What To Look For in Medical Billing and Coding Software

Doctor at a desk with calculator and computer

While running a medical practice without medical billing and coding software is possible, it is much less efficient. Without the software, billing is a labor-intensive process. Confidentiality breaches and other human errors are more likely to occur.

Nevertheless, not all medical coding and billing software types are the same, and some are better than others. Here are some of the most important features you should look for when purchasing the software.

Medical Billing and Coding Software Must Be HIPAA Compliant

One of the most important provisions of the Health Insurance Portability and Accountability Act is that health care providers and clinics must maintain the confidentiality of patients' protected health information. Fines for violating HIPAA can run to thousands or even millions of dollars.

In addition to PHI, the law requires that you keep both financial and personal information from patients confidential, and a medical billing system has to access both. Therefore, medical billing and coding software must include security features such as the following:

  • Multi-factor authentication
  • Role-based access control
  • Data encryption

Medical Coding and Billing Software Should Include Electronic Claims Management

Most patients do not pay for all their medical expenses out of pocket. Usually, an insurance company foots at least some of the bill. Your staff's responsibility is to prepare claims and submit them to the insurance companies.

Submitting, tracking, reconciling claims, and data entry of patient information are all necessary parts of claims management. Nevertheless, they can also be tedious and time-consuming. Fortunately, many of these tasks can be automated with the proper software for billing and coding. This means your administrative staff can focus on the tasks that need human intelligence.

Medical Billing and Coding Software Should Integrate With Electronic Patient Records

It is increasingly rare for hospitals and clinics to keep medical records on paper. Most have switched to either electronic medical records or electronic health records. EMR is an electronic patient record unique to a single facility, while an EHR is accessible across multiple facilities. EHRs are becoming more widespread as the government has incentivized their use.

Accurate coding and billing depend on access to patients' records. Therefore, if you already have an EMR or EHR, you should choose compatible software.

Two members of medical staff talking

Medical Coding and Billing Software Should Be Streamlined

The goal of adding new software to your practice is to make administration easier and less complicated. Ideally, all your practice management software would be streamlined so that you could run all administrative tasks from the same portal. In other words, your billing software would also be able to generate financial reports, schedule appointments, and track any changes related to patient information.

One way to handle the financial aspects of running your business is by purchasing medical billing and coding software. However, there is another alternative to handling billing by hand. You can also outsource coding and billing responsibilities to an outside company. Find out how we can help you find a medical billing company that meets your needs.


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