Tips for Buying Healthcare Billing Software

Medical equipment on a keyboard

Technology is improving business service delivery and customer experiences, though some aspects of the healthcare industry have been slow to respond. Many practices and organizations have yet to digitize patient files. A number of businesses still manually code, bill, and file claims, potentially resulting in errors and delayed payments.

Outsourcing is an option many have considered, but healthcare billing software is an efficient, cost-effective alternative with the potential to improve many aspects of your practice. Here are tips to help you find the right product for your business.

Understand How Healthcare Billing Software Fits Your Billing System

Your business already has a billing system in place, and you need to understand the parameters of that system before you choose a software provider. To some extent, your current system drives your choice of software features and determines what the software can do for your business. There are three billing system types: closed, open, and isolated.

Closed Billing Systems

Closed billing systems are contained within your practice and not shared with other providers or services. They frequently utilize electronic medical records. On-site healthcare providers and billing staff are the only ones with access to the files.

Independent practices frequently have closed billing systems. A closed system can limit the functionality of healthcare billing software. However, practices with this type of billing system may still find basic software features helpful.

Open Billing Systems

Open systems allow the transfer of data outside of the practice. These systems frequently use electronic health records containing more extensive patient information. Multiple providers, insurance companies, approved third-party vendors, and patients themselves can access EHRs.

With an open billing system, practices can take advantage of the full suite of billing software features, including claims submission and tracking. Full-service billing software may significantly improve your practice’s overall efficiency.

Isolated Billing Systems

This system is for patient use only and has little functionality with healthcare billing software.

Look for Providers With Expertise in Your Field

Medical billing software has applications across the healthcare industry, including family practices, pediatrics, emergency services, orthopedics, and mental health. Though billing codes are standardized, finding a provider with field specialization experience is still critical for accurate billing.

Check the Company’s Reviews

Any software company will make its product sound like the best there is. Customer reviews provide insight into customer experience and product performance. Try to look for off-site reviews to ensure you get a complete and accurate picture.

Medical staff talking to client about medical bill

Determine Compliance With the Healthcare Insurance Portability and Accountability Act

HIPAA legally requires healthcare service providers to protect patient data. Healthcare billing software needs to comply with the law. Investigate each company to determine compliance. It’s essential to check that the provider adheres to HIPAA across all service levels, including patient communication features.

Look for Software That Adheres to Coding Standards

Codes are standardized to ensure consistency across healthcare and related industries. With the passage of HIPAA, the Department of Health and Human Services established code sets for different functions within the healthcare system. These code sets are as follows:

  • International Classification of Diseases (ICD-10)
  • Current Procedure Terminology (CPT)
  • Healthcare Common Procedure Coding System (HCPCS)
  • National Drug Codes (NDC)

Accurate coding is critical for billing purposes and needs to be updated within the software with every new revision.

Investigate the Healthcare Billing Software Security Features

Technology improves efficiency and accuracy, but it also increases security risks. Cybercrimes are on the rise worldwide. As the healthcare industry moves to digital services for financial, administrative, and patient records, it is increasingly becoming the target of cybercriminals.

According to the HIPAA Journal, HSS’s Office for Civil Rights reported that cybercriminals jeopardized the privacy and security of 44.7 million healthcare records in 712 data breaches in 2021. Security in billing software is critical.

Many software companies store data in the cloud. Furthermore, billing software allows businesses to electronically share data across providers, insurance companies, vendors, and patients. These features are crucial for effective practice management but leave data vulnerable. Software companies should be transparent about their security measures.

Determine Which Healthcare Billing Software Is Suitable for Your Business

Not all software systems are suitable for every practice or organization. Some providers focus their products on large organizations, while others target small and independent practices. Additionally, you should ensure that the product caters to your specialization. Many companies allow you to tailor your software for your field.

Look for Products With Key Features

You can find a wide range of features offered in billing software products. Make sure companies provide the features you need. At a minimum, a full-service product should have the following tools and features:

  • Patient pre-registration and insurance verification
  • Appointment management
  • Automated coding and claims scrubbing
  • Electronic claims processing and management
  • Payment processing and management
  • Business intelligence, reporting, and analytics

The best healthcare billing software providers provide additional features and varying plan levels that allow you to expand your service as your business grows.

Choose a Product That Integrates With Other Programs

Even if you opt for a comprehensive software system with practice management tools, you should check the product’s integration capabilities. You want a product that can incorporate the systems you already use rather than one that requires you to start from scratch.

Learn How Much Support You Can Expect From the Provider

When you have issues with the software or your account, you need to be able to get ahold of the provider. However, customer and tech support availability can vary across companies. Look for healthcare billing software companies that offer 24/7 support with multiple contact methods.

Verify That the Software Is Automatically Updated

You should not need to worry about whether your billing software is keeping up with changing regulations, requirements, and security concerns. Check whether updates are automatic and included in all plans.

Compare Healthcare Billing Software Services Before You Choose

Comparing products can be tedious and time-consuming, but Medical Billing Hub makes it easy. You provide information about your practice, and we deliver a list of healthcare billing software services tailored to suit your needs. Get your quotes today.


More Articles