File maintenance, system tables, administration, master lists, etc. – it has many names depending on who you are speaking with and what practice management system you are working in but the definition is the same.  This is where the magic happens and determines what occurs and how.  It is very important to understand what the system can and cannot do.  It is equally important to understand the objective you are trying to achieve. 

This is an area of the system where the most control is needed.  Access to these tables should be restricted to persons with the knowledge and ability to configure settings appropriately.  Complete understanding of the question, the expected result and what else might be impacted by those changes is critical.

Open access to file maintenance can be detrimental to the revenue cycle.  Free reign to make changes based on wishes and whims rather than needs can break more than you are attempting to resolve when there is a lack of understanding on dependencies.  These tables are often integrated and a change in one most often affects another area in the system and/or the process, including interfaces and how EMR systems react to those changes.

In the infamous words of The Rolling Stones, ‘you can’t always get what you want’.  Control is the best approach without prohibiting users from being able to perform assigned duties.