Does a medical billing software actually enhance efficiency?

Gone are the days when providers used paper for almost everything, be it prescribing medicine, making notes, mentioning patient symptoms, and billing the patients. With EHR technology becoming more and more popular among providers in the US, a lot of vendors have started integrating Practice Management Software to expedite medical billing in their practices.

Although providers have found EHRs to be very useful for their practices; some of them are still hesitant towards using medical billing software. The reason could be that several medical billing tools are quite complex and costly for practices to handle. Some practices still prefer manual documentation over electronic, in order to protect data from being hacked, stolen or even used for corrupt purposes. After all, the chances of data being accessed by unauthorized individuals are higher in electronic data as compared to paper based data.

However providers must realize that medical billing software are bringing about a new change in the healthcare industry. Now the rate of claims being denied or delayed are decreasing significantly. According to Reviews, electronic medical billing has successfully reduced error per claim ratio with latest technology like Claim Scrubber. Here are some common features of medical billing software that can contribute a lot to increasing practice efficiency:

1.       Access to Patient information

Medical billing software has enabled physicians to run background checks on patients’ medical and insurance history. Now it’s easier to access patient information from anywhere. Not only does this speed up the billing process but also helps practices avoid claim errors.

2.       Reducing claim denials

The biggest problem troubling medical practices is the increase in their claim denial rates. While dealing with several claims directed towards different insurances at a time, mistakes are inevitable. However, with recent upgrades brought by medical billing technology, it has become easier to identify such errors and correct them before sending out the claims. This way more than 90% claims pass through submission in the first go.

3.       Increase in cash flow

Another change observed in practices that have adapted to electronic medical billing is the increase in their cashflows. Medical billing software not only increases the rate of claim submissions, but also helps providers reclaim their fee early by reducing payment time. Some medical billing software even have the capability to auto-generate modifications through which providers can follow up on their claims via regular reports and tracking.

For small practices that have not yet adapted to electronic medical billing because of the pricey and complex software, Outsourcing Medical Billing to a medical billing company is another appropriate solution for improving practice performance.

Rad more: Top reasons to Outsource Medical Billing

Does an Oncology EHR help optimize physician workflows?

Oncology has a unique set of terms and protocols as compared to other medical specialties. The intensive data and procedures involved in oncology list it among the most complex medical specialties. Therefore it is reasonable to understand why oncologists dislike using a generic EHR that doesn’t suit their practice. EHR vendors have tried coming up with an Electronic Health Record (EHR) system that can cater to oncology practices, but many have failed in doing so. However few have succeeded in either modifying their generic EHR to accommodate to specific oncology requirements or redesigning an EHR solely for oncology practices.

Oncologists expressed the urgent need for EHRs that could help them with more accurate documentation and safe-keeping of patient data, ordering and administration of chemotherapy drugs, clinical trials etc. The most useful features in an Oncology EHR that can drive outcomes, productivity and financial growth, are as follows:

1.       Chemotherapy automation:

 An Oncology-specific EHR simplifies chemotherapy automation for oncologists. Orders can now be delivered electronically and oncologists no longer need to manually calculate the amount of dosage to give to their patients. The automated dosing and scheduling function in these EHRs helps prevent dosage calculation errors.

2.       Customized templates and digital imaging

The availability of customized templates for various tumor-stages assist oncologists in the creation of structured notes. Many EHRs also have the feature to capture, scan and attach clinical images, lab tests and photographs directly into the patient chart, or through an integrated PACS. Additionally, these notes and images can be emailed or faxed to the referring physicians.

3.       Patient portal:

Patients need to be updated about changes in their condition from time to time. The patient portal facilitates patients in receiving test results as soon as they become available, and it also helps in keeping tabs on their health status. Moreover, some EHRs help patients in requesting appointments and refills online.

The Oncology EHR assists oncologists in improving their practice workflows by offering features including cancer mapping and stage identification, treatment recommendations, clinical trial support etc. However it is necessary for oncologists to recognize which EHR will be suitable to meet the needs of their specialty or subspecialty before purchasing any.

