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Medical Billing Service Software
Medical billing service software can help medical billing companies simplify day-to-day tasks, comply with regulations, and provide useful business insight to providers they serve, helping reduce claim rejections and expedite payment.
These software systems feature electronic claim filing capabilities and automation that makes it easy to report to clients on time, monitor submissions to payers, and pursue denied claims. During claims preparation, automatic coding and claim scrubbing features can also ensure your Current Procedural Terminology (CPT) and International Statistical Classifications of Diseases (ICD) codes are accurate.
Most medical billing service software systems include features to support the patient through each step at the provider’s practice. For example, your system should have eligibility inquiry features for the insurance verification phase. And a system’s ability to handle multiple and secondary payers, such as workers’ compensation insurance, can also be key.
Key Criteria for Evaluating Medical Billing Service Software
We recommend considering the following factors in your medical billing service software:
| Coding automation and scrubbing | Insurance claim submission rules are already quite complex to begin with - and the coding systems used in the claims process periodically change. Having a software system that assures you of potential coding pitfalls and verifies you have a clean and up-to-date code attached to your claims is essential. |
| Client invoicing and reporting features | Many software systems will have templated financial, referral and productivity report options that help you communicate about data on charges, revenue, appointments or productivity. Some will also allow you to export data to Excel or other third-party applications such as Crystal Reports or Microsoft Access. Depending on the degree of customization your system offers, you can sort or filter your reports for a single-use or recurring time period, and can include information on any combination of characteristics such as department, insurance, provider or place of service. |
| Automated billing with electronic data interchange (EDI) capabilities | Fully integrated management of billing, collections and revenue cycles will help make your job easier. Systems can include electronic claim submission, remittance and eligibility verification capabilities as well as online claim status tracking. Look into a system’s ability to handle multiple fee schedules that vary based on carrier and plan, and to optimize revenue cycle management by automating batch processing or data capture and storage. |
| Versatile account retrieval | Many different kinds of records and data sets will cross your desk. Therefore your software system needs to be able to perform various types of searches to retrieve information quickly. For example, many programs allow you to access accounts by search criteria including account number, transaction number, insurance policy number, social security number and date of birth. |
| User-friendly yet secure access features | If your company has multiple locations and individuals accessing your clients’ data, chances are you’ll want a versatile software system to help you all collaborate effectively. Top software programs will be scalable, allowing the system to change as your company grows. They should also be able to maintain the integrity and security of your clients’ data and offer independence based on each location and provider. |
| Integrated interface for maximum efficiency | It’s essential to evaluate how billing and collections are integrated with front office functions in a software system you’re considering. More specifically, you’ll want to consider the design of user interfaces to ensure efficiency of both client and patient management and claims processing. Advanced software programs will offer users a client-specific, rules-based engine to help you streamline your workload. |
Have an opinion on this guide? Email the authors. We appreciate the feedback.
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MediTouch EHR Electronic Health Record Software
Clients interested in using an iPad with their EHR will love MediTouch EHR™ for its speed, ease of use and simple navigation. HIPAA-compliant and fully integrated to eliminate rekeying data. Known for great customer service.
NueMD Complete
NueMD Complete’s helps you file claims securely online and includes reimbursement management, patient ticketing, and medical scheduling features. Offers filtered posting of batches and financial reporting breakdowns too.
Allscripts EHR
Allscripts EHR has a first-pass rate of 98 percent. Its versatile programs help you automate tasks to improve workflow. Incorporates payer and regulatory updates including HIPAA, ANSI 5010, and ICD-10 compliance.
CareCloud Charts EHR
CareCloud offers modern medical billing software that can be deployed in the cloud (i.e. over the Internet). It has payment posting, accounts receivable, denial management and more features. Good for all sizes of billing services.
AllegianceMD
Delivers “the most-advanced scrubber in the world” that could boost collection by 20-25 percent. Allegiance also has e-posting features to save you time.
Save weeks of research & costly mistakes. Our experts will recommend the best software for your needs.
MediTouch PM Practice Management Software
Automates all aspects of the revenue cycle, helping you manage visits, optimize coding and fee scheduling, and generate statements and reports. Electronic EOB / ERA.
NueMD PM
Speeds up billing activities and provides canned reporting options. Georgia-based NueMd also provides patient eligibility verification in seconds and offers integrated front and back-end office functions.
InSync by Intivia
Intivia’s InSync® can help you increase your efficiency with its 24/7 remote access, its user-friendly design built around your unique priorities, and its regulatory compliance assistance features.
Empathic Clinical
Integrating clinical notes, billing and patient management into a single seamless solution, Empathic is a web-based practice management system developed specifically for practitioners in the behavioral health field.
MDConnection
MD Connection supports you by offering code scrubbing to help you ensure your claims are accepted as well as features such as billing and scheduling systems. Runs on Macs and Windows and is best for small practices.
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