Top 5 Strategies to Improve OTC Payment Performance With Electronic Medical Billing Software

For many practices, the proportion of over-the-counter (OTC) payments has recently grown from an average of 15% to as high as 75% of total payments. Systematic OTC collections, including measurable process that emphasizes upfront collections, often yield double-digit billing performance improvement. Most importantly, a disciplined and transparent collections process improves provider-patient communications, while early payment collections are also quicker and easier. Better communications and happier patients mean better health and more profitable practice.

OTC payments include copays, fees for non-covered elective services or retail products, and any outstanding balances. Successful collections of OTC payments require measurable collections process, specialized information technology infrastructure, adequate personnel training, and discipline.

OTC payment collection performance and costs greatly depend on elapsed time between service and payment. Collections performance dependence on collections timing stems from the dynamic nature of price-value relation: initially, perception of value received is high in the patient's mind. Similarly, correlation between value and price is also high. However, OTC payment collections grows more difficult in step with fading memory of service benefit.

Systematic measurement of OTC payment quality is critical for its performance improvement. Vericle's OTC payment quality metrics include the percent of accounts receivable beyond 120 days and the time spent on collecting on old account balances. While the national average of the first metric hovers around 18%, some practices have accumulated as much as 50% of their accounts receivable beyond 120 days. The second metric measures the front-office collections efficiency and it too varies widely between few hours per month to double digit hours per week spent by front office personnel chasing unpaid OTC invoices.

According to Vericle experience, the following systematic and measurable payment collections process leverages electronic medical billing software and establishes the discipline required for double-digit billing collections improvement:

1. Publish your payment collections policy and standard responses to typical patient's objections.

2. Clarify patient statement generated by your electronic medical billing software:
   1. Make outstanding balance easily identifiable.
   2. Add specific statement about the time period expected for balance payment (typically upon service or product delivery).
   3. Include phone number to call for patient questions.

3. Use electronic medical billing software to
   1. Test patient's eligibility and coverage. The results of such a test define patient's copay prior to her arrival to the clinic.
   2. Generate front office alerts about impending patient visit with unpaid OTC balance.

4. Train clinic physicians to direct patients to front-office staff to review financial statements.

5. Train your front office to collect OTC payments:
   1. Hold your front office staff accountable by setting up specific and personal collection goals.
   2. Use electronic medical billing software to track individual front staff collections performance.
   3. Establish personal awards for accomplishing collections goals and periodically review personal collections performance.
   4. Train your office staff to receive electronic medical billing software alerts.
   5. Develop a payment collections script and rehearse it with front office staff to improve front-office staff-patient communications.

Successful OTC payment collections help patient relationship management and improve practice profitability. They require measurable collections process, specialized information technology infrastructure, and adequate personnel training and discipline.

Yuval Lirov, PhD, author of "Mission Critical Systems Management" (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net Billing Technologies and Services. Vericle? unites hundreds of billing services across the nation. Its electronic medical billing software tracks payer performance from a single point of control and shares compliance rules globally. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com.

Blue Cross Blue Shield Michigan Heads April's Chiropractic Office Billing Software Precision Index

Chiropractic Office Billing Software Performance Index (BPI) in April 2007 outperformed its March value by 4.3%, bringing the index from 18.9 up to 14.6, ahead of the national average of 17.7%, while replacing four of BPI participants in March on the list of top ten performers. BPI guides chiropractic office managers and helps the development of both chiropractic billing software and billing performance standards. This article describes a rule-based chiropractic billing index, including its coverage definition, update cycle, volume weighting, and provided information.

BPI = 14.6 means that the average of ten top performing payers working with Billing Precision clients have 14.6% of Accounts Receivable beyond 120 days. BPI is a key billing performance characteristic, as it is a proxy of the claims that are never paid. Obviously, the lower is the index the better is billing performance. The table below also lists the top ten performing payers and their relative index as recorded in the Billing Precision's system.

• Billing Precision Index 14.6
• Blue Cross Blue Shield Michigan 3.2
• Blue Cross Blue Shield Colorado 6.8
• Humana 7.9
• Blue Cross Blue Shield Illinois 11.1 (down from 11.2 in March)
• United Health Care 13.9 (up from 23.2 in March)
• Cigna 15 (down from 12.9 in March)
• Medicare New Jersey 16.4 (up from 20.5 in March)
• Blue Cross Blue Shield Texas 20 (down from 15.2 in March)
• Great West 22
• Aetna 22.1 (down from 20.9 in March)

April BPI dropped four participants since March:

• Blue Cross Blue Shield Pennsylvania
• Blue Cross Blue Shield Alabama
• Medicare Pennsylvania
• Blue Cross Blue Shield New Jersey

Three payers improved their index since March:

• Blue Cross Blue Shield Illinois 11.1 (down from 11.2 in March)
• United Health Care 13.9 (up from 23.2 in March)
• Medicare New Jersey 16.4 (up from 20.5 in March)

