3 Best Medical Billing Software & Buyers Guide

eClinicalWorks PM

Innovative, customizable solutions Primary care offices Ambulatory surgical centers Health centers Hospitals Mobile clinics 50 specialties Privately held leader

EpicCare EMR

Epic serves hospitals Medical organizations, Clinics Independent practices Academic centers Health providers, Fast physician-friendly, Ambulatory EHR software

Nextech Practice

Fully-integrated Electronic Medical Record & Practice Management Designed to improve efficiency across functional areas of practice Intuitive design & templates

Medical Billing Software

Medical billing software helps healthcare facilities with patient billing and invoicing jobs. It provides users simplify billing-related workflows, helps in managing accounts, bill patients for medical services, code claims, verified insurance coverage and processing of insurance claims, accepting payments, generating financial reports, and tracking patient demographics like contact and insurance information.

Benefits of Medical Billing Software

Reduce billing errors: Medical billing has a lot of treatment codes and medical terminologies that must be used correctly by medical staff, general staff, and accountants. A single mistake with a piece of incorrect information in a bill can lead to a denied claim for a patient and a legal issue for the practising doctor. Medical billing software offers to complete details for every code given along with the costs associated with the treatment, so practices can ensure that billing and coding are accurate.

The decrease in administrative tasks: With the accurate medical billing software, doctors and their staff can decrease the time spent on administrative paperwork through streamlined workflows, giving them increased time to spend with patients. This is especially relevant for smaller practices that do not have enough staff to handle both administrative workloads and patient care.

Stay compliant: Healthcare is an ever-changing industry, and similar vibes go with regulations and compliance needs. With medical billing software, practices can try to remain up-to-date on the latest rules and adhere to insurance companies protocols while submitting claims for insurance approvals.

Features of Medical Billing Software

Payment processing: Collecting and recording payments received from patients or their insurance givers for medical treatment and services provided.

Invoice history: Creating and maintaining an organized record of all invoices and viewing detailed payment history by a patient.

Patient eligibility checks: Verifying insurance claims and cross-checking patients’ eligibility with the insurance provider.

Claims management: Organizing claims and submitting them to insurance carriers for approval.

Code & charge entry: Assigning billing codes and cost to all treatments and services.

Practice management: Managing key business aspects of medical practice like capturing patient demographics and scheduling appointments.

Remittance advice: Document proofs and details provided by insurance payers following payments, adjustments, denials, and/or any uncovered charges in a medical claim.

Cost of Medical Billing Software

Most products available in the market are priced on a “per month” basis and can be divided into three pricing tiers based on their starting price. A premium product is rated higher must include unique features like e-claim submission and processing, advanced reporting, cross-practice billing, and built-in EHR or practice management integrations.

Consider while buying Medical Billing Software.

Integrating EHR and practice management software: Practices cannot wholly rely on billing software to operate efficiently. They also require an electronic health record (EHR) system and a full-fledged practice management software to build a complete modern healthcare facility. If a user is looking for independent medical billing software, it’s essential that use the software must start integrating with other solutions in the medical software family. This will offer the user safe from re-entering clinical and patient data.

Software deployment method: Medical billing software is available in different deployment options: cloud-based, self-hosted, and hybrid. Each deployment model has its benefits, drawbacks, and pricing model. Cloud-based medical billing software generally has a monthly subscription fee. In contrast, an on-premise deployment option has a more considerable predicted cost. Still, it can become economical in the long run for more substantial businesses like hospitals and multi-chain medical facilities.

Patient data security: Patients’ medical records hold sensitive personal information. If the user chooses a cloud-hosted option, it is vital to ensure the software will keep user data secure. Ask sellers how and where the clinical data will be stored, who will have access to clinical records, what security standards are used, what the backup policies are, and how long data is retained.

Medical Billing Software Trends

Computer-assisted coding (CAC): CAC is a refinement process which utilizes natural language processing to read medical prescriptions and charts and simplify them into digital text formats. It has built-in ICD-10-PCS, ICD-10-CM and CPT codes databases that convert prescriptions into universally accepted codes that can be generated in the bills and sent to insurance providers for claim approval. This will bring medical practices onto the uniform and stable ground and reducing billing errors due to incorrect coding. The need for uniformity of codes across practices, most medical billing software will start offering built-in CAC functionality in their solution. Hospitals leveraging CAC in their therapeutic billing process will realize an ROI of at least 20% higher than the others.

Artificial intelligence and blockchain will revolutionize the billing process: Blockchain adoption is rising in many markets and is expected to reach up to 5.5. billion by 2026 in the healthcare market. It can be a crucial technology for securing medical records as well as increasing the efficiency of data exchange between patients, practices, and insurance companies. Blockchain will make it easy to securely record patients’ medical history and share it with other facilities. Insurance companies will leverage artificial intelligence (AI) to analyze large datasets of patients’ medical records, their previous claims, codes used for billing, and other data points. This can help them generate business-relevant insights and establish a pattern between patients’ medical condition, type of treatment provided, and the cost of treatment. This kind of ideas can help insurance companies to emphasize upon errors in claims or even detect fraudulent activities.

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