Choose the best Electronic Medical Billing Software for your Practice or Billing Service. Learn what the options are, what to expect to pay, and what features are important for medical claims billing software.
The decision on what medical billing practice management software to select is probably one of the costliest commitments you’ll make. Costs can typically run from the hundreds of dollars for simple PC based systems to thousands of dollars for multi-user and client-server configurations.
What To Look For
If you've spent any time looking for electronic medical billing software, you've noticed the choices are overwhelming. It seams like there are hundreds of vendors – and they all claim to be the best. When I was evaluating software systems for our business, my objective was to find the best balance between cost, support, and features.
Almost all billing software applications perform the same basic function - a means of managing a database of patient and insurance information to accurately account for and bill for provider services. What I really wanted to know is what a software system was like to live with on a daily basis.
Just about all of the currently available electronic medical billing software (from reputable vendors) is compliant with HIPAA requirements, so patient data security is maintained.
What is Electronic Medical Billing Software
Electronic medical billing software is also sometimes referred to as Medical Billing Practice Management Software. However there is a difference. medical billing Software is for the financial aspects of the providers practice.
A full medical billing practice management software also includes other features to assist in managing the daily operations of a practice. This may include scheduling, medical records or imaging capabilities, advanced revenue management, patient correspondence ... the options are endless. But they are also more expensive than just basic medical billing software.
Most billing services only need the medical billing functions. The user inputs the patient demographics, visit treatment and diagnosis codes, tests, etc. The software has the ability to create an electronic claim file which is transmitted to the appropriate insurance company or clearinghouse.
The electronic medical billing software is where the insurance and patient payment information is maintained. Patient statements are created for charges the patient is responsible for such as co-insurance, co-pays, deductible, or procedures not covered by insurance. Most medical billing software has the ability to generate reports such as insurance and patient aging which detail unpaid claims and patient balances.
Practice management and billing software is offered in two very different methods - Traditional stand alone or Software as a Service (SaaS). Traditional electronic medical billing software is installed on a local PC or server based in the office.
SaaS applications run on a remote server located in a secure data center and is accessed over the internet. This is also sometimes referred to as Application Service Provider (ASP). The links below offer more detailed information on these options.
Medical Insurance Billing Software Examples
For those of you unfamiliar with medical billing software, here’s some example screen shots of electronic medical insurance billing software. Hopefully this will give you an introductory idea of what medical claims billing software looks like throughout the billing process.
Free Medical Billing Software Comparison Spreadsheet
Here’s a spreadsheet we created to compare the important features of electronic medical billing software. You can use it as a checklist or a way of grading or comparing features of the medical claims billing software or medical billing practice management software you are considering.
Here it is in both a PDF or a ZIP Excel xls format if you wish to customize and change to meet your needs:
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Software Platforms To Consider
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HIPAA Compliance and Software
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Lytec Billing Software
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Medical Billing Clearinghouse
Find out what the benefits of using a clearinghouse are and what to look for when selecting one.
Benefits of Electronic Medical Billing Software
Electronic medical claim submission has quickly replaced paper submission via the 1500 health insurance claim form. There are several advantages to submitting claim with a health insurance claim software. Every physicians billing service should be expected to have this capability.
Claims submitted via electronic medical billing software tremendously reduces the time to get reimbursed from insurance companies. With paper claims sent via mail, its not unusual for processing and payment to take 1-1/2 months. Electronic claims created using a billing claim medical software are typically paid within 2 weeks - and many time less. Most insurers prefer electronic medical claim submission as it significantly reduces the time and labor to handle and process paper claims.
Lower Processing Costs
Submitting claims electronically will lower processing costs not only for the insurance payer - but for the physicians billing service as well as the provider. Material savings for paper CMS 1500 forms, envelopes, toner, and postage. Not to mention the labor time spent stuffing envelopes and mailing medical insurance claims.
Electronic medical insurance billing offers a much lower rate of rejection due to errors - by some estimates as little as 3 percent. Most clearinghouses will “scrub” a claim prior to batching to the insurance payer. This provides another assurance that all the info is on the claim and in the right format.
A benefit of electronic medical claim submission is electronic confirmation that the claim has been submitted, received, and accepted by the insurance company. If there are errors it’s much quicker to correct and re-submit a claim up front instead of waiting one to two weeks for a denial notification.
ERA - Electronic Remittance Advice
Many new billing claim medical software programs offer the ability to post payment information in electronic format - Electronic Remittance Advice. The ERA is a payment explanation with details about the claims payment and denial explanations for any denied claims. Some electronic claims software can import this electronic file, interpret it, and post the payment information. This can save a tremendous amount of time and effort for a process that typically takes hours to complete manually.
Fill and Print Software
What if you just want to print CMS 1500 paper claims? Speedy Claims by SpeedySoft file and print software is an easy way to create paper claims if you don’t need to send electronic claims or need all the bells and whistles of practice management software. At around $115, it's an economical alternative for those who don't file electronically. One nice feature of SpeedySoft is that it remembers patient information so you don't have to re-enter it.
Desktop or Client-Server
Desktop is where the software application is typically installed on one computer. Client-server installations allow multiple users to access the application and data at the same time.
For our billing service we have our medical billing software application running on a server and access the application via Remote Desktop. It’s important the server has redundant drives and is backed up regularly off-site.
We use iBackup which runs on the server and performs backup of our practice database files every night. I highly recommend iBackup as it’s only $10 a month and it’s easy to setup and use. This way if we ever loose the server we’ll have the database files which can be re-installed on another server.
Many of the leading client/server medical billing software systems are available as an application service provider (ASP). This means that the system’s server is hosted at a professional data center. Our server has been located in a secure data center. They offer reliability and security that are that can't be offered in an office environment.
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