Three participants lowered their indexes with respect to March BPI:

• Cigna 15 (down from 12.9 in March)
• Blue Cross Blue Shield Texas 20 (down from 15.2 in March)
• Aetna 22.1 (down from 20.9 in March)

April BPI added four new participants since March:

• Blue Cross Blue Shield Michigan 3.2
• Blue Cross Blue Shield Colorado 6.8
• Humana 7.9
• Great West 22

Coverage

BPI is rule-based, i.e., payer participation in the index is defined by dynamically rules at the time of computation and not by a static listing of specific payers. Therefore, any specific payer may start or discontinue participation in the index, dependent on satisfaction of rule's conditions.

Current selection of payers for participation in the BPI is based on fifty top-volume providers across all United States that have received Billing Precision services for more than six months and have more than two hundred claims in their current Accounts Receivable.

Update Cycle

BillingPrecision.com updates BPI on a monthly basis.

Volume Weighting

BPI is volume weighted, which is important to accommodate future growth of provided information, index combinations, and sensitivity across multiple indices.

Information Provided

BPI computes the percent of Accounts Receivable beyond 120 days. Note that national average across all medical specialties of percent of accounts receivable beyond 120 days is 17.7%.

Summary

Chiropractic Office Billing Software Performance Index helps the development of both chiropractic office billing software and billing performance standards. Chiropractic office managers can use the index to benchmark their billing performance and guide its improvement over time. Rule-based index definition allows for automated inclusion and exclusion of payers in the index based on payer attributes, such as numbers of processed claims, accounts receivable distribution, certain mix of CPT codes, or patient demographics.

Yuval Lirov, PhD, author of "Mission Critical Systems Management" (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net Billing Technologies and Services. Vericle? unites hundreds of billing services across the nation. Its electronic medical billing software tracks payer performance from a single point of control and shares compliance rules globally. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com.

Medical Billing Software Concept

What is medical billing software More than ten years ago medical billing records were committed on paper. The advent of computers and the introduction of reliable medical billing software have largely phased out the paper system of keeping medical billing records.

Today's healthcare providers have realized medical billing software ensures their reimbursement claims are facilitated in a secure and efficient manner. It also tracks each patient's medical and insurance billing and accounting, all to the benefit of patients.

Here are three benefits inherent in the use of medical billing software as compared to the paper based systems.

1. Medical billing software improves staff productivity, as easy to use medical billing software improves efficiency.

2. Installing medical billing software in your office increases patient satisfaction. This is because a majority of medical billing software offers flexibility in scheduling and better access to personal information.

3. Fewer errors are committed in billing and insurance. When this happens, the medical billing software can easily correct these mistakes and the claims resubmitted in days rather than weeks. Medical Billing Training. With the complexity of today's health care and insurance system, medical billing has become an industry of its own. In order to manage the thousands upon thousands of patient, insurance company, and HMO accounts, doctors and hospitals rely on sophisticated medical billing systems. Far from having the time to run these systems themselves, large dedicated administrative staffs specialize in managing these systems and interacting with the account holders on a daily basis.

Medical Billing Training. With the complexity of today's health care and insurance system, medical billing has become an industry of its own. In order to manage the thousands upon thousands of patient, insurance company, and HMO accounts, doctors and hospitals rely on sophisticated medical billing systems. Far from having the time to run these systems themselves, large dedicated administrative staffs specialize in managing these systems and interacting with the account holders on a daily basis.

I maintain site http://www.popular-softwares.com having info on most popular softwares.

3 Benefits of Web-Based Electronic Medical Billing Software

When you decide to opt for Web-based medical billing software you will find many great benefits. These include but are not limited to, reduced install and maintenance costs, security from natural disasters, anytime access.

Anytime Access

A major benefit of a Web-based medical billing solution is that you can access the information anytime. Whether you are at home, or in the office, you only need an Internet connection and you will be able to access all the information you need. Late at night or early in the morning or during the day you will be able to access the information for your practice.

Reduced Install and Maintenance costs

Another benefit of the software being Web-based is that there are much lower installation costs. You will see this benefit right up front as it will be the first step that you go through. Another benefit is the reduced maintenance cost. Many server based technologies need to be upgraded and constantly monitored. This can sometimes lead to unexpected costs to help maintain your current system. With Web-based technologies these maintenance costs are much, much, much lower.

Accidents unfortunately happen

As much as we like to think that accidents never happen to us, there is a chance that they just may. Many people use insurance to cover them incase of these major accidents. But many people do not think about what is going to happen to their information in an accident. With Web-based electronic medical billing software there is greater satisfaction in knowing that if an accident where to go through a horrific accident, you would be not lose all of your records. If there were a fire, earthquake, flood and your servers were hit, you would lose all of your client information. But if you had a Web-based software solution, even though your office may be damaged, your records wouldn?t be. You would be able to be up and running in almost no time.

