Medical billing management requires a non-fragmented workflow. Workflow management requires multiple medical billing process tasks that move from one step to the next until the task is complete. Some of these billing tasks include the processes of patient’s insurance eligibility verification, pre-authorization, appointment scheduling, medical coding to ensure accuracy with the right ICD 10 codes, validation, and explanation of benefits posting, and more. Every care facility and hospital management system have their own set of billing rules that requires stringent management. OSP can learn about your current traditional billing system and its rules to bring healthcare automation through a billing and claims rule engine. We work to build custom-made medical billing solutions that simplify detailed data entry, complete charge capture, and the continual discovery and elimination of medical billing errors while boosting the speed and accuracy of medical billing solutions.
Automated appointment scheduling and tracking is one of the essential features of comprehensive and efficient medical billing solutions. Manual appointment scheduling is time-consuming and a process of hassle. A patient scheduling solution can save your time and take the hassle out of the task by automatically scheduling and tracking the patient appointments. Making appointment scheduling as a part of medical billing solutions, patient pre-registration is made simple.
We can build medical billing solutions as a healthcare cloud solution based on your requirements. Scheduling patients without verifying insurance eligibility can be hazardous to a clinic’s cash flow. Also, calling insurance companies to check a patient’s insurance eligibility is a resourceful task. We can build tailored appointment scheduling systems that can help automate insurance eligibility verification while setting up the encounter forms for procedure and diagnosis. You can also add scheduling rules based on physicians’ availability to make your medical billing management more efficient.
Medical billing and coding are a standard method through which standard ICD 10 codes are established to categorize patient information records and dictate medical billing towards the insurance companies. According to the CMS (Center for Medicare and Medicaid Services), medical coding errors have caused around $16.73 billion in improper payments in FY2019. Medical coding, if done manually, is a highly complex process and requires a workforce. Still, medical coding errors can break the cash flow and revenue management of a clinical facility or hospital.
OSP has experience building medical coding automation solutions that can add pre-defined ICD 10 codes to appropriate treatment procedures removing the chance for error and further denial of a claim. We can build tailored medical billing solutions that can help avoid billing inaccuracies and costly mistakes. These medical billing systems can identify and validate the right CPT codes and bring 100% accuracy in your claims for better case management.
Integrating EHR to the medical billing systems solves multiple challenges the providers face while maintaining their medical billing services’ optimum quality. Integrating the healthcare billing solutions with EHR reduces the risk of human error, leading to non-uniform data. Instead of being complicated and time-consuming, such patient billing can navigate and exchange data from your EHR system and vice versa. These billing systems can become interoperable and remain under one management system.
Medical claims management can be simplified with robust integrations to HIPAA compliant medical billing systems. EHR integration not only brings all the processes to a single platform but also helps to maintain the much-needed transparency in medical billing service. The medical billing solutions with EHR integration can eliminate the lost superbills and electronically generate superbills and then bill the insurance carriers. With an integrated EHR, healthcare providers are no longer required to devote their time and effort to fill out forms and process medical claims. The reduced billing workload gives the healthcare staff more time to focus on providing quality patient care.
Revenue optimization is the crucial goal of the RCM system. We build customized medical billing solutions that strive to maximize your clinical facility and hospital’s revenue optimization. Automated charge capture, timely payment posting, revolving credit balances in AR, seamless AR management, avoiding payment duplications, online statements, and payment plans can be incorporated while customizing medical coding solutions.
Medical billing companies determine what patients owe and what expenses the insurance companies cover. They process billing and send invoices to patients and insurance agencies, Medicare, and Medicaid to ensure they pay their respective expenses. The healthcare payment systems can be streamlined for revenue optimization and collection of payments through multiple digital payment modes, even e-Wallets. We can tailor medical billing solutions with a wide variety of functionalities like patient statements, bill generation, bill recording, billing rules engine, denial management, electronic superbill, payment reminders, and batch payments.
Medical claims management is the central process in a medical billing system. Healthcare claims management requires medical billing and coding, filing, updating, and processing medical claims. These medical claims are relatteed to patient diagnosis, medical treatments, and medications. Maintaining patients’ medical records, interacting with health insurance companies, and issues invoices for the rendered medical treatment is time-consuming and complicated.
OSP can engineer medical billing and coding solutions that can simplify the electronic claims processing and paperless claims collections. We understand the tour needs in detail and build medical billing solutions to streamline the medical billing process and prevent communications from being lost in the mail. We can build comprehensive medical billing management for you by adding insurance payment listing, electronic claims processing, claims scrubbing, claims tracking, managing claims history, claims reconciliations, and electronic remittance advice and alerts.
Medical billing is when healthcare organizations or providers submit claims to insurance companies to receive payment for the medical services rendered to the patients. These claims are generated by translating medical services, such as consultation, diagnosis, prescriptions, tests, etc., into universal alphanumeric codes that insurance companies can process. Following the claims submission, the insurers reimburse the providers for the services.
Patient payment in healthcare is when patients make payments that must be accounted for against the claim submitted. This is to prevent any discrepancies in the accounts receivables and to ensure proper settlement of the claim. The patients typically pay through credit cards, with some doing so with checks.
The use of a digital platform for medical billing has many advantages. Some of them include the following –
Billing at hospitals is how hospitals obtain payment for the medical services provided to patients. The majority of income for hospitals is in the form of reimbursements from payers, while out-of-pocket costs also contribute to hospital revenues. Generating claims to be submitted to the payers makes up for most of the billing workflows at hospitals, clinics, and even small practices.
Healthcare billing software is a digital platform for all the operations involved in medical billing. This includes translating the services into standardized codes, filling out claims, submitting the claims to payers, tracking the same, and processing payments. Moreover, a billing solution also provides consolidated oversight of all the billing operations.
An automated solution for medical billing eliminates the need for human staff to engage in manual, repetitive activities. This increases the speed of the activities and minimizes errors by limiting human intervention. Additionally, automation also results in a relatively more minor staff being able to do more work. To sum it up, automated software maximizes billing operations’ speed, productivity, and efficiency while lowering overhead.
The process of medical billing consists of the following steps –
The benefits of a medical billing solution are –
Medical billing software is an application or platform for all the activities involved in medical billing. In other words, activities like insurance verification, patient registration, medical transcription, coding, claims, and payment processing can all be carried out using medical billing software. It digitizes all the manual, paper-based processes.
The process of medical billing is as follows –