Choosing Medical Billing Software: A Buyer's Guide

Your practice has grown, and you need a software solution that coordinates your billing with your patient management. So how do you choose the right medical billing software for your practice?

RCM and How It Works with EHR

Revenue Cycle Management is the complete process of tracking the financial aspect of patient care, from setting an appointment to the final payment of a medical bill. An RCM system can be standalone medical billing software or an integral part of an EHR system.

Electronic Health Record systems organize and help providers track and store every aspect of patient care data. They allow the collaboration of multiple providers and the collection and storage of lab results and diagnostics. An EHR system also maintains complete data relating to patient visits, prescriptions, and insurance information.

The two systems work in tandem to streamline your administrative and billing procedures. RCM is sometimes included as part of an EHR; in other situations, RCM is integrated or coordinated with an existing EHR.

Medical professional using a small computer at her desk

Basic Considerations for EHR and Medical Billing Software

There are excellent software solutions available for any practice, large or small. The key is selecting a system that is suited for your specific practice.

Operating System or Platform

First, ensure that your EHR and billing systems will run on the platform of your choice. If you use Macintosh computers, you need a program that runs on IOS. Similarly, if you're running Windows or Linux, select compatible software.

Most of the top medical billing software systems on the market will run on any of these operating systems, but not all of them. So this is a simple item to check off your list, but don't forget to confirm compatibility.

Company Size and Scalability

Some medical billing softwares are designed for particular practice sizes. If you are a large city hospital, you won't necessarily have the same needs or concerns as a small family practice. If you choose a system designed for a specific type of practice, be sure the features and price are a good fit for you.

Certain systems are specifically created to be flexible and expand as necessary to handle any size practice. Unless you are certain that your practice will remain roughly its current size, choosing a system that can adapt to any changing demands you foresee is a good idea.

Cloud Based or Offline

Virtually all of the top EHR and medical billing software is available in either cloud-based or locally hosted versions.

Advantages of Cloud-Based Hosting

Efficiency and lower cost
Data backup and security
Automatic software updates
Scalability and storage capacity

For most practices, remote hosting is more cost-effective and efficient than local hosting. The expense of purchasing and maintaining your own server is significant. In a large hospital system, on-site servers may be practical, but for a smaller practice, they rarely are.

Your data is backed up constantly when hosted on a remote server. Backups are generally stored on multiple servers in various physical locations. This protects your data, such as patient records and management information, from server problems or a disaster such as flooding or fire at your physical location.

Hosting servers for medical billing systems are secure, HIPAA-compliant, and guarded by the latest authentication protocols and security software.

When you host on the cloud, updates to the software can be performed automatically, which is one less task for you or your staff to handle during a work day. Locally hosted updates are not necessarily complex or time-consuming, but they can be a nuisance in a busy practice.

Finally, the cloud has an infinite capacity to scale to your processing and storage requirements.

Advantages of Local Hosting

The only real advantage of keeping a dedicated server at your physical location is having direct physical control over your server. You can access your equipment, add to the infrastructure as you see fit, and upgrade when you deem necessary. Depending on your situation, you may feel more comfortable hosting your EHR and medical billing software in-house.

Price of Software

Cost is an obvious consideration for all practices. Software pricing depends on many factors, such as which options and services you choose, how much processing power and storage you require, and the volume of your billing. Each software company has its own pricing structure.

Carefully compare the costs of all systems that you are considering. Calculate not only upfront expenses but the cost of the system and services over time as your practice grows.

Medical office assistant working on medical billing

Reasons To Use EHR and RCM Medical Billing Software

As a health care provider, your time is better spent working with patients than filling out forms and managing patient records and billing.

A good software system goes far beyond saving time, however. It can allow you to improve patient care in significant ways, increase the efficiency and accuracy of your billing, and reduce the incidence of rejected claims.

Improve Patient Care

Patients have busy lives, and you have a busy practice. Using an EHR system is beneficial for practitioners and patients alike. Information is readily available, data coordination improves the process of diagnosis and patient outcomes, and communication is greatly enhanced.

Accessibility

Because the patient's health care history is accessible to you whenever and wherever you need it, you can get any information you require in real-time. EHRs also include interaction alerts and clinical reminders, reducing the incidence of adverse reactions or missed follow-ups.

EHR systems coordinate data from all providers involved in the patient's care in one organized, central location, allowing practitioners to see the big picture of the patient's health and medical history. EHRs allow new patients to provide you with an accurate and complete record from other previous or current providers.