So when deciding between Web-based and server side software remember these major benefits of Web-based medical billing software.

Alex Hachtman is a Marketing Specialist for AdvancedMD Software in Draper, Utah. For more information about medical billing software, please feel free to contact an AdvancedMD representative.

Medical Billing Software

Billing software is an application that can make the billing process a breeze at any medical office. Billing software and its use guarantees the practice proficient billing practices with less manual labor involved in handling the process of billing. In fact, software can help the office keep organized and make tax time a hassle free time for the office that takes advantage of such an application.

There are numerous software applications designed for the specific needs of the community. Billing software applications are engineered for family practitioners, clinics, billing service specialists, hospitals, psychologists, physical therapy offices, chiropractic offices, dental practices, and there are even medical software applications suitable for equipment companies. The software applications that have been engineered for medical office management are diverse, providing users with a variety of functions as well. Current software allows users to bill patients, report overdue bills to collection agencies; make patient appointments; handle scheduling; easily submit claims to insurance companies and software serves as an electronic database of patients records.

Clearly, software is something no practice or office should be without. The functionality of the program alone makes the software an imperative tool in every medical office. Current medical billing software applications have been designed to meet with the standards imposed by HIPPA and the fact that any claims made to insurance companies are electronic and not paper means that the office will receive payment that much faster.

There are numerous medical billing software applications designed for the specific needs of the medical community. Billing software applications are engineered for family practitioners, medical clinics, medical billing service specialists, hospitals, psychologists, physical therapy offices, chiropractic offices, dental practices, and there are even medical billing software applications suitable for medical equipment companies. The software applications that have been engineered for office management are diverse, providing users with a variety of functions as well. Current software allows users to bill patients, report overdue bills to collection agencies; make patient appointments; handle scheduling; easily submit claims to insurance companies and billing software serves as an electronic database of patients records.

Medical billing software will undoubtedly help you in your quest to establish more organized business practices. Most doctors and medical billing professionals find that medical billing software helps them execute their billing in a more organized and efficient way. No longer will you have files and piles of information that could be better organized. Your medical billing software will help you index information in a better manner so that you can pull up bills for clients, send them out in an efficient amount of time, and simply keep good records.

Medical Billing Management is an informative Medical Billing site that looks into all aspects of Medical Billing from Software to Management. To find out more visit Medical Billing

Medical Billing - Software Capacity

The one thing they haven't quite figured out yet in the world of medical billing software is how to make a package big enough in terms of capacity to handle any size company. In this article, we're going to take a look at the problem and just why it's a problem, along with some possible solutions.

Years ago, many years ago, if you had a meg of memory in your computer, you could do just about anything at all. Today, half a gig can just about get your operating system started. As systems and programs get larger, the requirements for these programs grow. But this isn't so much the issue here. Certainly today's PCs have enough memory and disk space to be able to handle starting up an operating system and a piece of software. The issue has more to do with the actual software itself and the mega businesses that use it.

Today, we have corporations involved in the medical billing business that are so massive, it isn't unusual for them to be billing hundreds of thousands of patients. Suddenly, a software package that used to run on a single PC is no longer able to do the job. So networks are built with the software running on individual workstations. The servers running this software are massive. The memory and disk space used by these servers are light years ahead of what they used to be. And yet, with all of this processing power, the software itself can only handle so much. Why?

One of the reasons is the platform on which the software is built. Unfortunately, most software companies build their products on databases that have serious limitations. For example. Some of the most popular DME software packages is built on the database known as Btrieve. While a good database, it has its limitations. One of them is the size it can grow to before you start seeing corruption problems in the database itself. When companies started getting large enough to poke holes in this database, the first solution was to break the database up into multiple companies. But this quickly lead to legal problems and other issues such as being able to get meaningful reports from multiple companies.

Another problem the software packages started running into was the actual processing of the data stored in the database once a solid platform was found. Many users began to notice that running a sales report for a company with 100,000 patients was taking a day to run and tying up all the resources of the server, thus slowing down the work of everyone else. So new network architectures had to be configured to make it so that the reports being run would not have any effect on other users of the system. This was easier said than done with a shared database. So the next solution was to duplicate the database using a RAID system and run the reports off the other drive.

And these problems are only the tip of the iceberg. The unavoidable truth is, as long as companies continue to grow and more and more data is needed, these companies will continue to outgrow the software that is being used. That's why there are constant updates for all these packages.

Michael Russell

Your Independent guide to Medical Billing

Medical Billing - Software System Reports

In the land of medical billing, we get so caught up in the day-to-day operations of getting the bills out, we completely forget about checking to see if our software system is operating the way it should. Needless to say, as problems become noticeable, it is usually because of neglect in keeping an eye on things. In this review, we'll go over some basic system reports that you should be running just to make sure that your software is performing the way it should.

