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Important Features To Have in Medical Billing Solutions

Medical billing Solutions

As complex as the American healthcare industry can get, medical billing solutions help streamline the activities in multiple administrative workflows at hospitals and clinics. Payment or reimbursement for providers needs insurance verification, healthcare services, followed by medical coding, and claims submissions. These are fragmented processes and are often prone to errors and inefficiencies.

Moreover, the activities in medical billing need dedicated staff to manage and the bigger a healthcare organization, more the patients it is bound to see, and subsequently, the greater the workload the staff are bound to face. In light of this, a medical billing solution acts as a means of consolidating the workflows surrounding the administrative and financial activities at a healthcare organization and brings about greater efficiency.

Let’s look at some of the most important features of electronic medical billing platforms –

Automated Medical Coding

The process of medical coding involves translating medical reports into appropriate industry-standard shortcodes. The purpose of carrying out medical coding is to convert a highly detailed medical report with lots of jargon into a useful summary of the treatments, test results, medication, and so on. It is used to send the claims to insurance payers.

But the process of medical coding is cumbersome and is prone to errors in larger hospitals. Mistakes in coding routinely cost the healthcare industry billions of dollars each year and affect the revenues of providers. However, automated coding within a medical billing system takes out the need for manual, repetitive tasks. In other words, it enables the staff to complete coding with a few clicks, without mistakes. Additionally, the solution also checks the coding for any errors, automatically. As it forms an integral process of billing in healthcare, automating most of the coding activity goes a long way in streamlining billing workflows for greater productivity and efficiency.

Claims Management

Filling out and sending claims is perhaps the cornerstone of a healthcare provider’s revenue stream. The claims reflect all the services provided by the doctor to the patients, for which he or she needs to get paid. Filling out claims is also a manual, tedious process and sometimes prone to errors, just like medical coding mentioned above. The claims are for services that include diagnosis, treatments, medications, and so on.

Moreover, the entire lifecycle of claims management includes billing, coding, filing, updating, and processing at the payer’s end. Needless to say, it can take up a significant amount of time and resources. Challenging denied or rejected claims makes things more difficult for both providers and payers. That is why it is highly prudent to implement billing systems in healthcare that have a claims management feature.
A claims management module automates most of the manual activities involved in the entire claims management workflow. This automation, by nature, eliminates the possibilities of errors and speeds up the processes. As a result, the healthcare organization needs to spend less time and fewer resources, and still manage to maintain a high degree of productivity in managing the claims.

Billing systems in healthcare are becoming the new norm as the industry embraces digitization. So, whether you run a hospital or a small clinic with few providers, the above-mentioned features within a medical billing solution are must-haves.