply because this was too big of an investment to back out now, but if we had to do it over again we would most likely go with RAPID doc and not get the RAPID PM.

Réponse de l'équipe de ACOM

il y a 11 ans

Dear Mountain View Chiropractic Center, Thank you for the positive ratings on our product Ease of Use and Quality, plus your recommendations for improvement. We have built our solutions based on customer feedback. An ACOM Product Manager will contact you about recent enhancements in the Practice Management software that should address all your concerns, and if not, the manager will garner your feedback to incorporate in the next release. Your comments about poor Customer Service are very disturbing for us. We are growing quickly and expanding our offerings. To support them, we continue to add staff. An ACOM Customer Service Manager will contact you immediately. Mark Firmin, General Manager, ACOM Health.

Vicki
CCPA (É.-U.)
Santé, bien-être et fitness, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Alternatives envisagées précédemment :

My Perception

5,0 il y a 4 ans

Commentaires : What makes it exceptional is the support if an issue arises. I'm made to feel that no question is too dumb or insignificant. [SENSITIVE CONTENT HIDDEN] is the best. We love her.

Avantages :

Rapid Doc and PM are easy to use. Finding a patient or scheduling a patient is a breeze.

Inconvénients :

The print out of the receipt is a little hard to understand for a lot of our patients. Maybe less is more. There is no alert for when patients run out of visits, even though it's counting down in Authorizations.

Sandra
Patient Coordinator (É.-U.)
Santé, bien-être et fitness, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

ACOM Health Software

5,0 il y a 4 ans

Commentaires : Getting billing out the door electronically or via fax is easy. Appointment scheduling is easy. Tech support is good.

Avantages :

The ability to electronically bill, attach notes to insurance billing, rebill with ease, appointment reminders, robust report writing. We are hosted online now instead of our own servers

Inconvénients :

Best use for chiropractic patients and not so much for functional medicine patients. Would be nice if cell phone numbers printed on reports instead of Home numbers. We work between time zones, would be nice to be able to toggle back and forth. Original cost of software was $36K, but now can utilize their online servers for a set monthly fee.

Glenn
Doctor (É.-U.)
Cabinets médicaux
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

I couldn't be more please with this product and support

4,5 il y a 9 ans

Avantages :

I have had this software for over 5 years. I couldn't be more pleased with the DOC software. It is extremely easy to use, is easily customized and has always been ahead of the game in regards to the continual changes and demands we all face. This software allowed me to easily satisfy "Meaningful Use" for Medicare reimbursement every year and was the first software to be approved. With all of the talk about ICD-10 I was getting quite nervous toward the end of September, but with the product support notices, free webinars and software changes the transition was much easier than anticipated. Have always been very satisfied with the software, technical support and customer support.

Inconvénients :

The things I have problems with about this product are, basically, problems I would have with any computerized system. After having used paper files for over 30 years, the transition was easier than I had anticipated. It takes a little more time to enter the patient information on a computer, but it is much more complete. It was easier to flip back through past notes with the paper system. With the "bird's eye view" I can see past notes (I cannot think of a better way a computerized system could do this than ACOM does), but it is just not as fast as paper.

Judy
Billing Manager (É.-U.)
Cabinets médicaux, Auto-entrepreneur
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Excellent Billing Services & Biller!

4,5 il y a 8 ans

Avantages :

I want to take this opportunity to express how much I, along with Dr. Hines, appreciates our biller, Fred Lamp. This young man is very knowledgeable about the software. We are impressed by his willingness to help both myself and our staff whenever the need arises. He is also very conscientious and motivated to do the best possible job for his clients. Both Dr. Hines and myself feel Fred has gone above and beyond as our biller. He is definitely an asset to ACOM Health and absolutely an asset to our Chiropractic office. Great job Fred, well done!!! I also want to say I like that the company is willing to develop individualized reports for their clients and are always working on enhancements to the software. Kudos also to IT support! Erika is always willing to walk me through developing personalized reports for our office. She is friendly and extremely helpful.