The first report that you should be running is an error report. All software packages track any kind of errors that occur during processing. This could be any kind of processing from submitting claims, to printing forms to running other reports. This error report should be run on a daily basis. The number of errors that occur should be minimal to say the least. If you find a gradual increase in the number of daily errors, this could be an indication that there are problems with the software. The most common of these are corrupted databases. If you suspect this, run a utility to check the integrity of your various databases.

The next report you should run is what is called a failed request report. This usually has to be run on the server unless the software package itself has this capability. Most high end DME software packages do produce a limited failed request report. But if you really want to get a full blown report with all the details that you're going to need. The usual cause of failed request is a bad network connection. If this is what you suspect, have your network administrator run diagnostics on the network. Also have him check all the wiring and network cards in all the computers. Usually the failed requests will come from one particular computer which narrows down your search for the culprit.

You're also probably going to want to run a report on network activity and system resources. For the most part, unless you have a massive billing department, the activity on the server should be minimal. Memory usage shouldn't even register a blip. However, if you find that there are spikes in memory usage, you might want to look at the times of the day that this is occurring. Find out from the billing department when their heaviest periods are as far as billing and other activities. See if there is a correlation between the two.

Finally, you're going to want to run a report to see the rate at which your databases are increasing in size. If you are a large medical billing company, your databases are going to grow at an alarming rate. While your server capacity may be in the gigabytes, it doesn't take long before you find that your medical billing software is hogging up 50% of your disk space. Once you see this happening, you're going to need to make plans to either add another drive or upgrade the one you have.

Medical billing is more than just sending out bills. If your system isn't functioning properly, you could be out of business before you even know what happened.

Michael Russell

Your Independent guide to Medical Billing

Billing Software, Free and Open this Time

Billing is one important area of all small and big businesses. Billing software market is crowded that choice of one becomes so difficult for a start up business owner. The question is will billing software survives the flood of software suits or packages offered by small and big software developing companies.

It should. The problem open software community today faces is the lack of skills or interest to learn the basics of programming and working of programs.

People also seek comfort zones all the time. We all live in an age of instant gratification and we are hardly programmed to wait or try hard to get something. This is the general trend and they will go for easily available packaged solutions, instead of trying to learn what it is about the working behind the things they see.

Needless to say a billing cum accounting system will, to a great extent take the load of learning accounting from your shoulders. With Free and Open Source Software (FOSS) the modern mantra, it is quite understandable if a few companies have taken the initiative to make major inroads into the field of free open source billing software.

It is necessary for the user to have a basic coding and programming knowledge to tweak the pieces of software to a workable suite. Then again the attempts in that direction should be recognized.

When introducing an open-source billing software, it is sure to be met with much skepticism and prejudices. No open source software is an exception. The whole hearted attempts from skilful people keep the trend alive.

A recent addition to free software, specifically billing software is JBilling, located at http://www.jbilling.com/. The open source software works with all major operating systems and supports My SQL, Postgre SQL and Hypersonic. It runs on JBOSS. It is thus a 100% free open source billing system that supports recurring billing, automatic payment processing using credit cards etc. It also handles web-based interface directly with end customers.

The software thus easily becomes an alternative to proprietary billing systems.

You can find more about Jbilling at {a rel="nofollow" href=" http://jbilling.com/"} http://jbilling.com/

Medical Insurance Billing Software

Working in a medical office can be hectic. However, medical insurance billing software can make your work day much more organized and easier. The days of hand writing all your patient's records are long gone. Using powerful software for organizing your patient's insurance information will make a big difference.

Having all of this information handled by a good medical insurance billing software means that you can automatically manage all insurance claims. This greatly decreases the amount of time you will need to spend sorting through past claims. Once all of this information is fed into the software, handling all this information becomes an easy task.

Medical insurance billing software can also notify you of any specific past due balances. With the click of a button you can send this notice to the proper place and have the patient notified of this balance. You can even have the system notify you of all patient's who have a bill due and take actions from there.

Privacy is a big concern with everyone and rightfully so. Medical insurance billing software gives you the option to encrypt patient's records. This greatly reduces the risk of having someone having his or her records falsely changed. No one will be able to view this information unless they have been given the proper rights to do so. Having this feature alone makes medical insurance billing software much better than a hand written file.

Another great feature offered by medical insurance billing software is that you will be instantly notified when a patient needs to make a co-payment. No longer do you need to make phone calls to the insurance company to verify this information. Everything will be automatically updated on your computer screen, and you will know exactly how much the patient is required to pay.

Streamlining your current office situation can be as easy as implementing a powerful medical insurance billing software. While they may take some time to get used to, it is definitely time worth spent. Training for these types of programs is even being offered in many medical schools around the world as this is the most effective way to manage this important information.

