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

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

Why does my practice need a medical billing company?

In our country, a medical billing service is the intermediary between a doctor and his payments. However, while the Health IT sector is flourishing, many providers are missing out on even greater revenues in the form of quicker claim processing and reimbursements. Can a medical billing company be that intermediary; a question on the lips of all providers.

Managing your practice is not a walk in the park with doctors having to manage their patients and in addition to working towards achieving Meaningful Use incentives and avoiding penalties, the ICD-9 coding process and the fear of the fast approaching ICD-10 diagnostic codes among other things.

How can an in-house biller or professional billing company change the doctor’s revenue cycle? The answer is simple; through the internet, the intermediary transmits insurance claims directly to the insurance. Yes there is a clearinghouse involved, but that’s for the biller to worry about. As a provider, you have one less aspect to manage.

In addition, Medicare prioritizes electronically submitted claims. Claims transmitted online take 10 to 14 days for payment, in contrast to paper-based claims, which can take approximately 27 days. With so many days saved, even more money is earned by the doctor.

Now comes the next question, in-house or outsourcing medical billing? There’s a pretty straightforward self-evaluation statement for this. With both avenues providing the same service; would you prefer dedicated billing staff, to which you’d have to allocate a separate room and computers? Or would you prefer a company with numerous billing professionals, who’d do everything to maximize your reimbursements, and who’d charge an extremely low percentage of your annual revenues for their services? 

The more practical choice would be to outsource your billing to a company who’d do all this for you, all without taking a large amount of space and money to carry out your services for you. Additionally, most EHR vendors offer to execute this service for you, which means that you don’t even have to worry about system compatibility issues.