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.

Practice Perfect - 10 Criteria For Best Chiropractic Billing Software And Office Management Solution

Information Technology (IT) is a necessary component of a modern chiropractic office," says Dr. Greg Loman, of Trinity Chiropractic and co-founder of Teach The World About Chiropractic. "IT helps maintain patient relationships, control audit risks, and ensure full and timely billing."

Dr. Loman has established one of the most successful chiropractic offices in the world, seeing over sixty thousand patients a year. A world power boat racing champion, Dr. Loman has learned what it takes to be the very best.

Teach the World About Chiropractic, which he co-founded with Dr. Ben Lerner, the author of Body by God, Generation XL, and One-Minute Wellness, helps chiropractors and students across the world. Their clients have the largest, most successful clinics in the profession today.

"Complete practice workflow solution starts with appointment scheduling and includes SOAP notes, and billing," says Dr. Lerner. "Few vendors today offer such integrated packages as they require powerful vericle-like technologies used by trained and skilled personnel implementing rigorous and disciplined service processes."

Chiropractic IT must meet five functional criteria and five technology criteria:

 

1. Clinical Relevance

    

   Technology can only help the healing process if it helps making treatment decisions at the point of care. Therefore, it must be available next to treatment table and it must have intuitive user interface to facilitate simple data entry and helpful online reporting.

    

2. Patient Relationship Management

    

   Successful practice development requires perfectly managed patient relationships, starting with establishing and tracking financial care plans, appointment reminders, balance follow-ups, and avoidance of unbillable appointments.

    

3. Compliant SOAP Notes

    

   SOAP is short for Subjective, Objective, Assessment, and Plan:

   Subjective describes the patient's current condition, including all pertinent and negative symptoms. Document how symptoms impact activities of daily living; Use the Standard SOAP format modified to SOAAP by adding an extra "A" for Activities of Daily Living.

   Objective includes vital signs, findings from physical examinations, and results from laboratory tests. Document functional measurements (e.g., Range of Motion), comparison data, test results, co-morbidities, etc. to paint a picture of what is going on with the patient.

   Assessment is a quick summary of the patient with main symptoms/diagnosis including a differential diagnosis, a list of other possible diagnoses usually in order of most likely to least likely.

   Plan is what the health care provider will do to treat the patient's concerns. This should address each item of the differential diagnosis. Document goals for the patient and establish a reasonable timeline to reach those goals. Update your treatment plan every 30 days or 12 visits or any time there is a significant change in the patient's condition, i.e., exacerbation, new injury, discharge exam. Document the patient's progress toward those goals in the daily SOAAP notes.

    

4. Full and Timely Payments

    

   Revenue cycle management software must help the practice manager to make sure that every service encounter gets paid in full and on time. It must provide full and detailed 24x7 account of all actions on every claim, systematic discovery of denials, patient invoicing, electronic claims submissions to payers, payment posting and reconciliation with charges, HIPAA compliance, built-in tests for medical necessity, and comprehensive online reporting.

    

5. Audit Risk Management

    

   Audit risk management consists of continuous monitoring for potential compliance violations and meticulous management of patient encounter notes.

    

6. Reporting and Transparency

    

   Without transparency billing may not be reliable. To be able to observe every step of the billing process on a continuous 24 x 7 basis, reporting must be available using a secure HIPAA compliant connection over the Internet.

   Vendors that manage their own billing technology typically have better control of reporting capabilities in terms of scope, analysis, frequency, and transparency. At the minimum, the following features must be available:

   Operational Report shows total claims and $ amounts submitted, paid, adjusted, written off, and failed. It allows breakdown by cpt, payer, referral, or a combination of such dimensions.

   Denials Report shows the list of denied claims and a log of followup actions. By sorting it by amount paid, you can tell the smallest payment the billing service will fight for.

   Compliance Report shows the potential for post-payment audit and itemizes compliance violations.

   Reports must allow arbitrary data aggregation and drill-in. Export to Excel spreadsheets for further analysis is a very useful feature.

    

7. Billing Quality Metric

    

   Make a list of metrics available online. Focus on collections completeness and payment delay. Can the system report the differences between payers and between various CPT codes in real time? What is the denial followup success rate?

    

8. Data Entry Protocols

    

   Modern technologies allow the doctor to take over coding and reduce the billing role down to claims processing and followup. Technology-competent vendor will supply your superbill online, along with a separate form for patient and charge entry, EOB posting, and on-line claim editing. Similarly, much of data entry validity, including some of claim scrubbing will be done online at the point of data entry.

    

9. ASP or SaaS Delivery Model

    

   Rapid technology progress results in low return on investment in software licenses, typical of client-server technology. Therefore, monthly leasing arrangements with zero upfront investment, typical of ASP (application service provider) or SaaS (software as a service) delivery models are preferable to license purchase.

    

10. Data Security and Protection

     

    Review data center facilities. Ask for evidence on HIPAA compliance: claims must be viewed only on the "need to know" basis, access to claims and modifications must be thoroughly documented. Data must be protected with redundant disaster recovery measures. Review backup process, backup intervals, and data restore capabilities.

     

 

Summary

Increasing regulatory scrutiny, poor in-house billing performance, and rapid technology progress are key growth drivers in chiropractic information technology. On one hand, thousands of outsourced billing solutions and software vendors ensure continued competitiveness in terms of both service quality and pricing. On the other hand, the lack of standards and uniform metrics among the vendors, combined with their large numbers, frustrates the selection process. Ten effective guidelines streamline outsourced solution selection process and reduce vendor switching costs.