Read More About Medical Insurance Billing Software

Lee Leong is the owner of Cheap Software which specializes in providing 100% free software information and resources for everyone

Medical Billing - Picking Your Software

In the many previous installments of medical billing that we have been through, we have discussed just about everything there is to discuss about medical billing software, such as what it can do, how to find problems and how to use it. But one thing we haven't covered, which is probably the most important thing of all, is how to choose your medical billing software. There are many brands out there. So how do you know which is the best one for your needs? Hopefully, after reading this installment, you'll have a decent idea of how to pick out your medical billing software if you haven't already done so.

The first thing you have to do is look at the size of your company and your computer setup. This is important for several reasons.

For starters, not all software packages run on all platforms. So if you're running a network on Mac computers, don't buy a software package that is made for Windows platforms. If you're running a peer to peer network, don't buy a software package that specifically says that it is for star based networks or similar client server networks.

As for the size of your network, if you have a company of 100 users, don't buy a software package that is limited to 50 user licenses. Conversely, if you only have five users in your company, it is wasteful to buy a software package that is specifically designed for companies with hundreds of users. You won't need all that power.

The next thing you have to look at is what your actual billing needs are. If you are a DME billing company, you're not going to have need for software that also does dental claims. You'll be paying for functionality that you don't need. Conversely, if you plan to bill all kinds of medical claims, then you better make sure that you get a software package that is going to handle all those claims. Adding on to a package at a later date is not always an easy thing to do.

The next thing that you want to look at is what extras the software company is going to provide for you, such as forms. Forms are a very big part of medical billing and there are a ton of them. If the software company will also provide you these forms at a reduced cost, then it might be worth it to go with them even if the software is not 100% what you're looking for, as long as it is close enough. Conversely, if another company will offer you forms and the one you're looking at won't, it may be wiser to go with the other company, if the software is at least close enough to what you want.

The next thing you need to look at is price and what you can afford. If your perfect software is way above your means, especially if you're a small company, then you might want to go for something that is a step down. You don't need all the bells and whistles to do this job.

Finally, you need to look at the support record of the company. Find out if there have been any complaints against them. You can do this through the BBB.

If you do all of the above, you have a good chance of coming away with the medical billing software that is just right for you.

Michael Russell Your Independent guide to Medical Billing

 

Medical Billing - Software ROI

One of the most heated arguments in the medical billing world, at least when it comes to the software company, is ROI or return on investment. This is something that is very difficult to calculate as far as what you want your ROI to be and everybody has their own theory and opinion on the subject. If you're a software company just starting out, or better yet, thinking of starting a medical billing software company, there are some basic things you need to consider when figuring out what you want your ROI to be. What follows is a list of the most basic of these items. For starters, you have to figure out what your cost of production is going to be before you even hire any programmers to create this software. This basically involves the cost of the lease on the building you'll be using as well as any other fixed costs such as utilities, insurance, etc. Add all this up and put the estimated total in one column.

The next thing you're going to have to calculate is the salaries of all the people who will be responsible for getting your product out. This includes programmers, QA persons, support techs and all managers. You will also need a networking department who, though they won't be directly responsible for working on your software, will be keeping your operation going. You need to calculate these salaries not just for the time that the software will be developed but also for the time after while you're supporting the product, which will hopefully be for the lifetime of the product. Will you keep the same number of programmers. QA people and support techs? What salary increases do you foresee? Figure all this out and put it in a second column.

The next thing you have to figure out is the cost of any add on items that you intend to include with the software at no extra charge. For example, in the medical billing industry there are a ton of forms that customers are going to need. Are you going to include these forms or are you going to have your customers get them from an outside source? What about peripheral equipment? Are you going to include barcode and retail sales machines? If so, you need to include the cost of these. Also, you're going to need to calculate the cost of maintaining all the equipment. If you deal in peripherals, you're also going to need a tech staff.

After you have figured out what all your yearly costs are going to be, you then have to decide what you want your return to be. In other words, let's say you plan to spend $1,000,000 a year and you want a 10% profit each year. You first have to figure out how many software packages the market will allow in a year. Let's say it's 10,000. If you want a 10% return, then you want to sell $1,100,000 worth of product. If you sell 10,000 units, doing the math, you will need to sell each unit at $110. This is actually very cheap for medical billing software as most packages go for several thousand dollars. So most likely, if you price your software correctly, you will make much more than a 10% ROI.

This is of course greatly simplified, but basically, this is what you need to do in order to figure out what your ROI is going to be for your medical billing software.

Michael Russell Your Independent guide to Medical Billing

What Is Billing Or Time Tracking Software?

Any business needs to be clear about their transactions to ensure smooth functioning. But often, it is found that the off invoice has gone missing or that there is no record of it. Most of the times, it is a simple case of the record aligning itself in the wrong place. Not much you think, but identifying this itself can be quite a headache eating into precious man-hours and not to mention the anxiety it can cause.

