Medical billing and coding is a vital healthcare process that allows hospitals and other healthcare providers to receive compensation for services rendered. Healthcare providers receive the majority of their compensation from insurance companies, but a complete medical billing solution must also be able to manage payments from other types of organizations and even individuals. In modern healthcare, medical billing software is used to achieve this complete solution in a user-friendly and efficient manner.
How Software Streamlines the Medical Billing Process
The interaction between an insurance company and a healthcare provider is highly structured, and almost all insurance companies in North America use the same protocol. This consistency lends itself to automation, and the main way that software streamlines the process is through automation and batch processing. In fact, most transactions between insurance companies and healthcare providers are completed with no human interaction at all. For the healthcare provider, software has reduced the challenge of medical billing to basic data entry, which is typically accomplished organically as the patient is admitted into and moves through the healthcare system.
Choosing Medical Billing Software
Despite standards among the insurance companies, there are differences among the software. Medical software applications are often built on different philosophies. In addition, they often include support for billing processes beyond just the insurance companies, such as direct billing, co-pay, co-insurance and so forth. The first step in choosing a platform is ensuring that it has an interface that will allow it to blend seamlessly with the standards and technology used by the institution. Other factors include user-friendliness, customization, future proofing and support.
EMR vs. EHR
The two main classifications of medical billing software are EMR (electronic medical records) and EHR (electronic health records). In most ways, EMR and EHR are interchangeable, but there are important differences. EHR connects to a greater network of electronic health systems, which allows it to pull information that is not available locally. EMR, on the other hand, is smaller scale and only has access to a digital version of the chart that has been created in the institution. Most hospitals require EHR software, but an EMR platform is likely more practical for a doctor’s office or small clinic.
Medical billing software has revolutionized the way the healthcare industry operates. Healthcare institutions are able to receive most payments promptly, which allows them to run more efficiently. The influence of billing software, however, extends beyond just payment. It has provided the backbone via which hospitals throughout the world are able to share information to better care for their patients.