medical billing software are they all the same

Medical Billing Software: Are They All The Same?

If you are thinking about outsourcing your medical billing, it is as good ideal to know what you are buying before you actually purchase something.  For starters, medical billing software is beneficial and necessary for every healthcare company and medical practice. You cannot do billing without it.  Your software needs to be HIPPA compliant. It is always best to work with a reputable software company before choosing a package that is right for you. Many hospitals choose to build their own software from the ground up.  This requires careful attention to detail and a sophisticated software engineer. Most software engineers today see your software as a unique product.

If you are a dental office, your billing software should be different than someone that does chiropractor care.  Many software’s today help us to examine what is good and not so good. In my opinion, it is best to sit down with a consultant in order to find good software for your company. If you plan on outsourcing your billing to a professional medical billing company, then you don’t need to buy any expensive software.  The medical billing company actually provides it for you.

Medical billing software is beginning to take more shape because of the introduction of ICD-10 coding. ICD-10 coding has around 100,000 codes to it and often complex for people to fully understand. Many colleges and universities are saying that a medical biller should know something about anatomy and physiology.  A biller needs to learn how to document a lot of information for insurance companies to see.  Most insurance companies today are looking for a way to reject your claim. If there is a misspelling or a mistake, they will most likely reject your claim. This could mean months of waiting for reimbursement.  Many doctors are saying that they are losing 20% to 30% of their income because of unpaid claims.  Some physicians are saying that insurance companies have all of the power and there is nothing that can be done about it. However, successful, trained and experienced ICD-10 coders are saying otherwise. Most coders today believe that you can get a high return because of accurate billing procedures.  They say that the more education you have, the better.  Many billers today have their bachelor’s degree and several certifications in billing. It is amazing how many hospitals today are turning to outsourced medical billing companies.

Here are a few basic tips about billing software.

  • Basic billing software depends on the users input skills and knowledge. It is often used by private sectors and Medicare agents.  The most common problem with this type of software is user errors.  Sometimes the biller will input incorrect information, wrong codes and missing patient and provider information.  This type of software is usually not recommended since you can’t override the programs or customize it.  Most mistakes in billing are used when using this type of software.
  • Informational software has basic software capabilities. It is common for using databases to access patient records and information.  Some common imperfections with this type of software are invalid code combinations, missing diagnosis, improper software configuration and much more.
  • Interactive Software gives many options for correcting problems from the software. This provides the user with information such as no pay, less pay or more pay.
  • Proprietary Software has the greatest misuse for several different reasons. This is often developed for a particular person in mind.  This software is known to have hidden programs in them. This software often produces inaccurate claims and in some cases, your practice may be labeled as someone that is trying to scam the system. This is probably the worst type of software.

If you are using an outsourced billing company, they most likely have software that is working well for them.  Many medical billing companies invest over $50,000 into their software in order to perfect it enough to get higher returns.  It is customized and meets the needs of their customers.  More doctors today are choosing to outsource their billing because they tend to get more results because of it.

Before making any kind of purchase, make sure that the software does exactly what you want it to do.  Ask the software company to allow you to use test software to see if you like it. Most software companies are happy to at least let you have a free trial because they know in the end that you will most likely buy the software.  It is a big investment and they know it.

Healthcare software is growing at an alarmingly fast rate.  More and more companies are beginning to see the need to upgrade their software because of ICD-10.  The codes are longer and people often want to know what is happening behind the scenes of the software packages.  It is important to note that making money today is not easy.  Every code needs to be entered accurately with an explanation.  The more documentation that you give to the insurance companies, the better.  They want to know that they can trust your billing. Eventually, your relationship with insurance companies will get better.  Once they know that you are not submitting claims with errors, you will find your reimbursements easier to receive.  Instead of waiting 3 months for a check in the mail, you may only have to wait 1 to 2 weeks.

Insurance companies are not our enemies.  In fact, they took drastic losses in 2014 because of many blood labs taking advantage of the system.  Many blood labs were doing multiple blood tests on clients.  It was not even medically necessary to do so. A lot of these blood labs wanted to collect insurance money.  Many blood labs were shut down and received hefty fines.  Today, things are done differently to ensure insurance companies that they are not getting ripped off.

Honesty is always the best policy.  The #1 reason why most claims are denied is because the medical biller is not inputting the correct data.  It is an industry that is slowly evolving and many people are beginning to see the need for changing the industry as a whole.