A full-fledged billing software suite can save you from these and many other hassles. Billing software that is rich in features can often help you ensure that you do not miss out on any details in invoicing. Take taxes for instance? you did not intentionally leave out one of the tax charges for your client, but who?s going to explain that to the taxman? What it also means is that you have to fork out this money from your pocket for the time being at least! Not a nice scenario, eh?

While the above processes may be streamlined in case of a large corporations where they have full-time finance departments that are paid to ensure all billings are done correctly, in case of smaller companies and more so in the case of a start-up, this could be a troublesome area. Why burden yourself with something that is not your job? Find a good package and just enter all the right data. The rest will take care of itself.

Another advantage most time tracking software offer is the ability to configure and make repeat invoicing easier. So for your long-term jobs, you don?t need to remember to make a new invoice every time. Come the time and your invoice will be ready. What?s more is the invoice can also be a custom made one that satisfies your and your client?s needs.

But even before you reach the billing stage, there is the need to know how much to bill. Even if you are working on a project that does not need you to charge by the hour, it would be worthwhile keeping track of how much time you have spent on what just to make sure you are working optimally. Using a proper time tracking software can help you do just that. In fact, there is some software that sits in your Outlook and can help you optimize the time spent on a particular client by syncing up with your appointments. So by the end of the month, you know exactly how much time you have spent on which client and how much to charge them.

Remember that your time is valuable and also your only tool to prove to your client the effort you have put in. No matter how passionate you are about your work, there is satisfaction in knowing that you have been compensated correctly and there is peace of mind in knowing that your books are up to scratch.

Aaron Reed writes technical write-up for AECTek - Offshore Software Outsourcing Company. AECTek is based in India and also provides Billing and Time Tracking Software solutions

Medical Billing - The Internals Of Software

The things that medical billing people take for granted. Open up your software, push a button, login. Push another button, get a patient menu. Push another button, pull up a patient. Click, click, click and the process goes on and on. Medical billers have no clue what is actually going on behind the scenes of their software. In the following installments and this is mainly for you tech heads, we're going to show you exactly what goes on behind the scenes with your medical billing software with the main parts of the system. To cover everything would take a lifetime.

We'll be covering how patient files get put into the system and how they are ultimately access by a biller and placed into a work order to be billed. While this seems like a very simple process, it is actually quite complex and requires a lot of indexing and cross-referencing.

Another thing we're going to cover is how a claim gets sent electronically. This is one of the mysteries of medical billing as this whole process is actually invisible. While you can see a patient being pulled to a page, you can't see a claim file being transmitted. How does it go? Where does all that data come from when you have so many record specifications? How does the software know to interact with your transmitting device, which is usually your modem? These and other questions will all be answered.

We will also discuss how forms are printed. How does the software know exactly where to place that patient name and address? How do you choose a form, as there are so many of them? Where does the data get pulled from when all you see in front of you is a patient name?

If you're curious as to how security is set and how the software knows to lock somebody out of a certain part of the system, we're going to cover that too. The many options that you have to security systems make this part of the system mind boggling to say the least. We'll do a detailed walk through of a DME security system and show how it works.

Wonder how your software knows how to read those automated posting files that come from Medicare with all your money tied up in them? No problem. We'll dig deep into the auto posting system so you can see exactly what is going on behind the scenes there.

What about those add-ons? How does the system know that you even have them or not? Remember, they are not part of the standard package and have to be added later. So what is actually done by the software maker to let your system know that an add-on is there?

Finally, we'll show you how the software manufacturer can tell if you have a valid copy of the software and when it's time to pay your maintenance fee on it. This gets into some really low level programming.

The above topics will all be covered in future installments. So get a box of lightly salted popcorn and enjoy the show.

Michael Russell

Your Independent guide to Medical Billing

Medical Billing - Getting Your Software To You

Medical billing agencies take a lot of things for granted. They purchase a piece of DME software in order to do their daily billing and they expect everything to run perfectly. Well, in the real world, it isn't quite that simple. There is a lot of work that goes into putting out a piece of medical billing software. While we're not going to attempt to dive into this process in great detail, we're going to try to give you a decent idea of what goes into getting your DME software to you. In future installments, we'll cover this in more detail.

The first step in the process is actually deciding what is going to go into the software itself. This is usually determined by the owners of the company, but frequently, the programmers have a big say in the final product because they may know what is and what isn't possible. Just because management wants something doesn't mean it's going to be done.

The next step is to actually begin the design of the software itself. This involves specifications that are general as well as detailed. The software needs to be given an overall look to go along with the individual bells and whistles that it comes with.

After the software is designed, piece by piece, each section is given to a QA person to test. It is their job to make sure that the section of the software that they are testing works the way it is supposed to, whether it be billing, printing forms, updating prices or whatever. Because medical billing software is so complex, a team of QA people are usually assigned to test it.

