The Most Important Thing to Look for in Your Medical Billing Software

Adaptability is the most important factor in medical billing software.

Regardless of your specialty in the medical field, you need medical billing software that gets the job done right, the first time, so that you can focus on doing what you do best: taking care of your patients. Whether you use your own employees to handle billing and accounts receivable or outsource the job, the software employed can make all the difference between insurance companies accepting and paying claims the first time through and weeks or months of wrangling over the bill.

Medical billing is no easy matter. Regulations change constantly, and everyone knows that one insurance company may not pay for the same procedures as the next. Nationally, only about 70% of medical claims are accepted by insurance companies on the first billing cycle. There are many reasons why a claim may come back denied (and need to be resubmitted) but the two main reasons are human clerical errors during data entry and billing software which is not up to date.

Of course, there's only so much to be done about human error. Regardless of what medical billing software you use, you are going to have the occasional human error, which will result in delays in the billing process. That's inevitable. Your system is only as good as the data which is entered into it.

With that being said, though, there is a great deal which can be done about your medical billing software. By keeping your application updated and current, you can significantly increase your percentage of medical claims accepted on the first pass. Some billing software companies boast acceptance rates as high as 99% on the first pass.

The Secret To Medical Billing Success

So, how do they do it? There are many ways you can keep your software up to date, but they are not all created equal. You can, of course, simply purchase new software whenever significant changes take place in the medical billing process. Of course, with the rapidly changing landscape of healthcare billing, that means you need to have your whole system updated every time the government changes regulations, insurance companies change their acceptance policies, or any other relevant changes take place.

Regardless of where you stand on the political issues surrounding the whole health care industry, there's no denying that the changes will eventually mean a major overhaul in medical billing practices. Chances are, this will mean that your system of choice will need to update even more frequently.

One way many medical billing professionals have overcome this hurdle is by purchasing software as a service rights (sometimes called SaaS). Service providers upgrade the medical billing software regularly, sparing medical professionals the need to purchase new equipment or software. Additionally, using SaaS for the billing systems enables medical professionals to pay as they go. Their costs are generally directly tied to the number of clients involved.

Regardless of how you choose to upgrade your applications, however, make sure that you do so regularly. As in any business, receiving prompt payment for services rendered provides the cash flow you need to operate your practice at an optimum level. And ultimately, the smoother the billing end of your practice works, the better for you, your employees, and your patients. Knowing that having up to date medical billing software can make the difference between 70% acceptance and 99% acceptance of claims on the first pass should be plenty to motivate you to make sure that it is upgraded on a regular basis.

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