Medical Billing - DME Software Add Ons

Everybody loves the extras. Getting what you pay for is one thing, but when you get those extra items, is when you feel like you're getting more for your money. In the world of medical billing, this is no different. Unfortunately, most software systems don't give you those extras at no cost. Still, there nice to have when you want to do a little bit more than just bill for services rendered. So what are some of the more common extras that come with DME software?

One of the common items that come extra with DME software is what is called barcoding. Barcoding has actually been going on for quite some time in the retail world. Just go to the local supermarket and you'll find those Universal Product Codes, called UPC codes, all over the place. As a matter of fact, most supermarkets now have automated checkouts using these UPC codes. How UPC codes work is beyond the scope of this article, but briefly, what the manufacturer of the item does is place a special code on each package that needs a special reader to read the price associated with it. This price is then stored in the system so that when the code is read, which is the product code, the price comes up on the register and is added to the subtotal. This functionality is added to some DME software to enable billing houses to sell over the counter items to patients.

This ties into another add on module that is called the retail sales module. This module is actually more than just software. It includes an entire retail sales checkout system, similar to what you would see in your local supermarket. These have to be specially installed by a trained technician. These retail sales modules can read the barcodes that are programmed into the barcoding module. So most people who get the barcoding add on will also get the retail sales add on as well. However, some companies only use the retail sales module and do checkout the old-fashioned way before they had barcodes. Usually small ma and pa stores will do this. These stores usually only do limited medical billing either to Medicare or Medicaid and don't handle a lot of private insurance companies.

Another common ad on, which many people believe should really be standard, is the electronic billing packages. The reason this is an add on in many cases is because standard forms billing is still pretty much the norm. Honestly, why this is the case is a mystery as electronic billing is so much faster and has a higher claim acceptance rate because of fewer errors. Eventually, electronic medical billing will be the norm and will come standard with all medical billing software packages.

There are other add ons such as special inventory control packages, auto pricing update packages and other updated packages for diagnosis codes, procedure codes and forms. Again, some packages include all this as standard but for the most part, if you want this functionality, you're going to have to pay extra for it.

Michael Russell

Your Independent guide to Medical Billing

Medical Billing - DME Software Overview

In this installment, we are going to be starting a series on DME software for medical billing. This is probably the most popular software on the market because it is responsible for billing more claims than probably any other branch of the medical billing industry.

DME stands for Durable Medical Equipment. This is equipment that is either sold or rented to various Medicare, Medicaid, Blue Cross, Blue Shield and many private insurance companies including Prudential and Web MD. This equipment ranges from wheelchairs to concentrators. The amount of money involved in this industry is staggering. Because of this, there are many brands of software on the market that billers can use to bill these medical claims. Logistically, it would be impossible to review each piece of software. However, because there are so many similarities between the various brands, it is simple enough to go over the main parts that each software covers. This way you will have a decent idea of what is involved in billing DME claims.

The first part of DME software that we'll be going over in detail, in a future installment, are the setup options. These options allow the user of the software to customize it to their liking. Some of this is just cosmetic, such as screen appearance. But much of the setup also involves setting up the type of DME billing that they'll be doing, including designating what kind of provider the software will be billing for, whether it be single or multiple provider.

The next part of the DME software that we'll be going over is how patients, doctors, facilities, items and other things are setup in the system. There is a complex process involved in medical billing of claims that requires everything in the system to be pulled together when either printing out a paper claim or billing electronically. This is probably the most complex part of the whole system. This will be covered in great detail.

The third part of the DME software that we'll be going over is how billing itself is actually done, whether it be via paper or electronically. We'll cover the various ways to print or transmit a claim. We'll also cover the legalities involved with doing so, such as what needs to be signed and when.

The fourth part of the DME software that we'll be covering involves what they call add-ons. These are additional services that many billers use, such as purchase order processing and barcoding of products. This part of the system must also be integrated with the main part of the system so that it works correctly.

Finally, we'll cover some common problems that billers should be aware of with each part of the system. Medical billing, because of all the things that can be billed and all the medical regulations, is complex and confusing, even to the seasoned pro. To the beginner, it can be a total nightmare. Hopefully, after reading this series, you'll have a very clear understanding of the basics of medical billing and the DME software used to bill DME claims.

