complete guide to medical billing and coding software

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Page 2: Complete Guide to Medical Billing and Coding Software

TOTAL INTEGRATION & PRECISE REVENUE CYCLE MANAGEMENT

The patient's eligibility is checked Their chart is created with insurance verified information Their schedule is set, assigned to a provider and has a custom appointment type for

easy tracking An ONC Certified medical billing software populates the appointment The provider completes the visit and documentation Completed note populates as a claim Claim populates the information from the eligibility check, from documentation, and

from a built in custom fee schedule Biller and coder then have an easier and faster experience in scrubbing the claim

using integrated scrubbing tools Claim is submitted via a built-in clearinghouse component Any follow ups are tracked in real-time within the software The claim is accepted and returned directly through the software in an on-board

ERA dashboard for posting.

Page 5: Complete Guide to Medical Billing and Coding Software

TIME-STAMPED INTERNAL NOTATIONS & COMPLIANCE/PRE-SCRUBBING TOOLS Even with the best possible systems and software in place, payers will

find a way to delay or deny claims.  When this happens, it is imperative that billers have a tracking utility built into the same system that a claim was processed through.

Each individual claim should have an area for time-stamped notations, filed by username, to properly identify who is working a claim, the status of the claim, any follow ups or reference numbers for calls with payers, etc.  This makes tracking claim submission and resubmits easy and increases reimbursement.  The power of payers is in the complexity of the process – simplifying this gives the power back to the biller.

Medical billing software should also include tools for pre-scrubbing claims prior to submission.  Using algorithms to find coding discrepancies, missing modifiers, or missing diagnosis pointers will increase first pass rates (ratio of claims being accepted and paid on their first submission) dramatically.

Page 6: Complete Guide to Medical Billing and Coding Software

AUTOMATED MODIFIER RULES AND FEE SCHEDULES

An important automation trigger that, surprisingly, is yet to become standard in billing and coding software, Modifier Rules and Fee Schedules are time-consuming aspects of billing. These should easily be set up during the implementation phase of a new software, then easily left to work in the background.

Clinicians aren't billers or coders, and when documentation is finished and populates to billing software as a claim, modifiers should automatically populate based upon pre-programmed rules that billing staff decides upon.

This same methodology should be applied to fee schedules.  Since various insurance companies pay out different amounts per code, patients assigned to a specific payer should have the payer-based fee schedule automatically populate for all of their claims without the billing and coding specialist ever having to lift a finger.

Page 7: Complete Guide to Medical Billing and Coding Software

CONCLUSION... AND YOUR NEXT STEP When the time comes to compare medical billing software

solutions, always remember the key components any medical billing and coding software needs have. 

Billing medical claims is complex, and there are countless ways for insurance companies to deny clinics money they are rightfully owed.

For more information on how In Touch EMR can simplify your scheduling, documentation, and billing, schedule a demo with us today.

In Touch Biller Pro is a medical billing and coding software with unlimited support via phone, email and live chat, along with a 60 day money back guarantee.

Click here to schedule a free 'strategy' call with the experts at In Touch Biller Pro, or call (800)-421-8442 to learn more.

To watch a quick 10 minute overview of In Touch Biller Pro, watch this video :https://www.youtube.com/watch?v=jlfddFkNxwo