If any bugs are found in the software through testing, the QA people send the software back to the programmers. This process continues until the software is found to be bug free.

The software is then given to the support people to learn. The reason for this is because they are the ones who are going to be taking calls from customers who have problems. So it is their responsibility to learn every inch of the software that they can.

Finally, after everything is completed, the manuals are written by the QA people or tech writers, depending on how the company is structured. These are the manuals that are distributed to the medical billing companies who buy the software.

When all of that is done, the software is then packaged in a nice neat and pretty box. This box is made by the graphic artists team. If you don't think presentation is important, think again. Presentation is almost everything in the business world.

After the software is packaged, it is then given to the sales people to distribute. These people usually have leads to companies looking for medical billing software. That's where they start.

It's a very long process from start to finish. So when you finally do get your DME software, try to understand that a lot of hard work went into getting it to you.

Michael Russell Your Independent guide to Medical Billing

 

Medical Billing - Software Manuals

Medical billing is complicated enough without having to know every inch of your billing software by heart. Because of all the complexities involved, medical billing software manuals are not only critical but they're also enormous. As a matter of fact, most medical billing software manuals are shipped in parts. So you have a decent chance of finding what it is you're looking for, we're going to give you a general breakdown of how a DME software manual is put together.

The first section of the manual is usually where you will find your installation instructions. These will contain step-by-step procedures for installing the software on each type of network, with subheadings for each network. Usually, the table of contents will include the networks covered so you don't have to go hunting for yours.

In this section, you will also find installation instructions for any add ons such as retail sales and barcoding. This is in case your company purchased these extra utilities. If they didn't, then this section won't apply. It's more cost efficient to include the add ons installation instruction in the standard manual than to send out a separate one only for customers who have add ons.

In your next manual, you'll find your instructions for setting up your databases. This is where you will find out how to enter data for doctor files, inventory files, patient files and so on. This section of the manual will usually have diagrams of each data entry screen so the user will know where each field is. Also, a complete description of each field will be included as well. For fields that tie in to medical forms, the manual will also tell the user which forms the field goes to as well as where on the form, such as line number.

The next set of manuals will usually focus on how to do billing, whether it be through printing out HFCA forms or sending claims electronically. Some software manuals have these sections separated. In addition to that, most software companies provide a separate manual plus record specifications for each carrier that is being billed, such as Medicare and Medicaid. In many cases, where a company has a large customer base and bills many different carriers, they may have as many as five or six different medical billing manuals or more.

And if all that isn't enough, there is usually a whole manual dedicated to troubleshooting the system in case there are problems. The reason a software company will go through all that trouble is to cut down on the number of support calls that they get, as each call takes up man hours, which is a lot more expensive than printing out a manual.

When all is said and done, a medical billing company can literally have a bookcase filled for just one piece of software. If a company does DME billing and then has another software for dental billing, that could mean another whole bookcase full of manuals. Because there are so many, usually there is a small manual that has the master table of contents so a person knows what manual to look in for what piece of information. Yes, medical billing software companies sure do kill a lot of trees.

And to top all this off, most companies have online versions of these manuals in case the hard copies get damaged or stolen. They've got all the bases covered so that the medical billing company can spend more time concentrating on actually billing and less time looking for things.

Michael Russell Your Independent guide to Medical Billing

Medical Billing Software Troubleshooting Overview

As much as billers don't want to think about it, software for medical billing is not perfect. There are going to be problems, sometimes lots of them. In the next series of articles, which will cover a number of critical areas of the DME software system, we will go over the most common problems that you will run into when operating your DME medical billing system. In this particular installment, we're going to just give a brief overview of the areas that will be covered in more detail.

The first part of the system where you are going to run into problems is the actual installation and running of the software itself. Even though manufacturers try to make software that will work on any operating system and network, this isn't always the case. Sometimes just installing the software itself can be a problem.

The second part of the system where you are going to run into problems is the entering of data, which is where you store your doctor files, patient files, inventory files and so on. These data entry problems can range from something as simple as a piece of data not saving correctly to losing whole chunks of information or even a whole database.

The third part of the system where you are going to run into problems is the actual billing of claims. This is where you run into the largest variety of problems because billing itself covers such a wide area. This installment will probably be further broken up into smaller installments in order to cover everything and not give you information overload.

The fourth part of the system where you are going to run into problems is with the printing of forms. This is another part of the medical billing system that is so complex because of the large number of forms that sometimes trying to determine the cause of the problem can be extremely difficult at best. These problems range from something simple like a form not lining up to fields not printing at all.

The fifth part of the system where you are going to run into problems is with your add ons. Because there are so many different add ons for medical billing packages, there is no one troubleshooting method that works for all of them, especially when you're dealing with something as complex as barcoding or retail sales equipment.

