Medical Billing Software 101
Electronic Medical Billing Software is available from a large number of vendors in many types and sizes. Frequently referred to as Practice Management Software, common features include
- Patient demographic information capture, either in a transactional format or a batch format (useful for entering many paper entries at once)
- Charge entry, again in transaction and batch formats
- Scheduling, registration and other front desk functions, such as co-pays and patient balance inquiry
- Claim editing or scrubbing
- Electronic claims filing
- Electronic payment posting (for 835 ERA’s or Electronic Remittance Advice)
- Manual payment posting
- Accounts receivable analysis
- Denial analysis
- Follow-up and other work queues
- Reporting
- Practice dashboards
Of course, there are many more specific features. One often overlooked capability is the practice workflow supported by the software, or not supported, as the case may be. Many systems assume a specific workflow. This is good when it matches your practice, assuming practice needs do not change. For this reason, more sophisticated medical billing software is driven by tables and masterfiles which allow the workflow to be tailored to each practice. This extra flexibility can seem complex at first, but the operational benefits are very rewarding.
The most sophisticated medical billing software is used by medical billing companies since they focus on only this one task. They also demand more performance for staff productivity, for collections effectiveness, and in reporting.
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