Electronic Claims Management
Ideally your clearinghouse claims reports should be integrated with your medical billing management software. This allows your software to be updated with the insurance claims acceptance or denial reports from the clearinghouse, and saves you the time and frustration of having to leave your PM software and then login to your clearinghouse website to get the status of claims sent for each patient.
Electronic Explanation of Benefits (EEOB)
Paper explanation of benefits (EOB) are going the way of the pony express. Most medical billing managers prefer to receive their EOB’s electronically. The EEOB, or what is often referred to as the Electronic Remittance Advice (ERA), is quickly becoming the standard in the industry. In fact, many insurance companies are mandating that the providers receive their payment AND EOB’s electronically.
While most Clearinghouses are able to receive ERA’s from a handful of payers, you obviously want a clearinghouse that allows you to accept ERA’s from the largest number of payers possible. You also need a seamless integration between the clearinghouse and your medical billing management software so you can have your ERA’s posted effortlessly.
Your web medical billing management software should have an integrated appointment scheduler. This will enable you to save time and provide a better customer service as you reduce the time it takes to checkout a patient: from collecting the co-payment, printing an encounter form, to scheduling their next appointment. The scheduler should be flexible and make it easy for the provider to access his or her appointments online from a PC or mobile device.
Patient Eligibility Verification
You know how important it is to check benefits before the patient comes in for the first time and at the first of the year, when most policies have at least a few changes. Unfortunately, in most busy medical practices, checking eligibility and benefits can take a back seat to seemingly more pressing issues.
This can lead to the patient being seen before coverage can be confirmed or what their copay or deductible will be. Not knowing the co-pay or deductible makes it very hard for you to collect the patients share of the bill. Ideally your software should have the capability to check benefits online, automatically, based on the capability of the payer.
Patient Billing & Collections
Your ultimate goal for patient billing is not to have any. This can only be accomplished if you always collect what the patient is responsible for at the time of the visit. Having web based medical billing software that allows you to automatically check benefits via the web, is a key first step. With the cost of healthcare premiums continuing to rise each year, the majority of patients have found it necessary to choose plans that have higher co-pays or deductibles in order to try to keep their premiums affordable.
This has caused the “patient’s responsibility” portion of the bill to increase each year, making the patient billing process even more important. You need to make it as easy as possible for the patient to know what their responsibility will be and to be able to pay promptly.
Make sure you choose a medical billing software that helps facilitate a smooth collection process, with easy to understand patient statements, and the ability to pay by debit or credit card in person or online.
Reporting Capabilities and A/R Management
You should expect comprehensive standard reports along with the ability to customize the reports to meet the the unique needs of your practice. Providers and their management team should be able to access their practice data 24/7. Having access to the right reports is critical to keeping a tight rein on the accounts receivables and to give the healthcare provider a clear picture of the overall financial health of the practice.