Features To Look For In a Medical Billing Software Company

Posted by on March 23, 2011 in Medical Information [ 1 Comment ]

Since HIPAA in 1996, medical billing software has blossomed in to a huge industry. For medical practices that are only receiving 70-80% of the reimbursements available to them, medical billing solutions make sense. Briefly, medical billing software saves your insurance company or medical practice time and money by transferring HIPAA compliant patient coded claims to insurance companies. On average, 25% to 30% of medical insurance claims are rejected. To lower you rate of rejection to lower than 1%, medical billing software solutions are often needed.

Medical billing submits electronic claims, pre-scanned by clearinghouses to the patient’s insurance provider.  The insurance company processes the claims and then sends back the submitted and rejected claims. Since most claims that are rejected are done so because they aren’t HIPAA compliant, it is important to make sure you have medical billing software that is both functional and practical.

Hosted Vs. In-House Prices

If you are looking primarily at in-house server based medical billing software, you may need to look at the total cost of ownership. Total costs of server based medical billing software runs in the $10,000 to $20,000 range. Hosted solutions however are much simpler. The software is located on a web portal, and you are able to access your customer data by signing in to your secure hosted database. Many of them have a monthly service charge of around $100-$200 per month, or take variable costs based on performance (ex: 6% of total collections).

Vendor’s Clearinghouse

Make sure your vendor’s clearinghouse understands electronic claims submission and contracts with others in your niche.

Experience

Make sure that the medical billing software caters to your niche. If you are a surgeon, your claims will be dealing with surgical procedures. Make sure the billing software is familiar and caters to your specialty, especially if you deal with primarily patients with Medicare or Medicaid.

Software Features
Medical practices typically will look for simple but yet robust software features that don’t burden them with extensive features but also provide data security. A billing software that effectively smoothes the transition from biller to provider will save your practice time and money on reimbursements.

Medical billing software can save your practice valuable time and money. It is a practical solution that often has a positive ROI. If you are looking to medical billing services, look to gather price quotes from medical billing software vendors.

Image Credit: HR Morning


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