The healthcare industry is quite extensive, and it is an integration of several functions from healthcare providers delivering medical services to patients, pharmaceutical companies manufacturing medicines and drugs, and also medical insurance services.
The U.S healthcare industry is among the top five biggest industries of the country and includes the provision and support of all the medical-related goods and services. In recent times, there is a significant increase in demand for medical services due to the aging baby boomer generation.
But the biggest challenge that medical business across the country faces is in the form of Coronavirus that has disturbed everyday life and, in particular, the healthcare department. Both the big and small medical practices are under immense pressure with the growing number of Covid-19 positive patients as there is a vital need not only to provide the medical services but also to stop the virus from spreading.
How the Healthcare System Works
The medical service can be explained by comparing it with an auto repair shop. For example, when the car you drive is not functioning properly, you drive it to the repair shop to identify and fix the issue. Similarly, when you are not feeling well and have an acute or chronic illness, you schedule an appointment, and a doctor will diagnose and provide the necessary treatment.
But the difference is that you pay for car repairs on the spot with no delays, while the payments in health centers is a different story. More than 90% of people have insurance plans that help cover the medical expenses, which means that once a patient gets the treatment, the healthcare providers have to make a claim and bill it to the insurance company to get the payment for the services that are rendered.
An established or large medical practice usually have the advantage of professional billers and the claims are submitted on time and with few errors. On the other hand, a small medical practice has to face delays in payments and face objections and denial of payments from the insurance providers.
The medical billing function is an essential and time-consuming task but at the same time directly responsible for streamlining the revenue cycle and ensuring the financial sustainability of a medical practice.
The in-house emergency services have decreased, which has affected the regular revenue stream. The patients suffering from acute or chronic illness stay at home, thinking that going to a hospital may make them susceptible to contracting the Coronavirus. On the other hand, the hospitals are struggling to manage the financial obligations, which include wages to healthcare practitioners, payment of rent and overhead, and equipment cost.
The Purpose and Need of Web-based Medical Billing Software
In these testing times, the best solution for a medical practice to streamline the workflow is to switch to web-based billing software that helps to reduce significant time and effort. The medical billing codes are not only updated every year but also increasing with different diseases and ailments.
Due to Covid-19 numerous CPT (Current Procedural Terminology) codes have been introduced for the diagnosis and treatment, which the healthcare center must be familiar with. The best medical billing companies in the USA have realized the growing concerns of healthcare centers and focused on providing valuable and efficient billing software solutions.
The medical billing software only requires a simple login, and there are many value-added features available such as integration of EHR (Electronic Health Records), updated ICD (International Classification of Diseases) and CPT codes, fast insurance eligibility verification, same-day medical claim submission, tracking and payment reminders, and quick correction of bill errors and resubmission.
The rapid progress in technology has allowed the need to design and develop custom billing software according to the needs of the medical practice or physician’s clinic. PETTIGREW is one prominent company providing advanced billing solutions with the help of skilled software developers and billing specialists.
The advantages of switching to custom web-based medical billing software are
- No need for an overload of paperwork, which can be quite confusing and frustrating. One software provides easy clicks for every task, whether it is checking insurance eligibility, selection of codes, getting information from EHR, or claim submission.
- The patient’s records are filled one time, and there is no need to get the information every time a patient visits the medical practice.
- Doctors and physicians all across the country can quickly access a patient’s medical history, diagnosis, and treatment, which can lead to better and efficient care.
- The digital billing software is updated regularly, which means that the medical practice gets to use the updated medical codes, and there is no claim denial as more than 50% of medical claims are rejected by insurance companies due to wrong medical codes.
- Easy selection of accurate codes helps to considerably reduce the denial of claims or objections from insurance companies.
- One of the biggest advantages is that the software can be operated remotely, and one does not have to be physically present in the health center
- Every essential task is streamlined and efficiently managed, from scheduling appointment, insurance verification to getting information from EHR to claim submission
- The patient information and the medical practice’s data are remotely secured on a cloud and safe from unauthorized use.
- The healthcare practitioners and support staff at the medical practice can spend more time on delivering best and quality services to the patients.
A medical practice, documents every detail of the patient's visits from scheduling an appointment, diagnosis of illness, treatment, and post-treatment services. The modern healthcare coding solutions ensures that the diagnosis and treatment of ailments is translated accurately into numerical codes. The codes are used to prepare the medical bill and then sent to insurance providers for timely reimbursements.
The innovative billing software makes it easy to track the medical claims and do regular follow-ups on unpaid claims. The software also helps identify the mistake when the claim is rejected, and the claim can be corrected and submitted again to get timely payments.
Although unintentionally, human error is one of the major reasons that can lead to incorrect coding, bill, and claim submission and result in thousands of dollars loss for the medical practice. Custom billing software can reduce the mistake and ensure a seamless revenue cycle.
A medical practice that partners with PETTIGREW, and has access to all of the services we offer, then the process begins. There is a wide range of options when it comes to setting up the software, and training is provided. The team ensures that all the checks and balances are followed, then the status of software is updated to ‘Live,’ which means medical claims can be submitted.