Convenience

Everyone appreciates when things are less complicated. An EHR system allows you to prescribe online, so prescriptions are ready when your patient goes to pick them up. With a cloud-based system, you can also access your EHR from another office or home when necessary, saving you from having to travel to your office or delay care during an emergency or off-hours.

Communication

Another significant advantage of many EHR systems is improved patient communication. A secure portal lets you communicate directly with your patients, sharing information such as lab results and follow-up notes from a visit.

For example, when you update a patient record, the patient can be notified automatically of the new information in their chart. Your office can also automate reminders through the portal, ensuring fewer missed appointments.

The portal is helpful for patients, too. They can ask you a question about a prescription or a health concern, make an appointment, or request a refill through the system at any hour.

All patient communication is retained, making it easy to review.

Improve Practice Efficiency

An EHR reduces administrative expenses by streamlining data entry and update processes. Because patient communication is largely shifted to the portal, administrators spend less time fielding questions, returning calls, and scheduling appointments.

However, one of the most beneficial aspects of this software is how it can improve your billing. Not all systems come with a fully integrated billing suite. Some have built-in features to handle coding and claim submission, while others are compatible with external billing software and services.

Whether your EHR includes RCM medical billing software or outsourcing billing services to a company that works with your EHR system, your practice will benefit. Regardless of how you incorporate billing software, you should see improvements in workflow and efficiency and increased revenue.

Better Coding

EHR systems are all digital, so there are no handwritten notes to be deciphered. Transcription, another common source of error, is greatly decreased as well. Your records are clear, legible, and correct, improving your data's precision.

EHR systems can suggest billing codes based on the record's content and allow medical coders to view digital records directly. Reducing legibility issues and providing remote access to original data improves productivity, increases the accuracy of your claims, and speeds up the collection of revenue from insurance providers.

Eligibility and Approval

EHR systems can also prevent some claim denials before they even begin. A patient's insurance eligibility can be automatically checked before a procedure. In the case that Advanced Beneficiary Notice is required, the system can alert the provider to ensure that this notice is obtained before providing the covered care.

Options To Compare in Medical Billing Software

Once you've decided to integrate billing with your EHR, you'll need to select software and/or services appropriate for your practice. You know the basic things to look for in an EHR system, but what about the medical billing features and services specifically?

How Much Should You Outsource?

There are two basic options for handling your medical billing:

1. Employ CRM Software and In-House Staff

With integrated medical billing software, you can continue to have your office administrative team compile and submit your claims. If you have a good EHR system and your office has a dedicated and experienced staff, your claims should generally be processed and paid without incident.

This arrangement works well for practices in which the medical codes remain consistent, without the need for the wider knowledge of a coding professional.

2. Use Software and External Service

For the most accurate claims and the fewest payment denials, especially if your practice is large or varied, you can use integrated medical billing software to collect data on billable procedures and then outsource the medical coding and claim submission to a billing service. In many cases, this is also the most cost-effective route.

Medical billing experts know the codes and the claims process intimately. They handle your claims efficiently and make very few mistakes. Coding professionals are up to date on the latest rules and procedures, and they are not disadvantaged by trying to complete your billing submissions while answering the phone, scheduling appointments, and juggling patients in your waiting room.

What Type of Practice Do You Have?

Many EHR and billing systems are built with a particular type of practice in mind. For example, some specialize in psychotherapy practices, and others are designed for pediatricians. Most have several cost options based on the size of a practice, and some have minimum or maximum requirements for how many providers are in a given practice.

Before you compare various systems, consider whether you prefer a specialized platform for orthopedics or radiology or whether you want a less specific framework. Cover the number of providers you have now, but don't forget to account for the anticipated growth of your practice.

Suggestions for Choosing Your Billing Software

Medical billing software can make a significant difference in how you handle your billing procedures and how well your claims are prepared. Proper organization and coding determine how quickly claims are processed and paid and what percentage of them are denied.

A growing practice will benefit from the capabilities of these programs, and you may consider integrating RCM software into your practice. You probably have a pretty clear concept of the features you're looking for in a billing system.

Explore the advantages and disadvantages of each program you consider, and ensure that the user experience is something you are comfortable bringing into your office. Some programs are more intuitive and easier to learn, while another may have a steep learning curve but also include a feature your practice can't live without.

Check the reviews by people already using the program. Investigate the customer service and tech support offered by each company. You will be using this software every day and likely for years to come, so make a list of specific questions and don't hesitate to ask them.

Medical Billing Hub can help you locate the best medical billing software systems and services available based on your criteria. We have a searchable database with a plethora of information on RCM systems for every type of medical practice.

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Sources:

Choosing Medical Billing Software: A Buyer's Guide

RCM and How It Works with EHR