I recently read an article over my morning coffee that said doctors leave approximately $125 billion on the table each year due to poor billing practices. Believe it or not, that's only a small piece of the pie. Groups like the Medical Billing Advocates of America estimate 80-90 percent of medical bills contain errors that result in doctors not being paid correctly. The Center for Medicare and Medicaid Services (CMS) released data in 2018 stating billing errors resulted in a $31.5 billion dollar loss to Medicare, accounting separately for cases of fraud.
When a billing system is outdated, the organization will suffer from billing mistakes like mismatched procedures, lengthy claims processes, failure to collect co-pays, and forgetting to stay current on coding. At the end of the day, efficiency of your medical billing automation operations majorly affects the success of your business.
So, do you think your medical claims billing software has what it takes to keep you running at peak efficiency? Perhaps you do. But as the saying goes, knowledge is power, and if you don't know exactly how billing software should improve your workflow processes and bottom line, you’ll never realize your full potential to improve and earn.
What Should Your Medical Billing Software Programs Improve?
There are certain features of medical claims billing software you should consider whether you’re opening a new medical office and need a software that can be used efficiently out of the box, or you’re an established medical practice looking to scale your current operations. Below is a list of features common in medical billing software programs that will help your practice through its growth phase and into maturation:
- Workflow Automation. Billing automation is essential in a high-volume, complex medical billing workflow. From the moment a patient steps into the front office to actually receiving payment. Automated billing identifies billing errors before a claim is even submitted, leading to cleaner claims and faster turnaround. Not only that, payments can be posted automatically to expedite the billing cycle.
- Turnaround Time. The speed and efficiency at which you turn claims into cash is a big determinate of whether or not a practice will thrive. The more optimized your submissions, the better your chances at a successful first pass rate will be. On the other hand, patient self-pay (including co-pays, deductibles, etc.) provide a large portion of patient services revenue. Your ability to collect on those balances in a timely manner drastically influences your bottom line.
- Data Analysis Tools. Even if you're profitable, there are probably cashflow kinks and untouched revenue streams that you’re unintentionally missing. With the right analytics in place, you can identify your practice’s strengths and weaknesses, while identifying areas for improvement and new revenue streams.
- Built-In Security. Medical billing software programs should provide patient information security that is HIPAA compliant. You can access clinical data, financial transactions and insurance information instantly and securely while staying up-to-date with the latest federal regulations.
- Cost/Time Reduction. Your medical billing software should do all the heavy lifting for you. Your staff shouldn't spend long hours on data entry or claim submissions. It should also prevent the need to hire extra hands in the future.
What is Automated Medical Billing Software?
Automated medical billing is a process when charge entry, claim scrubbing, and remittance are all performed automatically through timers and natural language processing every day, week or month depending on how often your business submits claims. As a result, the medical billing system improves cash flow, simplifies processes and streamlines medical billing workflow. Essentially, your organization is paid faster and more often.
Another important but often overlooked component of medical billing software programs is your health insurance billing software. Every healthcare insurance company has its own set of complicated guidelines. Health insurance billing software improves your quality of care by giving more time back to your staff to help patients. Health insurance billing software lets you file claims electronically, check the status of a claim, fix errors in your insurance claims, and receive payment in fewer days than what is allowed with a manual process. Best of all, healthcare insurance billing software integrated with your overall medical billing software allows you to automate the process, helping move claims seamlessly through the revenue cycle from submission to reimbursement.
Now that you really know what automated medical billing looks like, are you experiencing that "Where have you been all my life" moment? Yeah, that's the difference between life with versus without the best medical claims billing software.