Michael Russell Your Independent guide to Medical Billing

Medical Billing - DME Software Lookup Tables

In this installment of medical billing and DME software, we're going to cover a brief overview of lookup tables, which is probably the heart and soul of the whole DME system. Without lookup tables, the whole operation of the system, including the medical billing itself, would be extremely difficult.

A medical biller has a hard enough job as it is. When billing a medical claim, there is an enormous amount of information that has to be sent to the insurance carrier, including patient information, item information, insurance information and so on. If you read the series on DME NSF 3.01 record specifications, then you already know that hundreds of fields of information are transmitted to the insurance carrier. If the medical biller had to enter all this information by hand, the billing of one claim would literally take hours. To speed up this process, lookup tables are used.

A lookup table is essentially a self contained database that has information pertaining to that area of billing, whether it be patient, item or carrier related. The reason that many tables are used is because of the amount of information that is contained in each table. If they were all combined into one table, the lookup process itself would be slowed to a crawl because of all the records the lookup would have to go through. As it is, with very large billing agencies, these lookup procedures can take several minutes depending on how large the network is and its capabilities to handle the load.

Each lookup table is indexed, usually in several ways. By doing this, a medical biller can lookup patient information in a number of ways. For example, if the biller doesn't know the patient's ID number, they can look it up by the patient's last name. Some lookup tables allow you to do a broad search via city and state. For item lookup tables, if the biller doesn't have the sku number, they can look up the item by description. Of course, with many of the same items in the system, this method can be time consuming.

The main point of a lookup table is that for each table, there is a large amount of information that is tied to it. So by looking up a patient, the biller is pulling all the information associated with that patient, such as name, address, phone, date of birth and a number of other things. In the process, all these items are automatically pulled to the various forms that need to be filled out. So what would normally take maybe 5 to 10 minutes to fill out, can literally be done in seconds. Obviously, this is a real time saver for medical billing agencies and greatly reduces costs, which are high enough as it is.

Quite simply, without lookup tables, DME software would be pretty much worthless, as the bulk of the operation would be the manual input of hundreds of pieces of information, which would totally defeat the purpose of having the software, to speed up operations.

Michael Russell Your Independent guide to Medical Billing

Automotive Shop Billing Software

You have a busy automotive shop and not enough time in the day to take care of all your accounting yourself. Sure, you have an accountant, but you don?t even have the time to put together the materials to take to him so that they can do your bookkeeping. Automotive shop billing software is a great way for you to keep your business organized and functioning properly. The more organized the business is, the easier it will be to make a profit.

To find the best automotive shop billing software, you will first need to do your research. Ask other shops which software they like. Look online to find companies that have the software you are looking for. Find product review sites and magazines to see which program has the best reputation. You can also ask questions in forums to see what other people have to say.

In general you will want your automotive billing software to be easy to use yet still get the job done. Your software will need to keep track of your customer information. It will also need to keep track of work orders and be able to print invoices. You will also need to have their auto insurance on file. This is especially handy if you repair their car after an accident.

Once you find the automotive shop billing software that seems the best, you can then begin to comparison shop. Different companies often have completely different prices on their products. You can also consider buying the software used. Used software is much cheaper. However, you run the risk of getting it damaged, and the warranty may either be expired or it won?t transfer when the ownership switches.

Automotive shop billing software can help you manage your business better. Just do your research to make sure you find the program that best meets the needs of your business. Also research to find the best prices. Once you learn and use the program, you will feel much more organized.

Billing Software provides detailed information on Billing Software, VoIP Billing Software, Chiropractic Billing Software, Free Billing Software and more. Billing Software is affiliated with HIPAA Complaint Medical Billing Software

Medical Billing Software takes the Stage

Medical Billing Software

The practice is running smoothly, with patients coming in and out with smiles on their faces because of the great service your practice is providing. At the end of the day, you review the office secretarys billing records and realize you are behind, again.

Running a successful practice depends upon the efficiency of the billing. Unfortunately many practices still must deal with a variety of different databases containing different sets of information. The patient contact information and the patient histories may be in totally separate databases, both of which have to be accessed in order to put information into a third database containing billing history. Though the database information in this example may be different from information in your practices databases, the database confusion is the same.

In addition to the database difficulties, running on multiple servers, installing billing technology with IT, and backing up all of your data is overwhelming if not impossible to always be on top of.

Simplify

Medical billing software has simplified the practices office structure to open up more time to continue giving quality service to patients. Medical billing software is a solution employed by countless medical practices to ensure effective and accurate billing.

