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The benefits of an integrated medical billing system

August 24, 2016

Traditionally, billing has been a frustrating reality of the clinical experience. While it can be time consuming and tedious, it’s also a vital part of continued successful operations, as the financial health of an institution is largely dependent on translating patient visits into actual reimbursements. Navigating complicated insurance guidelines, understanding best practices for collection and parsing data to find opportunities for improvement are skills that are orthogonal to treating patients but no less important for any healthcare organization that wishes to remain in business.

For this reason, providers are constantly looking to streamline and improve medical billing processes. One method for doing so is pursuing an integrated EMR and billing system, a change that comes with numerous benefits.

Improved efficiency
Entering data by hand is a tedious and time consuming process. Integrated EMR and billing systems cut this work in half by requiring a user only to input data and demographic data in one place. Once the patient data is uploaded, it can seamlessly be transferred between systems, saving administration time and improving efficiency. For clinics that use outside billing services, integrated software reduces the number of faxes that need to be sent, saving both time and paper.

Higher reimbursement
An integrated medical billing system can save money in a variety of areas. They use less paper, which cuts that expense and some of the time needed to monitor it. Also, the reduced administrative workload can cut staffing costs, which opens up more funding for patient care.

One of the hidden values, however, is the benefits these systems can have on reimbursement. Incorrect data entry can lead to reimbursements that are lower than they should be, whether that be the ICD-10 code or the background data for the patient. Keeping up to date with changes in billing conventions can be difficult, and that knowledge isn’t easily transferred between physicians. With an integrated medical billing system, however, it is much easier to take advantage of every avenue possible to make sure that a practice is fully reimbursed for the work performed.

Fewer errors
With human entry comes human errors. Even the most conscientious employees are not above making the occasional input mistake, which often wind up costing a practice money. This is especially true if every member on the staff is stretched thin by mounting administrative tasks.

Automating processes ensures they are done correctly, every time, and open up resources that can be devoted to those things that can’t be automated – such as talking to patients and providing top-notch care. Christina LaMontagne, writing for Forbes, noted the prevalence of billing mistakes:

“The complex world of medical billing is ripe for errors. As many as 250 people — from the nurse to the medical coder — could be involved in generating just one bill. With all of those hands touching the bill that will ultimately end up in your mailbox, it’s no wonder some experts estimate as many as 80% contain mistakes.”

Better reporting
Linking billing and documentation opens up new avenues of reporting. With access to more information, hospitalists can determine which procedures are losing money consistently, and make strides towards closing any financial gaps. If patients are canceling consistently on a particular day or doctor, and the clinic is taking the monetary hit, that data will be evident via the system. When all the processes are integrated, it becomes much simpler to make inferences from one side to another. Should the clinic be open longer? What is the best way to reach out to patients? Which doctors are consistently billing higher than average, and how do they do it? These are the sort of questions for which accurately parsing clinical data can suggest answers for.

More thorough documentation
Claims forms, particularly when it comes to things like workman’s compensation, requires a thorough chain of documentation. This usually has to be hunted down by an administrator, which takes time. With an integrated system, it is much quicker and easier to find any relevant documents, make copies and send to all of the necessary parties. Both the physician and the billing clerk have access to the same information, so there are fewer disagreements over the best course of action.

The more time and resources a practice devotes to inefficient medical billing processes, the less it has left to provide for patients. Any healthcare organization that has to manage reimbursements or payments would be well-served by considering an integrated system.

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