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

Electronic Straight Through Billing Service and Software Methodology for Medical Practice

Medical billing complexity and massive volumes of daily claims render manual claims processes incapable of protecting both the provider and the payer from underpayments, overpayments, and billing compliance violations. Straight Through Billing addresses complexity and volume processing problems by automating the majority of the claim flow and focusing the billing follow-up specialists to exceptions only. A Straight Through Billing process flags problems, routes them for follow up, and enables online correction and resubmission. Straight Through Billing methodology implements billing service transparency and focuses management on strategic process improvement opportunities.

Straight Through Billing (STB) integrates billing process within the practice management workflow, automates vast majority of transactions, focuses manual labor on exceptions, and establishes a process for continuous improvement.

First, integrated practice management and billing workflow connects patient scheduling, medical record management, and billing into a single flow. Every participant of the practice management workflow receives a unified and coherent picture of practice workload, patient and provider location, resource availability, and cash flow.

Next, transaction automation streamlines and expedites billing process by automating claim validation, payer message reconciliation, and billing workflow management:

 

• Automated claim validation eliminates errors downstream and reduces processing time because it flags errors before submitting the claim to payer.
• Automated claim-message reconciliation eliminates costly search for the original claim and standardizes message communication, further eliminating the need to decipher the (often cryptic) payer's message.
• Billing workflow management drives the followup discipline required for resolution of claim denial and underpayment incidents and establishes high degree of process transparency for all billing process participants, resulting in full and timely payments.

 

Third, focusing manual labor to exceptions requires timely exception identification, routing to followup personnel, online error correction, and rigorous followup tracking. Again, process transparency, as implemented in vericle-like systems, enables tracking exception followup.

Finally, a process for continuous improvement requires continuous observability of every process attribute and a modification methodology for both automated claim processing and manual exception followup tracking.

STB implements billing transparency by design because billing transparency is an integral attribute of every component of STB process.

Straight Through Billing Architecture

Straight Through Billing systems architecture mirrors the architecture of general Straight Through Processing (STP) systems developed for the financial services industry. Such systems require effective workflow management, knowledge base validation system, connectivity to all process participants, including on-line data reconciliation, and tracking of problem resolution. Therefore, a typical vericle-like STB system has a three-tier architecture:

 

• Back-end processing engine designed for high-volume transaction processing environment
• Middle-tier uses Java Servlet technology
• Front-end is an HTML-JavaScript zero-footprint client

 

An STB system (e.g., Vericle) following the methodology outlined above implements rich functionality, which allows automated

 

• Computer aided preferential patient scheduling
• Integrated electronic medical records
• On-line computer aided coding
• Real-time claim validation and patient eligibility testing
• Electronic claim submission
• Payment posting, reconciliation, and verification of meeting contractual obligations
• Monitoring of audit risk and billing compliance
• Tracking of denial appeal process

 

Quantitative STB Management

STB methodology allows for quantitative management as the likelihood of failure of the entire process can be estimated as the product of such items for each individual workflow steps. A vericle-like STB system tracks the percent of clean claims (claims paid without any manual intervention in full and within the allocated timeframe) and focuses the management on those process aspects that yield the greatest potential improvement. Thus STB methodology focuses on exceptions both at tactical and strategic management levels.

Yuval Lirov, PhD, author of Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP 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

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: An Overview

Components of a successful medical practice. Healthcare professionals from many different specialties can benefit from some level of medical billing software. Innovations in the field of medical billing software have created a new standard of digital precision. Many software packages in general can now fill all the needs of your practice; you can easily locate vendors who know about health care management solutions and will work with your practice to maintain your lead in the business.

When investigating possibilities for your billing software, ask questions such as how and for whom the system was designed, and whether the data will be safe and secure on backed-up, protected, HIPAA-compliant servers accessible only to authorized persons. (“HIPAA” is the acronym for the Health Insurance Portability and Accountability Act of 1996.) Then you can ask for the total price (including ongoing costs like software upgrades) of the entire software package. Some vendors will allow you to build your own medical billing software quote by providing you with a series of questions that will identify your essential needs. Moreover, look for companies who offer free updates to ensure continued efficiency and HIPAA compliance.

To figure out your software requirements, you can either assess them for yourself if you have excellent computer and software knowledge, or contact one of the many medical practice software providers who can assist you in comparing features, prices, and services. There are many companies that will do this free of charge.

One popular option that some electronic medical billing software experts will recommend is to use web-based software. These are companies that maintain practice management programs, electronic medical records, and various software programs on remote computers. All of your data is web-based and accessible through the Internet. These companies are commonly referred to as application service providers (ASPs). All you need to use an ASP is an ordinary computer and a broadband Internet connection. Most packages include software support, security, database management and training. This eliminates the burden of maintaining network servers, backup tapes, upgrades or modems. Additionally, search for software providers (web-based or otherwise) who will consistently upgrade their products in a timely manner, anticipate future developments, and translate those advances into system features.

Because dynamic, scalable software is now readily available to the modern medical establishment, even the most humble doctor’s office can install a fluid software system that everybody can use. Further, as the demand for electronic medical billing software has blossomed, so have the available choices. Medical billing software is just one of the many options now available that make operating a medical practice easier than ever before.

Medical Billing Software Info provides comprehensive information about medical insurance billing software, HIPAA compliant medical billing software, easy and free medical billing software, and medical billing software prices and reviews. Medical Billing Software Info is the sister site of Medical Billing Web