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By: Stephen O'Connor

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November 20th, 2015

Why Your Medical Billing Software Should Include These 3 Features

Medical Billing / RCM | Practice Management

Medical Billing SoftwareLeading edge web-based medical billing software empowers medical organizations to personalize their billing and coding procedures to increase profitability, prevent errors and expedite claim reimbursements.

Although  every practice and facility need flexible medical software solutions that allow personalizing the billing processes and procedures to fit the enterprise, there are some common feature every medical organization needs. Below are three key features that are critical for financial health and stability.

Ability to quickly resolve recurrent error patterns

Comprehensive, accurate medical records are the key to “perfect” billing and coding. Medical billing software solutions with web-based interfaces enable providers to access stored data throughout the medical organization. Strong search capabilities help coders make well-informed decisions about ICD-10 coding for maximum reimbursement and speed up the claim lifecycle, which means there are fewer recurrent errors.

Customizable solutions, tailored to specific specialties, facilities and medical service organizations include multiple scoring models to isolate disparate patterns and risk levels. Automated, intelligent auditing provides insightful information that billing agents can use to spot potential coding criteria errors and implement changes to mitigate risks of claims rejection associated with avoidable errors.

Automating Electronic Claim Submission

Automated claims processing is an affordable solution that sends claims directly to the third party payer. Ideal solutions allow providers to post charges at the point-of-care to expedite filing. Software solutions enable insurance eligibility verification and allow providers or billing agents to process claims according to different insurance company requirements. For example, some carriers require office notes as supporting documentation for certain conditions or diagnosis codes.

Verifying coverage limits, co-payments and exclusions prior to coverage improves collections by identifying self-pay requirements at check-in. Along with automated claims submission, electronic tracking features allow financial teams to monitor claim status, improving cash flow management activity. Another benefit for administrators is electronic claim submission make internal review and auditing more efficient as reports can be generated to randomly assigned claims for internal audit based on practice or patient population criteria.

Monitoring Risks and Managing Compliance

Healthcare organizations must continuously review billing processes and procedures to ensure they are following best-practices. Medical billing software that includes frequent updates that mitigate coding and compliance risks strengthen the health and profitability of the enterprise.

Whether the organization is participating in the Meaningful Use Incentive Program or concerned about protecting patient privacy and data security, software solutions should offer features that enable qualitative and quantitative report generation, data aggregation and information sharing within a safe, encrypted environment.

Conclusion:

The relationship between workflow patterns and medical billing software is circular. Implementing efficient workflow patterns improves billing and collections, and an ideal billing software package provides clues and guidance to improve internal productivity and efficiency. Every medical organization requires different features and capabilities based on the size, organizational structure, care delivery model and patient-clients. However, every medical facility can benefit from these three features.

  • Electronic billing reduces payroll expense, reduces the error rejection rates, and improves cash flow.
  • Analytic features improve coding accuracy and identify recurrent negative processing patterns.
  • Best-fit medical billing software supports stronger security, compliance and risk management protocol, reducing financial expose for medical organizations of all sizes from the independent physician to major hospital systems with multiple clinics and hundreds of on-staff providers.

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About Stephen O'Connor

As a Director of Digital Marketing at Advanced Data Systems Corporation, Stephen spends his day's planning, writing, & designing resources for the modern healthcare professional. He has a strong affinity for snow crab legs, the ocean, and Rutgers Football.

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