The efficient billing process is the engine and timely payments are the fuel that keep a medical practice running smoothly. Both are possible with the right medical billing software.

Automating the billing process while maintaining organized data files can help a practice increase revenue as well as patient satisfaction. It also keeps you well prepared in the event of any legal hassles.

But implementing an inefficient billing solution can cost you dearly. It can affect patient flow, accounts receivables, payment postings and ultimately, the sustenance of your practice.

So, while you are in the market for the best medical billing software and are hearing pitches from multiple companies, here are some aspects to consider in order to make the right call.

1. Cost

Expense is always an important factor to consider. In case of a medical billing software, these costs can vary.

Some may be free to install but charge huge subscription fees to use their premium tools, some may cost less initially but display many hidden fees later while others can cost more upfront but include unlimited use of different functions.

Choose according to the needs and size of your practice. It is advisable to consider long term expenses and the scalability of the software as your practice expands. You don’t want to end up with a big surprise bill at the end of the year.

2. Features

Owing to leaps and bounds of technological advancements, medical billing softwares offer a host of features these days. Providers can choose the one that suits their current requirements as well as their vision for future.

  • Certain features like HIPAA compliance are a must. You must go for a software that provides encryption to maintain the privacy and confidentiality of patient and healthcare data.
  • A secure backup is another feature you will need to maintain documentation and data and get easy access when required.
  • Consider how many staff members and doctors will be accessing the software and whether it can handle the surge in billing periods efficiently.
  • Software that allows patient pre-registration is a boon, as new patients can complete the intake forms and you can verify the insurance before they arrive for their appointment.
  • Features that automate insurance payors listing, claims tracking, electronic remittance alerts, etc. are the core reasons for installing a billing software in the first place.
  • Accounting is a crucial feature. Software automates many steps of the revenue cycle management from staff payroll, timesheets to allowing online patient payments and keeping a record of accounts receivables.
  • If you have outsourced certain tasks like insurance verification to a medical or dental billing company, the software should assist their secure access of patient data, thus saving you the hassle of being a middleman.
  • It will also be time saving for you to choose a software that requires less intensive training to use various functions or tools.

3. Access

As mentioned earlier, you want the software to enhance your bottom line as you grow. Getting digitalized is a part of the process and you will be accessing patient records across various platforms and devices.

You need billing software that is supported by different operating systems on smartphones, tablets, and PCs. When associating with a company that provides medical or dental billing services, this access will prove instrumental.

If the software offers webinars and online training sessions for your staff, that would be a good influencer for your preference.

4. Provider’s Track Record

In October 2015, the Government mandated the transition to ICD-10 (International Classification of Disease Code). If the staff of the software provider is not proficient in the same, the maintenance can go for a toss. Ensure to prefer the one that is compliant and efficient in the guidelines.

Find out how long the provider has been in business and the reviews of their medical billing software from your peers. Look for testimonials that provide substantial information and not those intended for marketing purposes.

Future of Healthcare – Medical Coding with AI

Artificial Intelligence, Machine Learning, and Computer-assisted coding systems are the present and future of most industries that aim to take on challenges and achieve a more secure and efficient functioning. Coding for medical with Ai diagnosis and treatment is no exception.

In fact, the latest International Classification of Diseases ICD-10 international version has over 14,000 codes for diagnosis which gets further complex in the US with an addition of 70,000+ codes for diagnosis and another 70,000+ codes for treatment. It is beyond human abilities to memorize these codes and ensure accurate medical and dental billing services always.

The number of codes used in the enhanced version of ICD-10 in the US has already made medical coding and billing increasingly complex and vulnerable to errors. On top of this, healthcare

organizations are preparing for the implementation of the upcoming ICD-11 from January 2022. It is likely that the number of medical codes will go further up!

How Artificial Intelligence Can Help

Over the course of the last 2 decades, healthcare businesses have introduced and adapted to computer-assisted coding systems.

In fact, many such systems have already begun incorporating state-of-the-art Machine Learning methods and Artificial Intelligence aspects to enable the system to analyze the clinical documents and determine relevant codes. AI will take it leaps further in terms of increasing accuracy, efficiency and revenue by overcoming human challenges with cognizance.

The CMS (Centers for Medicare & Medicaid Services) reported in FY 2017 that errors caused improper payments of $36.21 billion. Healthcare costing frauds due to false claims and charges were estimated up to $230 billion.

The primary cause remains improper documentation and/or lack of it. From detection and diagnosis to treatment, it is in dire need of simplification of the process of medical coding.

Sophisticated AI and cloud analytics like IBM Watson are transforming healthcare and clinical needs by revolutionizing medical coding and billing.

Here’s How…

  • Al not only simplifies and increases accuracy but also empowers the organization by identifying developments and patterns, identifying and evaluating errors, reducing the chances of duplication of codes and billing frauds.
  • It identifies the use of unique or rare codes.
  • AI analyzes the clinical notes, reports, and documents for the most relevant codes. For example, if a procedure is an appendectomy in a healthy patient, the coding is simple. But the same in a 70-year-old man with kidney disease and diabetes can take much longer manually. This is when AI becomes instrumental.
  • It recommends codes based on the diagnosis and treatments performed.
  • It also identifies the right codes for unstructured data in free form text also known as verbatims for example, ‘patient cannot taste anything. Finding the correct med DRA code in such situations is one of the most time-consuming tasks without AI.
  • Provides data on patient activity, code usage, medical services delivered, etc. for further optimization of the system.
  • Track codes from patient history to avoid manual entry on every visit.

In addition to the above advantages, the good news for medical coding specialists is that AI is not here for their jobs. The field is far too complex and will always require manual coders due to specific circumstances and many variables.

AI is here to enhance the system, reduce errors and assist in faster revenue cycle management thereby, increasing revenue – the sustenance for every industry. Yes, the future is to move beyond the constraints of manually searching and scanning the codes to find the appropriate one. AI is designed to support the work of medical coders.

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