A medical practice or physician clinic involves delivering health care services and managing different administrative tasks which includes greeting incoming patients, scheduling appointments, taking down patient details, and submitting medical claims.
Medical billing is a vital part of revenue cycle that allows a medical practice to submit claims to the insurance company, so payment can be received for the services rendered to the patients. The medical claims are formed according to the medical codes that are selected based on the diagnosis, testing, treatment, and other procedures provided to the patients.
The Significance of Medical Billing Process
The medical billing process involves not only submitting claims but also tracking the claims, doing follow-ups, and correcting and resubmitting the rejected claims from the insurance company. In the healthcare industry, both the physician and hospital billing fall under the same category, but there are some differences such as
- Hospital billing refers to claims that are formed according to the inpatient, and outpatient services given by a healthcare center. The bill amount includes everything from laboratory services, medicines, use of medical equipment and supplies, and services of nurses. But the hospital billing does not include medical coding and only deals with payment collections.
- Physician billing is also known as professional billing, and its purpose is to get reimbursement for the medical services provided by the physicians and doctors to the patients. The elements of the physician billing process include a series of tasks from the moment appointment is scheduled until payment is received.
Physician billing is an integral part of the revenue cycle that helps a medical practice manage its finances and sustain in testing times, such as the one faced in the form of Coronavirus. The steps such as greeting the patients, scheduling appointments, check-in and registration, medical coding, and collection of payment are all included in the physician billing process.
It is a widely known fact in the healthcare sector that more than 50% of medical claims are rejected or denied by insurance companies due to inaccurate medical coding and billing. Big and small medical practices finding it hard to financially sustain due to the Covid-19 outbreak must use and take advantage of technology in order to streamline workflow and prevent the rise of rejected claims or reduce payments from the insurance companies.
The Essential Need to Implement Physician Billing Software
In medical practice, numerous patients come either for diagnosing or treatment of acute or chronic diseases. The first and foremost task of physicians and doctors is to provide services to incoming patients rather than go about the various steps of the medical billing process. We live in a technologically advanced world where purposeful software is made to perform particular tasks efficiently and effectively.
A physician billing system software is specially designed and developed for medical practices to ease the multiple tasks involved in managing the medical billing process. The billing software's main features include verification of patient’s insurance eligibility, selection of appropriate medical codes, claim validation and submission, and tracking and correcting billing errors.
Physician billing software is necessary to improve the daily workflow, reduce the billing errors, streamline the revenue cycle, and allow the staff to focus on better healthcare services rather than countless paperwork. Some of the reasons to install billing software are
- Patient satisfaction and quick registration procedure
Traditionally, a staff member spends considerable time on the phone not only to schedule appointments but verifying the insurance status of the patient. Every time a patient comes, details are taken down from medical history to demographics. A modern billing software provides automation of conventional manual tasks, which can save significantly save time and effort.
Patient’s insurance can quickly be verified, and patients requiring emergency care may not need to painstakingly wait for the registration and verification process. The software can help in real-time tracking of claims and payments and see how many patients are late in payments.
- Reducing costly billing errors
The insurance companies are very precise and particular when it comes to payment to healthcare centers. Insurance companies scrutinize every aspect of the medical bill and point out mistakes to reduce the payment amount or reject payment altogether. The innovative and sophisticated source medical billing software automatically updates the numerous medical codes and even highlights errors before a claim is submitted.
Even after the insurance company raises objections, the software makes it easy to identify the source of the mistake and correct it immediately, whereas traditionally, it took weeks just to identify the mistake among the pile of billing paperwork. A medical coder does not have to remember complex medical codes as the software makes it simple to select the required code for diagnosis and procedure as wrong selection of coding can easily lead to lawsuits when the services rendered do not match with the issued medical bill.
- Use of reports for financial analysis
One of the best features of billing software is that a medical practice gets access to valuable customized reports that can help to analyze current performance and plan for future growth. The reports on late payments can help to draw patterns regarding the flow of the revenue cycle. The Zip code can help to notice if a large number of patients are coming from a particular area and facilitating them by opening a secondary practice in that area.
The Trend of Customized Billing Software
The best medical billing companies In the USA have valuable resources from technically skilled software developers to billing specialists that help design and develop custom physician billing software according to the hospital's needs and requirements or for any other healthcare center. The billing software can easily integrate with the Electronics Health Record (EHR), and the coding and billing information can quickly be uploaded and stored in the database.
The massive influence of digital technology has led to a cloud-based billing feature that not only secures the data, allows remote working but also makes the patient information accessible to doctors and physicians. The patient's medical history, diagnosis, and previous treatment can easily be viewed on any smart device such as a smartphone or tablet.
PETTIGREW provides innovative and advanced physician billing software solutions that help file and submit medical bills accurately, allow staff quickly and efficiently manage the administrative tasks, get full payments from insurance companies, ensure entry of correct medical codes, automatic payment reminders, and improved patient satisfaction.
Traditionally, medical coding and billing was quite a complicated process that involved tremendous amount of paperwork for each patient. The patient records used to be massive, and at times it became difficult to search for particular file among piles of different files. But with automated software, the patient files are stored with dates and can be searched with filters, which makes tracking easier. An automated billing software allows to store, maintain, and update patient’s diagnoses, testing, treatments, and bills easily and efficiently.