What Data Should Be Transferred When Transitioning to a Medical Billing Software?

More professionals are choosing to switch to electronic health records to make their billing systems more effective. Medical billing software helps prevent accounting mistakes which makes this change a valuable investment.

Medical billing software operates using cloud-based servers. This helps eliminate the risk of data loss. Maintaining data in hard copy files is risky since they can be stolen or lost in a fire. Transitioning to medical invoicing software is the smart move. During the transition, expert coders translate all patient’s medical data into the system to initiate the billing process.

This article covers medical invoicing from start to end and all data used in the process.

Medical Billing Defined

The medical billing process entails a series of actions that hospitals and medical experts use to claim medical funds from patients and insurance payers. Medical invoicing intends to claim financial remittance for patient treatment services.

Medical accounting, aside from submitting claims, helps health organizations to remain organized. Patient data is entered into the system as codes for accurate clinical documentation. Such information helps improve accountability and shield medical centers from liability investigations if they are sued.

Some of the code sets used when transferring data into a medical invoicing software include:
·    ICD-10 Diagnosis Codes
·    Procedure Codes (CPT and HCPCS)
·    Charge Capture Codes
·    Professional or Facility Codes

There are two types of medical billing, namely institutional and professional billing.

1.    Institutional Billing

Institutional billing mostly applies to health institutions with extensive facilities. Hospitals with radiology, rehab, and laboratory facilities that support their inpatient and outpatient services opt for this type of billing.

Institutions will delegate the billing work to expert medical billers. The standard claim form for institutional billing is the UB-04 form.

2.    Professional Billing

This billing type is used by medical personnel in their individual practices. Professional billing claims are done on the CMS-1500 forms. Since they are often used on a smaller scale, the practitioner needs to know about both the billing and coding system.

Medical billing also includes additional aspects like the front- and back-end operations.

Front End 

Front-end billing signals the initiation of medical invoicing since it happens after patients register their information at the health center. 

As a requirement, patients complete pre-registration forms containing their insurance coverage and home address. The hospital’s administrative staff confirm that the plan will cover the patient’s treatment at the facility. Authorizing such a case verifies the patient’s financial responsibility and viable coverage information.

Back End

Back-end billing involves data and documentation that health providers will use to institute claims. Coders in back-end medical invoicing deal with several sets of data, including:

Provider Information

This information provides a detailed insight into the health facility and its staff attending to the patient. Such information is critical for filing and submitting claims to payers.

The data under this category include:
·    Provider name
·    Provider location
·    Signature
·    National Provider Identifier codes for all attending and referring physicians

Patient Information

Provides a detailed overview of the party receiving treatment. Patient information is for payers to check that they administer treatment to eligible members.
Some of the data here include:
·    Patient’s name
·    Patients date of birth
·    Insurance information

Visit Information

Information in this category digs deep into the patient’s condition and treatment approaches. The payer will use the information to confirm that the administered treatment is proper as per the patient’s situation.

Data under this category include:
·    Treatment dates and time
·    Diagnosis and procedure codes
·    Code modifiers
·    Authorization information
·    Items used and quantity in units

Why Opt for Billing Software in Medicine?

Medical invoicing software has become increasingly popular due to its numerous benefits. The transformation to medical invoicing software is a great investment for three main reasons.

1.    Enhanced payment options

Patients enjoy convenient payment options, which are offered with medical invoicing software. Customers that agree to customized payment plans also enjoy hassle-free automated payments.

2.    Automation

Sending reminders of bills that are past due can be done manually. Medical invoicing software automates the whole claims process, resulting in faster settlement of billing records. The claim validation process is also automatic, which reduces the chances of it being rejected.

3.    Information Accuracy and Security

Mistakes in billing can cause health organizations to run losses. Medical invoicing software help manage expenses and track claims. Patient invoices are accurate, reducing the possibility of losses.

Patient information can be lost if files are exposed to natural disasters or fires. The best remedy to tackling information security concerns is using cloud-based medical invoicing. Hospital information gets backups across different encrypted servers, guaranteeing data security.

Work With the Medical Billing Experts

Medical billing is among the key operational areas in any health organization. Incorporating technology in managing operational functions within the facility allows the expert to focus on delivering quality treatments and growing their business.

Sanjit Dhabekar

Sanjit Dhabekar is a passionate Digital Marketer and Blogger. He loves to explore new opportunities to rank websites and earn money online.

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