How to compare EHR medical billing modules
Many EHR systems come with billing capabilities. If the one you are considering does not, you should reconsider your choice. An EHR needs to integrate seamlessly with the billing system. The integration process is easier if the billing system and your EHR are from the same software maker. However, not every billing software is created equally. Most software makers offer special “billing modules” to add to your chosen billing system. The biggest differences between medical billing modules come from their capabilities. Understanding your practice’s needs and wants is important when deciding which modules to add and which to ignore.
Although electronic claim capabilities should be standard in billing systems, oftentimes they are not. Find a billing system that allows electronic claim submission. For many carriers (including Medicare), electronic submission is becoming the norm. In addition, claim processing times are shorter when you submit claims electronically from your billing system to a clearing house and to the carrier.
Similar to electronic claims, electronic remittance is becoming the norm. Receiving payments electronically (and often in bulk) helps your cash flow and your billing processes. Open claims may be needlessly tracked if it appears a claim has not paid. Physical checks can take several business days to several weeks to be fully processed and arrive at your office. In contrast, receiving payments directly in a bank account, which can be processed in the billing system, ensures that your claim statuses are up to date. A carrier can send your office an electronic payment, which in turn notifies the system to automatically close the affected claims as paid (or denied).
Office notes and operative reports are critical to billing processes. To handle these notes and reports, look for a transcription module. They tend to involve some recording capability to allow providers to dictate their notes and reports into the system. Once dictated, the reports can be then reviewed and approved. Those same reports will be available to medical billers in real time, allowing them to print and send worker’s compensation and no-fault claims immediately.
Scheduling may seem less billing-related than remittances and transcription, but it also affects billing. The ability to see past and future visits benefits the billing office. They may need to send medical records from three visits ago or call an insurance carrier for pre-authorization for a future visit, particularly if there have been billing issues in the past. Similarly, seeing past and future visits helps coders understand what was billed before and what may be billed in the future, allowing them to anticipate potential coding issues before they occur.
In the end, choosing an EHR is about your practice needs, but consider the impact of a medical billing module and the benefit to your practice.
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