Billing
Billing and claims are vital elements to keep your medical practice generating revenue. They are tools that facilitate the automated creation of the SuperBill, claims processing and collection support.
There are two different types of billing: Onsite and Offsite
On-site:
When seeking an Electronic Health Record, several EHR Companies will offer you an ‘integrated suite.’ This integrated suite includes the EHR System as well as the Practice Management system.
Each medical practice has a designated person or department to ensure that the practice is receiving the appropriate revenue. Most of the time, the billing person will have extensive knowledge of coding. This is an extremely complex process.
A major benefit of having a Practice Management (PM) system is the ability to have all of the ICD-9 and diagnosis codes pre-loaded within your integrated suite. Although the PM will assist you in billing, it will NOT replace your billing person or department.
Speak to your EHR Vendor to see if they have any of the available features for billing and claims:
- Creation of the SuperBill within the EHR that is automatically sent to the billing software via Electronic Data Interchange (EDI).
- Creation of the SuperBill within the EHR that is manually entered into the billing software.
- Ability to validate and update the patient’s demographics, insurance and employer status.
- Ability to take a co-payment and post it to the patient’s account.
- Ability to create a payment receipt for the patient.
- Ability to identify the current status of the patient’s account and handle all collection issues.
- Ability to identify the status of all SuperBills.
- Ability to have the Service or Diagnosis SuperBill format exactly match the format currently used by the practice.
- Ability to interface to the Clearinghouse used for billing.
- Ability to interface to insurance companies for submission of a bill.
- Ability to match the encounter documentation to an E&M consultant tool to ensure the code chosen matches the requirements for E&M coding levels.
- Ability for a coding tool to suggest ways to correctly up-code encounter documentation to receive a higher level of reimbursement.
- Ability to have the SuperBill codes automatically suggested by the encounter documentation.
