Medical Billing Solution. Panacea or Headache?

Medical Billing Solution

Today’s technology holds great promise for medical organizations who must maintain a competitive edge to survive. Digitalization continues to help them meet efficiency expectations in better managed practices, and that includes the use of comprehensive data analytics to transform healthcare services at all levels. One of the most affected components is the increased performance and utility of specialized medical billing software, which determines the revenue cycle from claim to payment.

Although it is now vital for both providers and insurers to leverage modern medical billing software, there are still questions as to whether or not it is really a panacea, or simply an expensive headache. Let’s examine the main benefits of comprehensive medical billing solutions for the healthcare practice.

Automated and structured billing life cycle resulting in efficiency

The tailored medical billing solution that conforms to industry standards is a customized software with the ability to assess individual needs and practice preferences. It must be both accurate and fast. Electronic billing must make it easier to:

  • Validate all billing data according to the insurer’s protocols for required information, like
    • eligibility,
    • EMR/EHR,
    • financial reporting available in the system resulting in faster payments.
  • Minimize errors.

A medical billing solution streamlines data exchange processes with utmost accuracy. Almost all transactions between the facility and the insurance provider are performed automatically, and should “catch” common mistakes, thus removing the potential for human error.

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Saved infrastructure and practice overheads

Since medical billing is a really complicated process in the US, the major investment involved to build a good customized billing solution will still prove to be more cost efficient than hiring extra employees, paying extra payroll taxes for those new employees, performing additional administrative tasks, building additional infrastructure, etc. With the needed features and the right technical support, fewer employees can streamline a practice’s operational and financial processes.

Some practices, particularly smaller ones, prefer to outsource their medical billing to a third party for this reason. These third parties can provide medical billing services like invoicing, insurance verifications, reimbursement tracking and collection assistance. They also address specific billing challenges, allowing healthcare practices to save time and effort and to concentrate on their own core services.

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Increased practice efficiency and workflow results in customer satisfaction

Comprehensive billing solutions can be a huge benefit for any practice in terms of internal staff productivity. The staff spends more time caring for patients instead of performing excessive administrative tasks. For example,

  • medical billing solutions help staff to improve workflow and optimize communication through improved access to all integrated data.
  • electronic invoicing allows remote access to send invoices to healthcare insurers, which also expedites reimbursements.
  • a sophisticated billing solution offers the practice as well as the insurer complete transparency, e.g., the ability to track charges in case of denials, delays or incorrect processing, etc., in a timely manner.
  • the industry standard code system performs invoice information verification, and issues alert notifications, which then facilitates correction and resubmission of the invoice.
  • automated processes and integration of the systems, e.g., EHR, EMR, finances, insurance regulations, etc., free up and allow staff to dedicate efforts to customer care, which in turn increases job satisfaction.

Top security and regulations conformance

Due to the complexities of insurance criteria and confidentiality compliance requirements, most practices will benefit from billing solutions that can help speed up claim reimbursement, and at the same time provide the highest possible protection for sensitive financial and personal information. Any reputable billing solution will facilitate secure data backup and transfer via encrypted network connections to minimize or eliminate the risk of data breach.

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Ease of access and use

The utmost benefit of any medical billing software should be ease of access and use. All this brings ultimate value if used with the right custom functionality. The core features should include the following categories:

  • Practice management. This includes workflow dashboards that facilitate scheduling, patient insurance eligibility verification, full visibility into insurance plans, and appointment-related tasks.
  • Claims processing and payment collection. This includes automatic claims checking, submissions, insurance billing, patient statements, electronic remittance, batch payments, patient/provider portals.
  • Reporting and analysis. These include reimbursement tracking, standard and customizable performance reports, revenue rates, intensive claims follow-up.

There is no question that comprehensive medical billing solutions are transforming the healthcare sector. They can help healthcare organizations achieve positive ROI by gaining control of operations and delivering better value to their customers and patients. With automated claims management processes, eligibility verification and appeals, reporting and analytics within HIPAA compliance and insurance regulations, these custom solutions productively interact with insurance companies, support their patients requests, and are able to offer streamlined and cost-effective service.

Can your practice benefit from medical billing solutions?
Connect with Avenga experts to learn more.
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