Inconvénients :

It would be beneficial if clients were able to contact them earlier than 8:am and later than 6:00pm. We begin our day at 7:00am and usually are not done until 6:00pm. Our office is extremely fast paced and the workload doesn't leave much free time for phone calls.

Kristin
Doctor of Chiropractic (É.-U.)
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

ACOM Health RAPID Software Review

4,0 il y a 4 ans

Avantages :

[SENSITIVE CONTENT HIDDEN] is EXCELLENT and has extensive knowledge about the software. I have been a customer/user for 11 years and customer service has always been a weak point. However, [SENSITIVE CONTENT HIDDEN] is an exception and always been able to solve our issues quickly and with accuracy. I will also comment that when I used the billing service, our biller [SENSITIVE CONTENT HIDDEN] was excellent.

Inconvénients :

Lots of extra unnecessary steps in both doc and pm. Not up to date; PQRS and medicare G-codes are irrelevant and causing denials. Initial tx date should be automatic and not manually have to be added.

CHANTELLE
Office manager (É.-U.)
Santé, bien-être et fitness, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

[SENSITIVE CONTENT HIDDEN] is the best

4,0 il y a 5 ans

Commentaires : [SENSITIVE CONTENT HIDDEN]has been a great help with training

Avantages :

Once learned it is easy to use. My training with [SENSITIVE CONTENT HIDDEN]has been invaluable. The layout is simple and clear.

Inconvénients :

Sometimes there are glitches which could be operstor error though.

Cortney
Manager (É.-U.)
Santé, bien-être et fitness, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Billing Service

4,0 il y a 6 ans

Commentaires : The Documentation software is good. It is expensive for what you get. And it takes more than 30 seconds a patient. But it is easy to learn, and it is quicker than most programs. The billing service, if you ever think you will go cash, do that instead of adding the billing service. Getting out of the billing part is too tedious!

Avantages :

I love my biller. Lashon usually goes above and beyond.

Inconvénients :

I have gone mostly cash practice, and no longer need help billing. So i quit the expensive service. They now want to train me to use the services I already have. They keep coming up with things to charge for "to make your life easier." I want more money. Not more services. Now that I am getting out of the billing service, My biller doesn't take our calls or emails.

Judy
Office Manager (É.-U.)
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Office Manager

5,0 il y a 4 ans

Commentaires : The ACOM support team is Awesome . Every time I have called the support team my problem was solved right then . No leaving a message and waiting for someone to return your call . [SENSITIVE CONTENT HIDDEN] was my initial contact . She was so patient with me and made sure I had a clear understanding each and every time I called .

Avantages :

Scheduling. Our office has two Chiropractors, and we stay very busy . The ease and speed of scheduling is a must in our office . This software meets the challenge .

Inconvénients :

Our office had been in practice for 28 years before we made the switch, so it was pretty hectic for awhile . The prior software was really outdated so there was a lot of changes all at once . I can't say there is anything I don't like about the software.

Dawnette
Office manager (É.-U.)
Hôpitaux et soins de santé, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Review

5,0 il y a 4 ans

Commentaires : Having support from ACOM has been amazing. The staff is wonderful and it is great that you can call in and get help whenever needed.

Avantages :

Having integrated software is a great benefit of this product. The EHR is great and when we have to send records to other offices or audits everyone is impressed by our notes.

Inconvénients :

I wish we had more control over adding/changing things in how the kiosk works for patients signing in with notes. I also thought our A/R would greatly improve when we added the billing component but it hasn't changed all that much. We still have a huge amount of insurance accounts that are outstanding over 120 days.

