A medical practice’s main focus is to provide their patients with extraordinary care, which is why many physicians are moving their billing from utilizing in-house personnel to outsourcing to medical billing companies who manage their claims and improve the revenue cycle time between patient care and payment.
With pressure being placed on medical billing companies to achieve results, they need to find the most efficient way to collect practices’ encounters and efficiently turn them into claims with the correct diagnosis and procedure codes, ensuring the claims are successfully submitted to payers.
In order for medical billing companies to be successful, they need the right tools so choosing the right billing software system is critical. We’ve researched the top 10 benefits of utilizing electronic medical billing solutions:
- Central Billing Office Functionality – Medical billing companies are adopting billing software that provides them with Central Billing Office (CBO) functionality and single sign-on technology to manage all their clients from one account. So regardless of a billing company’s client base size, from a solo doctor to an organization with multiple locations, they only need one sign-in to see all the metrics associated with those groups.
- Customizable Reports – Reporting is a critical aspect of any medical biller’s daily strategy to evaluate the status of claims, revenues and a vast array of other important billing metrics. The more reports a practice management solution can provide for a medical biller, the better grasp they will have on their tasks and overall business success.
- Drill-Down Technology – To improve the rate at which claims are successfully transmitted to the insurance payers, it is important that diagnosis codes are known down to the highest level of specificity to avoid denials. To help medical billers find the proper ICD-10 code(s), electronic medical billing solutions either integrate with or have a full database of every possible ICD-10 code that can be used to narrow down results, ensuring a smooth claim submission.
- Claim Scrubbing – Along with drill-down ICD-10 coding technology, another way electronic medical billing solutions help improve the rate of a successful claim submission is incorporating built-in code scrubbing before a claim is sent to the clearinghouse. This is one more check that affords medical billers an extra set of eyes on their claims before going out.
- Real-Time Claim Status & Access to a Clearinghouse – Many billers utilize third-party clearinghouses to process electronic claims. Most software vendors have partnered with a clearinghouse to offer a seamless hand-off. As an added bonus, software vendors have added real-time status updates on claims directly into the software, allowing billers to quickly check-in on their claims and report back to their clients. Confirm there are no clearinghouse fees added.
- Custom Procedure Macros – Upon setup of the billing system software, medical billers can create customized procedure macros. These macros can be created from frequently paired diagnosis and procedure codes, as well as modifiers, to quickly create and submit claims that are regularly billed for, saving time when creating batch claims.
- Front-end Data Entry – Along with CBO functionality, billing software allows practices to manage and record information in the encounter that occurs on the front-end, leading to a smoother transition when billers step in to process a claim. Ensuring that the diagnosis is marked to the highest specificity and linked with the appropriate procedure codes before submitting a claim reduced the chances of any errors or rejections in the future.
- Electronic Remittance Advice (ERAs) – ERA functionality allows medical billers to see payment and denial explanations, making it easier for billers during reconciliation to find specific line-items that may need to be altered. These are automatically sent to billers upon the status change of a claim (accepted, rejected or denied).
- Mobile Applications – Charge capture applications are critical in helping medical billers support their practice clients. Charge capture allows practices to enter super-bills at the point of care that can then be pushed to a biller, avoiding confusion in the claims creation process. Most mobile applications are available on iOS and Android applications. Look for a system that separates denials for further review without holding up accepted claim payments.
- Interactive Guides – A handful of vendors offer interactive guides for their clients, which are extremely beneficial to avoid disruption when billing for clients. When billers have a simple question about using the software system, instead of having to call into a support line, they are able to search within a vendor’s interactive guide, which will show them how to proceed with a step-by-step guide within the system.