Complete Guide to Medical Billing and Coding Software One of the most time consuming steps for new practices or practices looking to update their internal systems is when it comes time to compare medical billing software.
Billing
medical claims is an intricate and complex process, even for those who've received schooling in medical billing and coding. The options are limitless, and pouring through the countless online articles on the best software for medical billing is arduous and time consuming. That's why In Touch EMR has put together the Complete Guide to Medical Billing and Coding Software, outlining the most critical areas to look for in medical billing and coding software.
Integration & Proper Cycle Management In the world of 21st century health care, having all of your key components working together and transmitting information is vital to a practice's success. Integration is no longer a matter of convenience – it is a matter of survival.
Your medical billing is dependent upon a wide variety of factors (payer type, secondary and even tertiary insurance, authorizations, eligibility, and more), all of which should be automatically assigned correctly to a claim, ready to be scrubbed and submitted to a clearinghouse. Medical billing and coding software should be directly connected to eligibility information, the practice's scheduling component, and an ERA interface. In Touch EMR and In Touch Biller Pro handle all aspects of your patient and claim cycles seamlessly.
The best possible workflow for a practice should be a simple cycle that checks for needed information, then populates it where applicable at every step of a patient encounter. Below is a comprehensive breakdown of the most efficient workflow: •
The patient's eligibility is checked in In Touch Biller Pro.
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Their chart is created with insurance verified information using In Touch Biller Pro's Create Chart function.
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Their schedule is set, assigned to a provider and has a custom appointment type for easy tracking
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The appointment then appears automatically in the ONC Certified In Touch EMR for clinicians to view.
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The provider completes the visit and documentation using custom templates in In Touch EMR
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Completed note populates as a claim back in In Touch Biller Pro for billing staff to take over
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Claim populates the information from the eligibility check, from documentation in In Touch EMR, and from a built in custom fee schedules
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Biller and coder then have an easier and faster experience in scrubbing the claim using In Touch Biller Pro's integrated scrubbing tools
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Claim is submitted via our built-in clearinghouse component with Health fusion
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Any follow ups are tracked in real-time within In Touch Biller Pro
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The claim is accepted and returned directly through In Touch Biller Pro in an on-board ERA dashboard for posting.
Click here to watch a prerecorded demo of In Touch Biller Pro. Using this method, practices can streamline the entire work flow of the patient encounter by having eligibility, chart creation, scheduling, documentation, fee schedules, pre-scrubbing, clearinghouse submissions, and ERA posting integrated into one systematic methodology.
Online Instant Eligibility & Chart Creation All practice's should have software capable of running instant eligibility checks to see what a patient's insurance company will cover, how many visits a patient is entitled to, copay amounts, as well as a plethora of other useful information. What is often missed is that this functionality should be directly connected to your medical coding and billing interface (in In Touch Biller Pro, it is connection to eligibility, scheduling, and chart creation as well as billing and coding).
When these two components are locked into the same system as billing and coding, a distinct advantage occurs.
Once eligibility has been run, front desk personnel have the capability to create a new or updated patient chart in In Touch Biller Pro based upon the information and demographics found in the eligibility results. This not only saves the front desk time on entering demographics manually, but when integrated with billing and coding components also ensures that demographics found on the electronic claim form never vary from what is on file with the payer. This means fewer denials due to typographical errors or due to patients updating information with either the clinic or the insurance company, but not both.
Click here to schedule a demo of In Touch EMR and In Touch Biller Pro.
Built-In Clearinghouse Components & Autoposted ERAs When a practice owner or clinical manager is about to compare medical billing software, a key factor to consider is what clearinghouse the software connects to and the level of sophistication that connection entails.
With In Touch EMR and In Touch Biller Pro, your medical billing and coding software
incorporates components from a connected clearinghouse (Healthfusion) to better meet the needs of dynamic medical billing.
A biller should have the option to track claims beyond submission without having to call the clearinghouse or payer, and all relevant information should be displayed in an intuitive fashion within the same software. Billing staff have the ability to easily track claims by payer, patient, provider, date, and monetary amount (down to the penny), at every step of the claim life-cycle with In Touch Biller Pro.
Should a claim be rejected at the clearinghouse level, the information on the rejection is displayed within Biller Pro and adjustments can be easily made and tracked with time-stamped internal notes.
Once a claim is accepted and set for payment, Electronic Remittance Advice information should always be populated automatically through the same billing software as a claim was submitted through. This ensures outstanding claim data is easily compared and contrasted with paid claim data, and leads to a verifiable AR stream.
Billers should be capable of posting ERAs line by line or by batch, which
automatically assigns correct dollar values against correctly itemized payment lines. With In Touch Biller Pro's ERA Dashboard and AR Auto posting technology, all of this is taken care of for billers to simplify and automate the process. AR should be a metric, not a task.
Time-Stamped Internal Notations & Compliance/Pre-Scrubbing Tools. Even with the best possible systems and software in place, payers will find a way to delay or deny claims. When this happens, it is imperative that billers have a tracking utility built into the same system that a claim was processed through.
Using In Touch Biller Pro, each individual claim has an area for time-stamped notations, filed by username, to properly identify who is working a claim, the status of the claim, any follow ups or reference numbers for calls with payers, etc.
This makes tracking claim submission and resubmits easy and
increases reimbursement. The power of payers is in the complexity of the process – simplifying this gives the power back to the biller.
Take back the power that payers rely on – schedule a discovery call with In Touch EMR today.
Continuing with the theme of empowering billing and coding staff, a practice's software for billing medical claims should always have easy to use tools for pre-scrubbing claims prior to submission.
Using
algorithms to find coding discrepancies, missing modifiers, or missing diagnosis pointers will increase first pass rates (ratio of claims being accepted and paid on their first submission) dramatically. In Touch Biller Pro's Denial Defender tool, integrated with our clearinghouse, Healthfusion, lets billers pre-scrub claims
for all of the most common (and some uncommon) causes for rejection, all before the claim leaves the system.
Automated Modifier Rules and Fee Schedules An oft-forgotten automation trigger that, surprisingly, is yet to become standard in billing and coding software, Modifier Rules and Fee Schedules are time-consumers that should easily be set up during the implementation phase of a new software, then easily left to work in the background.
Clinicians aren't billers or coders, and when documentation is finished and populates to billing software as a claim, modifiers should automatically populate based upon pre-programmed rules that billing staff decides upon. In Touch Biller Pro takes the guess-work out of modifiers by allowing unlimited rules to be set before a claim is every populated.
This same methodology is applied to fee schedules in In Touch Biller Pro. Since various insurance companies pay out different amounts per code, patients assigned to a specific payer have the payerbased fee schedule automatically populate for all of their claims without the billing and coding specialist ever having to lift a finger.
When the time comes to compare medical billing software solutions, always remember the key components any medical billing and coding software should have. Billing medical claims is complex, and there are countless ways for insurance companies to deny clinics money they are rightfully owed. For more information on how In Touch EMR and In Touch Biller Pro can simplify your scheduling, documentation, and billing, Contact us today. Visit http://intouchbillerpro.com/compare-medical-billingand-coding-software/