Learn More About Medical Billing Software
What is Medical Billing Software?
Any health care organization, whether it’s a small, specialized practice or an enterprise hospital, deals with invoices, payments, insurance claims, and overall finances. Many medical practice management solutions come bundled with medical billing functionality that ranges from automating the creation and sending of invoices to thorough claims processing. However, some practice management solutions do not include medical billing functionality, and some health care practices have no need for a comprehensive, end-to-end platform to streamline their billing process.
This is where medical billing software comes in.
In a nutshell, medical billing software automates a medical practice’s invoicing and claims processes. The solution has the ability to turn an office paperless and digital, which has the happy result of reducing overall billing errors and time spent on monitoring and managing a practice’s financial processes. Additionally, medical billing solutions can be deployed as an in-office solution, be outsourced to a medical billing service, or exist as a module within a comprehensive revenue cycle management system.
What Is the Difference Between Medical Billing Software and Revenue Cycle Management Software?
Revenue cycle management software takes on both administrative and clinical functions, simplifying and centralizing the overall patient revenue management process. Revenue cycle management systems leverage patient data, helping businesses uphold financial best practices, as well as effectively track the treatment and reception of patient care. Revenue cycle management software facilitates interoperability within a practice and even between a practice and insurance provider. Revenue cycle management software even provides granular data analytics that will help clinics and hospitals better understand billing practices and speed up existing reimbursement processes.
Why Use Medical Billing Software?
Medical billing software does more than automate billing and invoicing, thereby reducing the loads of paperwork and time usually spent on creating statements, verifying insurance coverage, and processing claims.
A few of the other benefits of using medical billing software include:
- Better adherence to ICD-10 coding
- Reduction of paper-based processes
- Reduction of errors and more thorough, accurate documentation
- More efficient processing and collection of claims
- Efficient reimbursement cycles
- Productive dialogue with insurance companies
- Customization of billing according to specialized practice needs
- Improvement in levels of patient satisfaction
- Accurate tracking, monitoring, and reporting of patients’ finances
Who Uses Medical Billing Software?
A few of the common users of medical billing software include:
- Medical practitioners
- Front desk staff and office managers
- Insurance companies
- Health care providers
- (Medical) billing service providers
- Patients who receive invoices
Medical Billing Software Features
On a very general level, medical billing software eases the accounting needs of a medical practice. However, a user should know what distinguishes the variety of medical billing software from each other and identify the key features that will most benefit their practice. Common medical billing software features include:
Claims processing – Electronically processing and scrubbing claims enables a medical practice’s financial department to operate at higher volume, more efficiently and in a timely manner. By submitting claims to be scrubbed and processed, medical practices can avoid the time-consuming process of resubmitting them due to error.
Insurance verification – Verifying the status of a patient’s insurance coverage prior to their arrival helps minimize any uncomfortable or confrontational situations. This benefits front desk staff, especially if the chosen medical billing solution makes it an easy, simple process.
Electronic remittance – Electronic remittance advice (ERA) provides details about medical insurance payments, particularly regarding claim denials and their explanation. Many medical billing solutions facilitate importing information from ERAs so that your patient payment history can be completely comprehensive.
Invoice templates – Medical billing software provides templates that either come predefined or can be customized according to need.
Invoice generation – Invoices and statements are automatically generated and sent to patients, reducing the laborious task of creating and sending those out on a one-off basis.
Compliance – Medical billing software relieves the manual process of ensuring that practices adhere to relevant health care regulations.
Potential Issues with Medical Billing Software
Software evolves, and with that evolution, identified pain points are eased. However, issues still crop up when deploying or using medical billing software.
Lack of EHR integration — While some medical practice management solutions bundle together EHR and medical billing solutions, not all clinics have coexisting patient management and billing systems. Such disparate systems that begrudgingly communicate (if at all) with each other can severely dampen the efficiency of the medical billing solution. After all, if a health care organization can’t easily access, migrate, or share patient information, then the entire finance department gets frustrated.
Denial management — Not all claims will be okayed and processed duly. The biggest hurdles to claims denials include coding errors and value-based reimbursement policies. Providers and administrators have to constantly learn the ins and outs of factors like ICD-10 implementation and meaningful use processes so that they don’t inadvertently compromise the claims lifecycle.
Training and onboarding — Like any piece of technology, effective training and onboarding will speed up the adoption of the medical billing solution. The quicker that practitioners and administrators become comfortable with the software, the more empowered they will feel when utilizing and communicating about the solution. Regular training will also reduce any mistaken use, insufficient documentation, or miscommunication. Training will benefit staff when it comes to everyday use, as well as reducing errors in coding.
