A healthcare provider works to help patients in a practice where his job is to make sure that all the necessary requirements are met. But to keep a practice run in a smooth system, it needs a billing and coding system that works interruptedly to cope efficiently with the billing process. To proceed with this system in a competitive way, a practice needs billing software. Plus, they also need to check the features and capabilities of medical billing software that their practice needs.
In addition, before purchasing software, it also needs to figure out by the medical professionals that what kind of features they need. Whether they need electronic health records software or medical practice management software. Besides, if they are already using one of these, then do they still need additional medical billing software to provide the billing solution?
It gets overwhelming to know the exact answer for a billing professional without having complete knowledge. This is because we have listed must-have features and capabilities of medical billing software to ease the struggle and help you make an informed decision.
Features and Capabilities of Medical Billing Software
Pre-registration of Patients
Patient pre-registration is essential to provide a smooth transition before a patient visit to a clinic. With this, it becomes less complicated and time-consuming to collect data at a visit or for administration tasks. By doing this ahead of the appointment, a healthcare organization experiences a higher quality consumer satisfaction which keeps them coming.
In addition, this will enable patients not to wait for scheduling check-ins, insurance eligibility, and medical history checks.
Claim management against rendered medical services is a complex process consisting of diagnosis, treatment, and prescription of a patient. In addition, the process needs interacting with patients and the insurance companies, managing invoices, medical regulations compliance, and compliance with federal obligations. This takes a lot of time, and taking this into consideration, medical facilities often outsource their claim management service to medical billing agencies.
In the absence of effective claim management for a practice, patients at the end wouldn’t know how much they have to pay, and the medical facilities would never receive reimbursement for the services they rendered in the given time.
Electronic claim management allows the paperless collection of claims which helps make the transaction more streamlined. Plus, with the medical billing software, communication between the responsible authorities becomes easier. Every agency or the concerned party will remain on the same page. Practices with regular day-to-day engagements can make error-prone claims which can easily be detected through efficient claim management. Here are some of the alerts and advice checklists that competitive claim management software can help in;
- Insurance payer listing
- Paperless claim collection
- Claim tracking
- Claim scrubbing
- Electronic claim scrubbing
- Alerts and advice on electronic remittance
When there is a medical treatment for a diagnosis, they are then coded according to CPT/ICD-10 codes by the administrative staff. Once the codes are compiled for the services rendered, they are then sent to the insurance companies for a thorough billing and determination of coverage. When medical billing is processed, the medical billing company processes a hard and an electronic copy to figure out the cost owed by the insurance company and the patient separately. With this, patients and insurance companies will know their share, and the facility will get information about the amount both parties owe. In many cases, in the process of claim management, state-sponsored agencies like Medicare and Medicaid also take part in paying the number of healthcare services.
This proves the fact that how claim management is operated and the records are maintained in a digital platform. Here are some other functions that denial management and collection software perform;
- Bill generation
- Generate soft collection letters
- Patient statements
- Bill recording
- Automated billing
- Denial management
- Billing rules engine
- Electronic Superbill
- Central billing generation
- Batch payment
- Payment reminder
De-cluttering paperwork and handling patient records are undoubtedly complex tasks. With the ease of access and centralized interface, it makes it possible even for patients to see their health records through a patient portal. Besides, this ease of access not only can reduce back-to-back communication between patients and medical administrative staff but eliminate multiple pharmacy visits for basic information, which eventually elevates patient satisfaction. Plus, it doesn’t engage medical staff in fielding and attending to the calls and messages of patients.
Here’s what the software reserves as patient information;
- Patient medication lists
- Master patient index
- Patient records
- Patient Portal
- Patient allergy list
- Referral creation and tracking
Financial and Account Management
Another feature that medical billing software should have, is the function of handling accounting and management systems. If your existing medical billing software doesn’t perform financial and account management, then you need a separate medical accounting software. These complex tasks can be a headache if you manage to do that in-house. This is why it is important to have software that performs the required tasks.
Many medical billing software categorized under EHR work on accounting modules. However, some provide medical billing software solutions that are easier for practice.
Here are some financial and account management perks that medical billing software should be providing;
- Multiple claims
- Accounts receivable and payable
- Online bill pay
- Outstanding payments
- Revenue cycle management and automation
- Write-off payments
- Credit card processing
- Claim generation
- Prompt financial errors
With a workflow management feature in medical billing software, it gets even easier to automate the medical office process and can even help streamline them. In addition, it reduces the exercise of repetitive tasks that happen at a practice office, normally including gathering and validating data, ensuring data accuracy, and posting an explanation of benefits every time when a patient visits the facility. In general, the system should provide the following;
- Rules management
- EOB posting
- Data validation
- Charge and code entry
With all these features and capabilities of a medical billing system, you can make an informed decision. There are multiple medical billing systems in the market, and choosing one for your practice can be complex. Make sure the software functions efficiently and gives you a smooth implementation of data before you purchase it. For this, you can try the trial feature of a software ad make an informed and experienced decision.