Read more: We did it again! CureMD ranks 3rd in the Top 20 most Popular EHRs.

Prepare yourselves: Less than 300 days to ICD-10

This time next year, practices not using the ICD-10 code set for their billing will not receive a dollar for their services. The CMS has announced September 30, 2015 as the date until which the ICD-9 diagnosis codes will be used. The very next day, on October 1, every practice across the nation will need to use ICD-10 codes if they want to get paid.

Yes the changes will be huge, as the current ICD-9 code set contains roughly 13,000 outpatient diagnostic codes while ICD-10 has around 68,000. Yes, the codes will become more complex and detailed (with more characters and subdivisions), and physicians will need to learn them all over again.

However, technology has resulted in this alteration, and technology will aide in the adoption; EHR vendors will eventually come up with quick and efficient conversion, mapping and support tools so that providers can switch to the new codes with ease.

Keeping this aside, there’s still a lot you need to do. First of all, immediately get in touch with your EHR vendor and inquire as to his ICD-10 readiness. This is because no matter how prepared you are, if you EHR vendor isn’t ready; your efforts will go down the drain.

Get a new, ICD-10 ready Electronic Health Records (EHR) now rather than later if that’s the case. Most EHR Vendors will also give you an overview of the conversion process, and teach you more via a paid consultation. Next, get in touch with your clearinghouses, billing company, and insurance carriers to check on their status; you’ll get more advice as to getting started from these sources too.

The next step is to establish how your documentation, e-Superbills and reporting will change when ICD-10 is applied. Consult the above-mentioned sources, the internet, government support sources and other providers determine this.

When you’re done with this, your staff needs to be made aware of how their roles will change, and provide them with the required training for ICD-10. This will ensure a very smooth conversion, and keep disruptions to your practice workflows at a minimum.

Conduct both internal and external testing at least a couple of months before October to see how well you’ve adopted to the workflow changes, and so you can make alterations to bridge your shortcomings before the October date.

The time to ICD-10 is decreasing, so make sure that you’re ready before October 2015 to prevent the loss of revenue and the disruption of workflows at your practice. 

Read more about: How will my claim submission process change with ICD-10?

Using a medical billing company to safeguard your practice from ICD-10

There has been a lot of talk about the ideal medical billing company, particularly with respect to the intimidating ICD-10 changes which threaten to be a huge burden for practices.

A Black Book Rankings survey comprised of responses from over 20,000 trained and qualified users between November 2013 and April 2014 reported interesting findings; including this one on outsourcing medical billing. When asked about their practice’s operational priorities over the upcoming years, about 90 percent of single-physician and small practice physicians with in-house billers said they would potentially outsource most or all their billing-related functions over the next two years.

The preference for a medical billing vendor by smaller practices in particular looks to be a result of the complex nature of ICD codes, which make billing extremely time consuming.

ICD-10 is going to be big, and the new coding format mean that there are additional subdivisions for most diagnosis.  Moreover, the numbering will be completely different from what it was before.

And with ICD-10 and thousands of new codes almost upon us, physicians, especially those who understand the current codes; don’t want to go through the hassle of learning the codes all over again.

If we look at the advantages of using a professional billing company for ICD-10, the need for trained, competent and experienced billers is essential. They will have the necessary tools that are required to ensure that the billing progresses smoothly.

Moreover, any difficulty in billing that these professionals encounter is likely to be dealt with in significantly less time. This is because they will have experts for different dimensions of medical billing; and with these experts will have the option to solve problems among themselves. In contrast, one or two in-house billers at your practice encountering similar problems could take significantly longer to resolve such problems; resulting in potential collection delays and in turn lesser revenue for your practice.  

Other benefits of medical billing vendors include lower staff costs, faster claim reimbursement and lesser chances of fraud.

Must read about: Why Physician ICD-10 Fears are unfounded, CMS explains