Electronic Medical Billing

Jeremy Sacco
BuyerZone.com Editorial Staff

Software to help medical practices manage their finances has been around for decades. However, today's electronic medical billing programs are more accurately called medical practice management software (MPM software), and bears only the most basic resemblance to its older counterparts.

Electronic medical billing software covers a wide range of functions:

• tracking patient demographics, visits, and diagnoses
• collecting, transmitting, and tracking billing information and insurance payments
• managing appointment scheduling
• generating a variety of reports

In addition, most medical billing programs will also bring you into compliance with the sections of the Health Insurance Portability and Accountability Act (HIPAA) that specify increased security standards, ANSI billing formats, and more. Note that we say "most" - some software may provide only partial HIPAA compliance. You should quiz vendors carefully about the HIPAA compliance of any software you are evaluating, particularly around electronic billing and security measures.

Wide-ranging benefits

Besides HIPAA compliance, there are several other important benefits to be gained from the right electronic medical billing software:

• Improved staff productivity - easy-to-use software improves efficiency
• Increased patient and customer satisfaction - more flexibility in scheduling and better access to personal information
• Faster payment from insurers - paper claims usually take 30 - 60 days, electronic claims are usually paid in 10 - 14 days instead
• Fewer errors in billing and insurance - correct and resubmit in hours, instead of weeks

How to investigate an electronic medical billing program

First, make sure you include the right people in the purchasing process. Physicians, office managers, receptionists, and billing managers will all have different viewpoints and important concerns: taking any major steps towards a purchasing decision without involving every role is likely to lead to problems down the line.

Next, see what practices like yours are choosing. Find offices similar to yours in size and specialty and visit their offices to see the software in action. While this may seem like an obvious tactic, it is highly effective.

Try to find software that matches your specialty and office size by asking these types of questions, as they apply to you:

• Does the system handle scheduling quirks unique to your practice?
• Does the system recognize all the procedure and diagnosis codes your practice uses?
• Can the system handle multiple offices and multiple doctors?
• Can information be accessed from multiple locations?
• Does it include inventory tracking or the ability to manage several separate accounts?

Of course, the best way to compare ease-of-use is to try it yourself. Many vendors allow you to log in to a sample account or will send you a sample CD to let you try out the software: take advantage of these opportunities. Have all the interested parties from your practice go through their most common activities to get a sense of how easy the software is to use - watching "canned" demos does not give you the same in-depth look at the products.

How to choose the right supplier

A successful medical billing software decision includes not only choosing the right software - but choosing the right supplier. Qualified suppliers will listen to your needs during the sales process, help your office run smoothly during and after the transition, and provide the training and support you require.