Don
É.-U.
Temps d'utilisation du logiciel : Non fourni
Source de l'avis
Source : SoftwareAdvice
5,0 il y a 11 ans

Commentaires : I went online with ACOM October 1, 2011. I had 2 weeks to download the software and train so I would be eligible for EHR in 2011. ACOM was the only company that was willing to accomplish this for me. Most other systems told me it would be at least one month just to train me. Michelle at ACOM stayed in contact with me all the way including after the installation to make sure I was happy. She answered any questions I had in timely fashion. I felt I was totally taken care of. I know that even now, if I had any problems I could still contact her and she would take care of me. You are not abandoned once you sign on. It took less than 2 hours to download the software into all of my computers. I have not needed any support in the use of my software, so I have to say the training was easy and complete. My only contact with the techs has been to update my software a couple of times. I was even given a coach to help me get through my EHR attestation. He was also a Chiropractor, so he was very familiar with how this program worked in a Chiropractic setting.
Since being with ACOM, I have had requests for records from private insurances and Medicare regarding the care in relationship to billing. The bills for patient care has always been approved and paid for. I have sent many patient notes to attorneys and insurance companies on personal injury cases and I have been proud of my notes. A couple of times an insurance company has requested that I take discounts on my billed fees. I tell them that I feel my fees are justified and refer them back to my notes. They have always been approved and I have been paid with no reductions.
Recently I have been hearing about the problems other chiropractors are having regarding being audited and not getting paid. Since having ACOM, I do not lose any sleep over it. I know my notes contain what Medicare requires, and if I needed to, I am willing to do battle with confidence.

Cory
Office Manager (É.-U.)
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Five star program! Highly recommend for growing or starting your Chiropractic office

5,0 il y a 6 ans

Commentaires : Perfect for anyone just starting out, or for anyone looking to update their practice to a more compliant, accurate, all-inclusive system.

Avantages :

Ease of use. Accuracy of medical information, billing and collections. Awesome customer support and training.

Inconvénients :

As with any medical program, the only con I have was the price. However, after using the product, I can now say that the price was well worth the program. My staff, my doctors, my patients and myself are happy with how easy it was to learn and use.

Douglas
Chiropractic Physician (É.-U.)
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis

Acom

5,0 l’année dernière

Commentaires : We are able to stay on top of our record keeping with minimal time

Avantages :

We are able to customize our software to fit out practice

Inconvénients :

Quarterly cost to keep the system up and running

Gharett
Owner (É.-U.)
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

My Review

4,0 il y a 3 ans

Commentaires : Meh.

Avantages :

I like the documentation side of the software.

Inconvénients :

The billing software is garbage. Any time you have more than one policy in a patients file the software will randomly choose to bill incorrect policies. I have tried and tried to rectify this with ACOM to no avail.

Tom
É.-U.
Temps d'utilisation du logiciel : Non fourni
Source de l'avis

DON'T DO IT!!

1,0 il y a 10 ans

Commentaires : I paid a lot of $ for this because I wanted an integrated system. It was highly recommended, but it is a VERY INFLEXIBLE system built on OLD technology and the support is basically "sorry we can't do/fix that but we'll recommend it as an enhancement". The billing system CANNOT even do simple arithmetic to add up the patient's total outstanding balance on the patient statement. Plus it CANNOT print out a summary page of the patient's statement (prints ALL pages) and does NOT even print them alphabetically! The Doctor reporting side is NO better: LIMITED number of diagnoses, LIMITED number of patient complaints...I could go on and on but YOU GET THE IDEA!! JUST DON'T!!

Réponse de l'équipe de ACOM

il y a 10 ans

Dr. Tom Arnold: ACOM Health's Support department will contact you to show you how our Software can successfully manage the issues you¿ve raised in your comments. Support will show you: How Patient statements accurately calculate the total due and alphabetical sorting by patient name. How reporting software for Dr.'s permit documenting up to 15 diagnoses/visit (an additional 25% over the 12 diagnoses claim form limitation). How SOAP notes can support an unlimited number of patient complaints. ACOM's development team has taken painstaking care over many years to successfully develop Rapid software, including the latest in technology, software code set and chiropractic-specific functionality to meet evolving provider needs and regulatory requirements. We work hard to rectify customer concerns and look forward to help your practice understand how the software does meet your needs. Thank you for the opportunity to serve you - The ACOM Health Team

Angela
Office Manager (É.-U.)
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Review after support

3,0 il y a 4 ans

Commentaires : Every time I reach out for support the team is very friendly and informative. They will do their best to answer all my questions

Avantages :

The software is user friendly in many areas.

