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by Eileen O'Loughlin,
Market Research Associate
Last Updated: August 27, 2015


Here's what we'll cover:

What Is Medical Accounting Software?
Common Features of Medical Accounting Software
Evaluating Healthcare and Social Services Accounting Software

What Is Medical Accounting Software?

Accounting software for healthcare or social services industries will include a number of features that support the management of day-to-day accounting and business practices. Beyond just accounts payable/receivable and general ledger, they support billing to insurance companies, as well as Medicare and Medicaid. Specific budgeting tools for the financing structure in those industries are typically included, and integrate with electronic medical records software for meaningful use.

Common Features of Medical Accounting Software

In addition to core features, look for the following specific features:

Medical materials management Manage the purchasing and disbursement of supplies, especially any pharmaceuticals or lab materials with a shelf life. This prevents lost inventory and/or charges.
Patient/insurance/CMS billing Between copays, reconciling EOB forms and the Centers for Medicare & Medicaid Services, the bureaucracy associated with healthcare accounting adds several layers of complexity most industries don’t have to deal with. These systems typically includes ICD-9 and CPT coding information, claim scrubbing and electronic claims submission.
Integration with electronic medical records Electronic medical records (EMRs) track patient notes, demographics, family medical histories and medications. They also typically include features like e-prescribing, lab and medical device testing integration and voice recognition notes software. In the move for all providers to adopt EMR technology, integrating with that data is critical for most buyers.
HIPAA compliance If your system contains any patient data, you’ll need a solution that not only performs the necessary accounting functions, but also complies with HIPAA’s privacy regulations.

Evaluating Healthcare and Social Services Accounting Software

The most critical factor to consider in selecting your healthcare/social services accounting software is your size and type of organization. A hospital provides a large number of disparate services, whereas a private practice may have only a handful of physicians within a single specialty. Inpatient facilities track patients differently than outpatient facilities. For example, phthalmologists will need to monitor retail sales, while a cardiologist does not. Social services, palliative/hospice care and rehab all have their own unique needs, too. Therefore, it’s essential to ensure your software solution is designed to handle the accounting functions that meet your facility’s unique needs.

When evaluating these systems, buyers should consider the following:

  • Do you bill primarily to insurance companies, Medicare/Medicaid, patients or a combination?
  • Will you also need electronic medical records (a.k.a. electronic health records) software, or do you already have software that will need to be compatible with your new accounting system?
  • Will you be storing any patient-sensitive information in your accounting software?
  • Do the features fit the size and type of facility (for example, hospital vs. private practice; outpatient vs. inpatient; medical vs. social services etc.)?
  • Can it generate the appropriate reporting documents for auditors?
  • Does it scrub medical claims and reconcile insurance billing with explanation of benefits forms?

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