One of the biggest ways medical billing software saves practices extra work is by enabling information on various servers or databases to be synchronized onto one account. By logging into your account you can access all of the information you need on any patient.

In addition to streamlining the billing process, medical billing software simplifies the financial obligation to billing and database technology by cutting most of it out. Using medical billing software enables tracking, billing, and security of all accounts online, eliminating the need for a costly IT infrastructure. The cost is usually a monthly fee payable as you use it.

Feel free to access your account from anywhere, including your PDA.

Secure

No practice should read an article like this and be convinced to find medical billing software without asking itself if an online medical billing software system is a secure system to change to.

Some of the examples of security precautions medical billing software takes includes electronic back ups, automatic posting, HIPAA and HCFA compliance, and secured accounts only accessible to authorized viewers.

In selecting a system for medical billing to suit your medical practice needs, consider a solution recognized by countless medical practices already. A secure a simple way to streamline medical billing is with medical billing software.

Joe Miller is specialist in online advertising. For more information on medical billing software, please visit AdvancedMD.com

Electronic Medical Billing Software Products in Press (June - July 2006)

Medical Billing technology has witnessed continued expansion during the first two months of this summer, as evidenced by press releases about some ninety products accumulated in BillingWiki. A practice manager may find it difficult to select the best product from such a large product variety. This article roughly tabulates some eighty-five press releases about medical billing technology products and/or vendors across two-dozen service categories.

Asset Life Cycle Management: Products that help healthcare organizations optimize the performance of their capital assets, uncover hidden expenses, gain more visibility and control over their asset and facility operations, and improve safety. Such systems also serve as repositories for hazards, alerts and recalls facilitating a closed-loop process that documents the hospital's course of notifications and corrective action. See St. Croix and LYNX.

Audit and Compliance: Products that help providers and payers to manage compliance by facilitating internal audits and planning external audits respectively. Such systems assist an auditor to spot errors, omissions, fraud, and abuse. Solutions span spectrum from basic audit reporting to complete automation of the audit process by using data mining, natural language processing, and statistical methods to produce a random sample of medical records, data scoring, and potential revenue loss estimate.

• Claim Audit: A-Life, CodeRyte
• EFT Audit: GlobalSCAPE
• HIPAA Privacy and Security Compliance: MedicalSuite

   

   

 

Certification and Awards:

• Best in KLAS: KLAS is a leading source of information on Healthcare Information Technology vendor performance, with information gathered from users at more than 4,500 healthcare facilities nationwide. Performance data collected from 300 Healthcare Information Technology vendors and 500 of their products is evaluated and made available to subscribers through the KLAS website as well as through periodic reports and custom research. See press releases about VantageMed and athenahealth.
• CCHIT Certification: The CCHIT Certified mark - a "seal of approval" for EHR products - provides the first consensus-based, consistent benchmark for ambulatory products. See LSS Data Systems and Misys.
• DOQ-IT Testing: CMS, an agency of the U.S. Department of Health and Human Services, established the DOQ-IT initiative program to encourage physicians to adopt EHRs and, in turn, improve the quality, safety and efficiency of health care. In order to gain official DOQ-IT recognition, vendors must meet all 35 DOQ-IT reporting requirements. See Misys

   

   

 

Deals: This category shows business development activity based on leveraging reciprocal client relationships and complementary product capabilities. See A-Life, Affinity Billing, athenahealth, eClinicalWorks, Eclipsys, GE Centricity, H-Quotient, Healthnostics, IngeniousMed, JPI Data Resource, LEAPpm, Massachusetts Medical Society, MedLink, Misys, medFORCE, medHost, MediSys, Nexplicit, Nicka & Associates, Nightingale On-Board Communications, PatientKeeper, Quantum Group, RXHub, Scandent, Streamline Health.

Electronic Charge Capture: MedAptus

Electronic Data Interchange (EDI): The ability to access one single source of continuously updated claims tracking data to perform real-time status checks directly from local PCs instead of spending hours on the phone calling one insurer after another to track down the status of submitted claims. See MicroSys.

E-learning: AlphaQuest, Care2Learn

Enhanced website: CAP-MPT, Companion Technologies, Patientrak

Factoring: Factoring provides healthcare professionals with automated electronic insurance claims management solutions and advance funding on medical claims, as submitted, through a revolving line of credit. See MDWerks

Integration: Products that expedite revenue cycle by integrating office management functions, which in the past used to be performed separately. Integration eliminates data entry repetition, reduces errors and costs, and streamlines revenue cycle. See press releases about four integration aspects outlined below.