Inconvénients :

There are some areas in the report side of the software that can be difficult to utilize without guidance

dianna
dr (É.-U.)
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

[SENSITIVE CONTENT] at Tech sup

5,0 il y a 3 ans

Commentaires : [SENSITIVE CONTENT] always helps me out

Avantages :

[SENSITIVE CONTENT] at customer service is always very helpful. He is always nice and knows what he is talking about.

Inconvénients :

I like the software just fine. I don't know what I would change

candace
chiropractor (É.-U.)
Santé, bien-être et fitness, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

rapid

5,0 il y a 3 ans

Avantages :

The software is user friendly and customizable.

Inconvénients :

I wish there was an easier way to access the notes rather than having to go the the symptoms tab each time

Elizabeth
Office Manager (É.-U.)
Cabinets médicaux
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

Don't waste your time or money

1,5 il y a 9 ans

Avantages :

The Rapid documentation is quite good and integrates nicely with the practice management side of the software.

Inconvénients :

Customer service and price. This product is a big investment and with that we expected the great customer service we experienced in the beginning to remain as we moved forward. However, the customer service at ACOM is sorely lacking. I felt like they kept trying to be better but never quite made the mark. The service contract also states that updates are included but that is not true. If ACOM spends more than they anticipated creating an update they pass that cost onto their customers.

Loreley
practice manager
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : 1 à 5 mois
Source de l'avis
Source : SoftwareAdvice

Very pleased

5,0 il y a 8 ans

Commentaires : Our clinic purchased the software and had our front office trained. Long story short, our office manager was resisting technology and any growth in the practice that would increase patient visits. After we became aware of the situation ACOM was more than happy to train our new employees with as much time and dedication as had been invested in our training program when we made the initial purchase. The software has functioned exactly as described. Because of the support from ACOM, we were able to have a college student with no medical or office background handle all the functions that the prior office manager with ten years of billing experience was doing and then some. ACOM is easy to use. The screens are intuitive and it saves a lot of employee time.

Avantages :

Easy to use

Inconvénients :

We had one morning when the system was down for about two hours, but it was back online soon enough to avoid any big problems. We totally rely on it and do not keep a backup schedule in a paper form so it has to be available.

Cortney
Doctor
Cabinets médicaux, 2–10 employés
Temps d'utilisation du logiciel : 1 à 5 mois
Source de l'avis
Source : SoftwareAdvice

ACOM BILLING

5,0 il y a 8 ans

Commentaires : I have worked with Lashon in the Billing Department for months. Lashon is wonderful. Lashon is detail oriented, and quick. Lashon will answer questions, and she always has a solution for any problem. Within minutes any billing question I had has been resolved. Lashon will talk to patients, if they have questions. Lashon is wonderful! I have been assured that the entire Billing Service is top notch. But Lashon is an angel!
I would not want to run my practice without Lashon.

Avantages :

Checks keep coming to the office, I scan them, and they are applied. This saves me hours of time each week. It is all done correctly. Lashon does all the additional billing paperwork surrounding Workaman's Comp and PI. She fixes any mistakes I have made, and she is kind when she does it.

Inconvénients :

If insurance billing is not what you love, Hire the billing team to do it for you. The only con is that you didn't sign up sooner!

arianne
doc of chiro (É.-U.)
Santé, bien-être et fitness, 2–10 employés
Temps d'utilisation du logiciel : plus de deux ans
Source de l'avis
Source : SoftwareAdvice

i would recommend, and customer service is always on point

4,0 il y a 4 ans

Commentaires : great

Avantages :

customer service all in one up to date

Inconvénients :

could improve some use to increase function

Eric
É.-U.
Médecine douce, 2–10 employés
Temps d'utilisation du logiciel : 6 à 12 mois
Source de l'avis
Source : SoftwareAdvice

Great service

5,0 il y a 6 ans

Avantages :

I love this service. THe Rapid PM software is easy to use and the customer service is outstanding. Very easy to get what you need. Plus, they are always improving and updating.

Inconvénients :

Very small and specific issue - hard to put alerts on a patient file, or, rather, the alerts don't "ding"/popup easily. You need to look out for them. I wish there was a way to alert front desk easier.