The sixth part of the system where you are going to run into problems is with security and administration. This is probably the last place you want to have a problem because security is so critical. These problems can run from something as simple as a person who is supposed to have access to a module not having that access to somebody literally breaking into the system.

The final part of the system where you are going to run into problems is with the communications system. This comes into play when you're doing things like electronically billing or running an online update for the system itself.

We'll be covering all of these topics in more detail in our future medical billing installments for troubleshooting your software.

Michael Russell Your Independent guide to Medical Billing

Medical Billing - DME Software Forms

As is true in most of the administrative world, there are more forms than people know what to do with. Go to a doctor's office for a procedure and he'll most likely have you fill out a slew of forms that will end up taking you longer to do than the whole examination or procedure itself. Well, the world of medical billing is no different. There are more forms than you can possibly imagine. We take a look at some of the more common of these forms.

Probably the most common form in medical billing is the HCFA 1500 form. This is the main claim form to bill for services. These forms are enormous. There is more information contained on a HCFA 1500 form than probably on any other form in existence. The amount of information contained in a HCFA 1500 is beyond the scope of this article but some of the main pieces of information are patient personal information, insurance information, items billed and patient medical history. HCFA 1500 form manufacture is big business and these forms are very costly to billers. That is why many medical billers are switching over to electronic billing so that they don't have to deal with these HCFA 1500 forms.

Another billing form, though not as common but gaining popularity, is the UB-92 form for billing. The main difference between the UB-92 and the HCFA 1500 form is the format. For the most part, the same information is transmitted. It's just in different places. There are some things contained on one form and not on the other. But for the most part, they serve the same function.

Another common form is the Certificate Of Medical Necessity, or CMN. CMNs are needed for any item given to a patient where the biller has to show proof that the patient is in medical need of this item, such as a wheelchair or oxygen concentrator. This proof has to come from the doctor who fills out a CMN, which he then has to sign. CMNs are also big business and very costly forms, though not as expensive as HCFA 1500 forms.

Not quite as common are forms called Centers For Medicare And Medicaid Services, or CMS forms. These are actually very new and as of this writing, a new version will be coming out in April of 2007. These forms cater specifically to Medicare and Medicaid claims.

And there are a number of other odds and ends forms to add to the above list. Each one has its own specific purpose. Some you may use only once in a year but if you don't have it, it could lead to lost revenue. So be assured that the price you will pay for that form will be a hefty one.

And if all that isn't enough, each of these forms comes in either regular dot matrix form or specially made for laser printing. Yes, the laser forms are much more expensive.

Make no mistake about it. Medical billing forms is big business and one of the biggest costs to any medical billing agency.

Michael Russell

Your Independent guide to Medical Billing

Medical Billing - DME Software Updates

In this installment of DME software for medical billing, we're going to cover one of the most important parts of the system, updates.

As much as medical billers would like the DME and medical billing industry to be stagnant, that is just not the case. Regulations are constantly changing as well as prices, diagnosis codes, procedure codes, electronic billing specifications and on and on. So what does one do when they just got the latest software and one week later Medicare pricing for wheelchairs has just changed? That's where updates are so important.

In the DME system, there are a number of updates and not all of them are done at the same time. Some are done monthly, some quarterly and some are done whenever needed. For example, diagnosis codes and procedure codes are usually updated on a quarterly basis. These updates, however, are not automatically done by the system. Each DME system is different. Some have updates that you get via the mail in the form of a CD and have to install yourself. Other systems have updates that you can get via the Internet. In most cases, these updates are not included with the software package and not free. You need to subscribe to the service in order to get them. This is particularly true with diagnosis codes and procedure codes.

In the matter of electronic billing module updates, these usually are included with the purchase of the electronic billing package for each carrier. Part of the contract that comes with these modules includes updates for life. Usually there is a small yearly fee to get them. Some companies actually provide free updates because the software itself is so expensive.

In the matter of price changes, these work a little differently. Prices for Medicare and Medicaid allowables usually don't change often. Usually, they only change once a year. Sometimes they may not change for a couple of years. These updates, because they are so seldom, usually are included with the software at no extra charge, though you can bet that the actual cost of the software has these updates factored into the price at the time of purchase.

And then there are odds and ends updates for things such forms. Medical billing forms are always changing because the carriers are always trying to find better ways to do things. One of the most nerve wracking jobs of the biller is to keep up with all the forms changes. Because these changes occur so often, the actual changes to the software are done on an as needed basis and the charges are per form. This is where the software makers usually make a good deal of their money. Some do offer contracts where the biller pays a yearly fee, usually quite high and the software maker will take care of all forms changes free of charge.

Software updates are more common than the common cold. That's why you'll see version numbers of the medical billing software going into double digits. And don't ever expect the updates to stop. As long as the medical billing industry is always changing, the updates will keep coming.

Your Independent guide to Medical Billing