• Billing and Coding: ChartLogic
• Billing and EMR: Affinity Billing, MediEMR, Siemens, NextGen, athenahealth.
• Billing and Compliance: Billing Precision.
• Billing and Imaging: IMPAC, AMICAS, Fujitsu, MedLink.

   

   

 

New clients: Ingenious Med For, Lumetra, Misys, Per-Se, MediSys, Craneware, PaperFree, athenahealth, Picis, MicroMD, intraNexus, Visionary Medical Systems, AllScripts, LUMEDX, Streamline Health, LYNX, Sullivan Group, PHNS, Streamline Health, ECDS, McKesson

New billing products and services: Automed, HealthWare, JP Morgan, Physmark-Transplant, LabDAQ

Online Supply Store: Antek HealthWare

Patient Payment Ability Verification: Offers predictive reporting functionality to determine a patient's ability to pay for services and verify a patient's billing address in real time. See Per-Se.

Payer-side automation: See Guidewire ClaimCenter, XPERT Connect.

Personal Health Record Smart Card: Patients and health care providers can access medical health records, and send and save their most vital personal medical information instantly using the Internet or multiple devices, such as smart cards, USB keys, mobile phones, PDA's and Tablet PC's. See Patientrak.

Telemedicine: eNotes.

Yuval Lirov, PhD, author of Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP Notes, Care Plans, Coding, Billing, Collections, and Audit Risk (Affinity Billing) and Mission Critical Systems Management (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com

Chiropractic Office Billing and Patient Relationship Management Software

Return patients generate approximately 80 percent of clinic's revenue. Patient Relationship Management (PRM, also known as CRM, for Customer Relationship Management outside of healthcare) can enhance financial performance of the clinic by helping retain current and attract new patients. Effective PRM uses integrated data using patient travel card (SOAP notes), frequency recommendations (care plan), and billing (charges, payments, and balance).

PRM is a data-driven and patient-focused methodology to strategic practice building and effective patient relationship development. PRM helps identifying new service needs and then designing care programs and office and billing processes to meet the needs.

PRM also helps providing timely, patient centered, and efficient care, emphasizing preventive instead of reactive care. A basic PRM system captures patient information during entire period of the care plan in terms of functional health improvement, care plan implementation, and billing.

Patient Relationship Management Principle

PRM includes a travel card (TC), treatment frequency measures, and billing balance. PRM system tracks changes in the travel card, in Frequency Recommendation summary, and in billing balance, and generates reports to alert office management about lists of patients reaching important thresholds. The office manager or the doctor can review such reports and respond according to practice development strategy, using call centers, Internet, direct mail, or personal conversations during office visits.

Electronic Travel Card

An electronic equivalent of a paper travel card (Electronic Travel Card, or ETC) contains complete information about patient's health and care history. It is similar to electronic medical record and subject to same HIPAA compliance regulations. ETC includes:

 

• Numbers and dates of visits
• SOAP notes for each visit
• ICD-9 and CPT codes
• Care frequency recommendation summary
• X-rays and posture images

Frequency Recommendation

Frequency recommendation summary presents an interpretation of patient's compliance with doctor's recommendation in concise form and allows specification of PRM thresholds. Specifically, it has four parts:

 

• Weekly treatment frequency recommendation, typically a single digit between 1 and 3
• The number if weeks when the patient complied with the recommendation
• The total number of weeks for a given recommendation
• Care plan start date
• Number of missed appointments along with documented reasons for missing an appointment

For instance, a frequency recommendation summary [3X: 3/13] means that treatment is recommended three times per week for thirteen weeks, and the patient complied three weeks out of thirteen.

A treatment plan then is a list of such frequency recommendation summaries, for instance, [3X: 3/13], [2X: 15/15], [1X: 4/12].

In summary, Patient Relationship Management (PRM) can become a major differentiating factor in building successful and competitive chiropractic clinics. It requires integrated systems combining data about patient's health, care plans, and billing.

Yuval Lirov, PhD, author of Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP Notes, Care Plans, Coding, Billing, Collections, and Audit Risk (Affinity Billing) and Mission Critical Systems Management (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com