Healthcare News & Insights

Medical Billing

Physicians and caregivers today cannot solely focus on patient care; they must also focus on ensuring they have a qualified staff of professionals that can handle the procedures that take place after a patient leaves the office.

This is where the medical billing cycle begins, and where healthcare providers must work hand-in-hand with insurance companies to ensure that proper reports, coverage, and payments are made for the patient and to the physician.

Single practices, large hospital organizations, clinics, and multi-practice offices all have to deal with the medical billing procedure, and recent medical technology has allowed many offices to simplify the once time-consuming job of bookkeeping and coding. This is one of the many technologies that healthcare providers rely heavily on to ensure that their practice or organization runs smoothly.

While in the past most claims were paper-filed, almost all practices today use electronic medical billing software in accordance with the requirements set by HIPAA. With the increased use of EMR software systems under this law, medical practices now have the ability to initiate the claims process to check with an insurance company if a patient’s treatment is eligible for or details about coverage right from one software system.

Tips for Choosing Medical Billing Software

There are a lot of different medical billing companies and software systems on the market today, so choosing one that is the perfect fit for a healthcare organization is a challenge.

Here are some things to keep in mind before you make a decision to purchase:

  • Research whether your practice would benefit more from a web-based service or an office-based software system that requires its own server.
  • Make a list of all potential contenders.
  • Look into training programs, updates, and services included in each package.
  • Assess the monthly and annual fees associated with each company or program that will be providing the medical billing service.
  • Make sure the system you choose can handle electronic claims, has direct billing for patients and co-insurance, co-pays and expenses not covered by insurance.
  • Check if all diagnosis and procedural codes are included in the package, and if they are not, check what the costs associated with them would be on a monthly or yearly basis.
  • Most medical billing software comes with an exhaustive and updated list of CPT, ICD, and HSPCS codes, but some may not, so it is wise to check before making the investment.
  • HIPAA compliance is a big issue for many healthcare providers today – be sure that the chosen medical billing software can make a significant contribution to HIPAA goals.
  • Be sure to ask how data will be handled if your organization should choose to switch providers.
  • Ask for references and check to see if all customers have been satisfied with the provider’s services.

There are many features that can be compared and considered when choosing the perfect medical billing software for your practice, and new software and systems come out often, but doing intensive research into all of the possible options will greatly increase office efficiency and reduce the stresses that may come along with the medical billing process.