Top requirements for medical billing

Of all the EHR features available on the market, EHR billing represents one of the many features that can offer significant gains in cutting waste and optimizing revenue flows.  EHR billing features offer providers two significant benefits that can reduce operational costs and improve revenue flows. Firstly, EHR billing offers a way to reduce time and expenses related to billing. Secondly, it also gives providers a way to improve the accuracy of billing processes by reducing the risk for costly billing errors 

Medical billing software can help reduce the risk of errors that may be more likely to occur with traditional billing staff. When inputting massive amounts of billing material, the comparable rate of errors between humans and billing software is substantial, as software can catch common coding mistakes that even the best trained medical biller will make.

According to the Healthcare Business Management Association, error reduction not only reduces audit risk, but it also captures potential lost revenue due to incorrect coding. The Healthcare Business Management Association notes that “proper coding and clinical documentation can make or break an otherwise well-run practice.” Medical billing software can provide a means to make billing more efficient by automating the billing process; it can also provide a safety net through which errors can be prevented or caught prior to claims submission. 

Selection teams considering deploying medical billing software for the first time or for those looking to replace existing software should consider the following requirements when selecting an EHR product.

Integration with EHR

Medical billing software can be purchased as standalone software, or as an add on to an existing EHR or practice management product. Most frequently, it is also included with EHR or practice management software. Given the need for the seamless sharing of billing data across departments and the importance to incorporate clinical data into the billing and claims process an integrated or add-on system is the best way to accomplish this goal. 

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Reports and Analytics

Billing software should allow users to generate reports using data collected through billing software. Further, it should also give users the capabilities to analyze this data. When conducting operational reviews and planning it is important to examine billing data and analyze these data to make informed decisions.  

Eligibility Verification

To ensure services will be reimbursed providers should have a system in place to verify eligibility for reimbursement for services. A medical billing system should offer the ability to check eligibility prior to services being rendered. 

Custom Superbills

Medical billing software should be able to generate a superbill. A superbill is used as a primary source for generating claims for reimbursement. A superbill provides an itemized list of all services provided including CPT codes, ICD-10 codes, provider name(s), and referral information. 

A medical billing solution offers practices the ability to eliminate costs related to outsourced billing, cut down on administrative resources needed to submit claims, and collect revenue while also ensuring accuracy.

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green

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