Practice Management Software

Medical billing software is an application that can make the billing process a breeze at any medical office. Medical billing software and its use guarantees the medical practice proficient billing practices with less manual labor involved in handling the process of billing. In fact, medical billing software can help the office keep organized and make tax time a hassle free time for the office that takes advantage of such an application.

There are numerous medical billing software applications designed for the specific needs of the medical community. Medical billing software applications are engineered for family practitioners, medical clinics, medical billing service specialists, hospitals, psychologists, physical therapy offices, chiropractic offices, dental practices, and there are even medical billing software applications suitable for medical equipment companies. The software applications that have been engineered for medical office management are diverse, providing users with a variety of functions as well. Current medical billing software allows users to bill patients, report overdue bills to collection agencies; make patient appointments; handle scheduling; easily submit claims to insurance companies and medical billing software serves as an electronic database of patient’s records.

Clearly, medical billing software is something no medical practice or office should be without. The functionality of the program alone makes the software an imperative tool in every medical office. Current medical billing software applications have been designed to meet with the standards imposed by HIPPA and the fact that any claims made to insurance companies are electronic and not paper means that the office will receive payment that much faster.

Here are some criterias to look for in a good medical billing software:

Scheduler

  • Automatically search for open appointments, attach notes and assign appointment classes
  • Be able to view appointment schedules in various ways by week, day, location and provider
  • Have patient waiting lists so office can fill missed appointment slots
  • Verify eligibility in real time without leaving the appointment screen
  • Store new patients’ information temporarily and convert the patient’s data into a permanent file, eliminating double data entry.
  • Track the lenght of every visit and have reporting features that can monitor referrals, pre-authorizations, and appointment histories
  • Be able to customize appointment’s duration, color-coding and other practice parameters

Registration

  • Scan the patient’s picture, id or insurance card as part of the patient’s record
  • Assign multiple primary insurance coverages and create multiple medical cases for a single patient account
  • Track patients’ insurance effective dates and maintain histories of bills and claims
  • Generate personalized letters, reminders, labels and referral letters
  • Track chronic diagnoses and store encounter-specific notes
  • Define custom data fields to suit your organization’s needs

Billing

  • Maintain multiple customized charge slips
  • Define explosion codes for grouping multiple charges and posting them under a single code
  • Post payments manually, one at a time, in batch mode, or with AutoPosting from electronic remittance
  • Generate simple bills, which show only patient-responsible amounts, or more detailed statements, which include amounts pending from payers
  • Integrate with own EMR or another electronic medical record (EMR) system for automatic charge capture

AR & Collections

  • Automatically populate claims, appeals or patient collectibles work lists
  • Organize queues by patient name, carrier, aging, rejection type or other variable
  • Systematically route cases to the staff member most qualified to handle them

Claims Mgmt

  • Verify patients’ insurance eligibility before each patient’s visit
  • Perform batch eligibility checks based on the appointment schedule or as patients check in
  • Access claims tracking data, from submission to forwarding and adjudication to payment or rejection
  • Perform real-time claim status checks
  • Receive electronic remittance advice from clearinghouses for multiple carriers

Reporting

  • Measure actual day-to-day operations and identify trends to drive efficient administration, process improvement, compliance or other efforts
  • Generate financial reports that help you assess accounts receivable, manage month-end close, analyze payer mix or protect cash flow
  • Save frequently-accessed reports and their settings for future use
  • Export reports to Excel or Access database formats to share or analyze further
  • Display report data in graphical formats for on screen review

Mobile solutions

  • Review appointment schedules and check-in and check-out times
  • Access patient notes, diagnosis codes, procedure codes, charges, date of admission or discharge orders
  • During hospital rounds, access basic patient lists sorted by name or hospital room number
  • Enter charges directly to minimize lost reimbursement

Access Security

  • role-based access control for all users within your practice that support HIPAA regulations
  • System must maintains audit trails for tracking all system activities

Systems Integration and Interoperability

  • Interfaces with laboratory services
  • Integrates with third-party services such as appointment reminder or EMR systems
  • Connects with clearinghouses, E-Statements, and direct payers such as Medicare and Medicaid
  • Supports HL7 standard
  • ODBC compliant