Is Electronic Medical Billing Software Necessary?

Electronic medical billing software is no longer optional. Filing paper claims has gone the way of the eight track tape and Doctors will not only assume you are capable of filing insurance claims electronically, but expect you to. We will explore the many different billing options and how they factor into your choice of software and medical billing clearinghouses.

Benefits of Electronic Medical Billing Software vs Paper Claims:

Faster Reimbursement:

Electronic claims filing eliminates time wasted on snail mail. Instead of the typical 45 day turnaround to receive payment, you can receive your money and an EOB (Explanation Of Benefits) in as little as 7-14 days. In addition, more insurance companies are following the lead of Medicare and trying to mandate the electronic filing of claims.

Reduced Costs:

You will eliminate postage, envelopes, CMS 1500 claim forms, printing and the labor expense associated with mailing your insurance claims.

Increased Productivity:

Push a button and your claims can be transmitted directly to your Clearinghouse. No need to stuff envelopes and you won't have to wait weeks to find out if a claim is rejected by the insurance company. By using electronic medical billing software your claims will not only get therefaster and with fewer errors, but also will usually receive priority processing. Many sources as much as a third of all paper claims are lost or rejected vs just a 2 to 3 percent rejection for claims filed electronically.

Immediate Confirmation:

Acknowledgment of successful electronic transmission assures you that the appropriate insurance companies received your claims.

Electronic Remittance Advice:

Another key benefit of electronic claims software is the electronic posting of payments. Most of the top web based billing programs give your medical biller the option to replace tasks which used to take hours posting EOB's by hand, with tasks that can now be done in a minutes electronically with participating insurance companies.

Electronic Statement Processing:

This can be a big time saver for your medical office staff; If your clearing house offers this service you simply upload your statements electronically to the clearing house who will then print the statements, fold, stuff, put them in a stamped envelope and mail them all for about same cost as your billing staff doing it themselves.

Eligibility Verification:

This is another way your business could save time and frustration if your software and clearinghouse allow you to check benefits through electronic eligibility verification. Again, when you need to verify with insurance companies about whether or not a patient will be covered for a procedure you won’t have to do it over the phone. You can do all of your insurance verification through the computer without having to sit on hold all day. An electronic medical billing software system automates this process and could save a busy medical billing practice hours each day.

The good news is that most medical billing software packages will include the ability to file your claims electronically to a clearinghouse with very little additional training.

The bad news is that many medical claims billing software programs limit or are only compatible with a few inferior/overpriced clearinghouses. An obvious option would be to choose a billing software that is compatible with a larger number of clearinghouses.

If you find yourself stuck with software which has limited electronic claims submission options then you could consider filing some of your claims direct to the insurance carrier. In many states you are allowed to file Medicare and Medicaid claims, as well as other select insurance carriers, directly for free.

While the FREE part may sound enticing, of course there is a catch. In most cases you will need to do "double entry" since the free software is typically not compatible with your billing program. You will need to enter the claims info in your medical practice software so you will be able to generate your monthly reports and follow up on unpaid insurance claims. You will also need to key much of the same information into the free direct billing product.

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