Medical claim software buyers guide and features explained. Before you make such an important investment, learn what questions to ask and features to consider for your practice or billing service.
The importance of choosing the best medical billing or practice management software for your needs is one that has lasting implications. That's why we’ve compiled this buyers guide to help you think about all issues associated with selecting the best software for your situation.
Most people start out looking for a cheap medical billing software. But the billing software is something used on a daily basis - typically by several people. Savings up front can quickly be lost in poor productivity. However are many affordable software applications available that will meet the needs of almost all practices or billing services.
Many of our providers regularly use the reporting features to see what the financial performance of their practice. The medical practice billing software is typically used by many people; the provider, office manager, biller, coder, receptionist, consultants - a wide variety of people with different backgrounds, training, perspectives, and agendas.
So although this purchase can mean several thousand dollars, its important to remember that its a key business tool for the income of your practice or billing service. Some features while they may cost more, can ultimately save you greatly in the long run with increased productivity, fewer rejected claims, or tools to identify issues with the billing.
If you already have experience using a medical claim billing software, think about the features of the systems you have used that were helpful. Also think about the features you wish the software had that would have made your work easier.
We’ve also compiled the form below to help you in selecting the best medical claim software. Feel free to use as you wish - add to it, modify, mark-up, etc. It’s in both PDF and Excel format:
Another good resource in finding the best medical claim software is the Software Advice Buyers Guide. Their expertise is determining the best software based on a users needs - they provide free and un-biased recommendations. This can save you a lot of time and effort by narrowing down the best software solution based on your needs and budget.
When you demo a medical claim software program, think about these issues:
Reporting - running insurance aging reports is a necessity for the billing. Can you select the date ranges? Can reports be customized? Can you select the fields you want to display? Organize by insurance carrier? These are very helpful features to working the aging of a practice.
The billing compliant hipaa medical software features are extremely important with regard to the HIPAA privacy standard and HIPAA security standard.
By now most all medical claim software accommodates the provider NPI. However HIPAA is being implemented over several years so it’s important the software be able to accommodate the changes introduced by HIPAA.
HIPAA compliant medical billing software should have the following features:
Online Medical Claim Software
Online or web based medical claim software is becoming increasingly popular with the advent of “Cloud Computing” in other businesses. As online providers become more reliable and secure, this is certainly more attractive.
Vendors who provide online medical practice billing software are also referred to as application service providers (ASP’s) or Software As A Service (SaaS) providers. These applications actually run on a remote server host.
Online medical claim software is a good option for just about any practice with single or multiple locations. It’s especially well suited for access from many locations by many parties. For example if a practice uses a billing service, they may consider an integrated online solution that offers medical claim software, electronic medical records, and scheduling.
The advantages that make online medical practice billing software attractive are:
The disadvantages of online medical claim software are:
Upgrades & Conversion
Upgrade - the mere mention of the word brings back painful memories. The best advice we can offer is that when you are considering which medical billing software to commit to, do so for the long term. Even if it costs a little more up front, if you can avoid converting to another software or upgrading, its worth it. Don’t purchase a medical claim software with the intent of changing vendors in a few years. Go with something the is robust enough to grow with your practice or business.
When you go through an upgrade or conversion of your medical claim software, plan for the worst. When we went through an upgrade of our medical claim billing software a few years ago, it was the later version of the same product. We verified with the software provider that the existing forms and reports would be compatible with the later version. They assured us it would.
Well when we upgraded the server - and this is a one-way trip - none of the forms or reports would work. And when we called the software tech support folks they were absolutely no help - clueless. We were on our own. None of the forms used to create claims would work so we had to work out re-mapping our electronic claim files with the clearinghouse again - and this took a while. And on top of that we had issues with the licenses that prevented us from logging in.
Luckily all of the database files imported without problems. But if you are converting from one software to another, it can take a lot of “clean up” work. The exported database files from your old medical billing software must be put into a neutral format and order for import into the new medical claim software. And many vendors do not format this information the same. This can be a very labor intensive and time consuming effort - and the new software provider will charge for this.
There is an initiative called HL7 which stands for Health Level 7. This is a not-for-profit, ANSI-accredited standard with the intent of providing standards for the exchange, sharing, and retrieval of electronic health information. However not all software vendors in the health information field have adopted these standards.
If you are dependent on a IT support person or service for upgrades or conversion to another medical claim software, it can be very expensive and disruptive. In our case we couldn’t send claim files for almost a week. Try explaining that to your clients!
Medical Billing Codes & Software
Some medical claim software programs offer an add-on to import or pre-load the ICD-9 and CPT-4 codes most common for many popular specialties. They can also periodically update the medical billing codes so you don't have to be concerned if you're using the most current ones. This can be a real time saver. One of the very labor intensive tasks can be entering in all the diagnosis and treatment codes you practice commonly uses.
Of course this comes at a cost. But when you consider the cost of labor and time necessary to perform such maintenance tasks, this option can sometimes be cheaper.
Be wary of software reviews. These are many times thinly veiled promotional ways that vendors use to promote the features of their medical claim software offering.
Who is ultimately making the decision on what medical claim software to purchase. Make sure those using the application the most have a lot of input on the selection. Are the people who use the software the least making all the decisions? Sometimes you have office management or providers deciding what the best medical billing software is based on vendor sales without considering the needs of their staff who have to live with it.
Here’s some other related medical billing software topics that provide more in depth info:
Cheap Medical Billing Software
Looking to save money with a cheap medical claim software? Here’s some of the more affordable medical billing software offerings for starting a medical billing business or small practice. Also learn more about a good free medical billing software and clearinghouse service.
Free Medical Billing Software
Get the real story on Free Medical Billing Software. Learn where to find a free medical claim software and what features to expect. This can be a viable option for the practice or billing service just starting or not in need of a lot of feature options.
Software Eats Medical Billing
A discussion on how the healthcare reimbursement process is ripe for innovation. An opportunity to contribute your thoughts and comments on the topic.
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.
Best Medical Billing Software
Learn what features are important and how to find the best solution for you. I share my experiences selecting a billing software program.
Online Billing Software
Is web based the way to go? Having no upfront software cost is appealing. Learn what the costs and pros vs. cons for online practice management systems.
Comparing Medical Billing Software
Have you seen the sites that compare medical billing software? What to watch for in medical billing software reviews. Key points in reviewing billing insurance medical software.
Software Platforms To Consider
Here’s an description of the different Health Insurance Claim Software platforms to consider when selecting a medical billing software.
Free Online Medical Billing Software
Is free Online Software available? Where to find free online medical billing software and what to expect.
Medical Coding Software
What are the options for Medical Coding Software and some online coding resources.
Lytec Billing Software
Opinions on Lytec Billing Software from a Medical Billing Business Owner. Gripes and Likes of Lytec Software.
Medical Billing Clearinghouse
The benefits of using a clearinghouse are and what to look for when selecting one.
Feb 19, 18 08:57 AM
Free Medical Billing Training – what’s the catch? There are some good free resources available. Check out our FREE course.
Jan 09, 18 08:52 PM
Just starting out and need specific information on how to submit secondary claims. I understand you need EOB from primary. Do you send entire page with
Jan 09, 18 08:36 PM
What claim form would a Home Health Agency use to file a claim for telemonitoring? Response: We haven't had any experience billing for home health services
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