Many healthcare facilities struggle to maintain a sustainable business model. According to Deloitte, “traditional revenue sources are under pressure as the aging of the US population and lower reimbursement from government payers put pressure on health systems.”
In the United States, healthcare providers, government agencies, and health insurance spend close to $360 billion annually on overhead. The time spent on billing accounts for a considerable chunk of those expenses.
The goals of moving toward paperless medical billing include cost reduction, more efficiency, and happier patients. Many hospitals and clinics, however, have been slow to adopt viable alternatives to electronic billing. It’s possible that these groups are putting themselves in danger. Businesses that adopt digital skills, such as electronic medical billing, may have an advantage in today’s market, says McKinsey & Company.
In order to speed up the revenue cycle, increase patient payments and provider revenue, decrease expenses, and promote patient happiness, third-party medical billing businesses are using electronic medical billing alongside hospitals, health systems, and physicians’ offices.
Electronic medical billing: What is it?
A healthcare practitioner or third-party billing organization may submit an electronic medical bill or claim to a patient or third-party payer. (typically an insurance company).
After a patient visit is over, the doctor will record the visit using diagnostic and procedure codes. Insurance companies can use these codes to better assess claims and coverage. Electronic ANSI 837 files are used to submit healthcare claims to insurance companies, as required by HIPAA (Health Insurance Portability and Accountability Act of 1996).
Adjusters for medical claims review petitions for payment and get a certain amount per procedure if the petition is approved. Claims that are refused are sent back to doctors for further information or clarification.
Direct billing, or electronic medical billing, refers to the practice of sending bills to patients without going via insurance companies. Medical practices can complement or replace their paper billing process with electronic medical billing, mobile billing, or digital billing to expedite payments and save costs.
Comparative Benefits of Paper Billing
Lower expenses and shorter revenue cycle durations between patient care and payment are the most often claimed advantages of using electronic medical billing. Electronic medical billing can have extra positive implications for a practice when integrated with electronic medical records and other digital activities.
Cost savings and expedited refunds
It’s possible that healthcare organizations’ bottom lines may strengthen after adopting electronic medical billing. Economist David Cutler from Harvard University has calculated that transitioning to electronic billing may save the US healthcare system $32 billion per year.
Providers stand to gain in a number of ways if their customers decide to switch.
A More Valuable Assortment
In an era where patients are increasingly connected digitally via tablets and smartphones, many medical professionals think manual, paper-based billing is becoming less relevant and efficient. The revenue cycle can be greatly improved by transitioning to electronic medical billing. This medical billing service, which helps more than 400 doctors in Tennessee, saw a 43 percent increase in customer payments after switching to electronic billing.
Administrative Expense Reduction
Switching to electronic billing reduces costs associated with paper bills, filing cabinets, and postage. The office staff no longer has to spend time printing and mailing paper bills and reminders for patients to follow up.
Helps Doctors and Nurses Get More Done
By eliminating the need for paper invoices, electronic billing frees medical professionals to concentrate on patient care.
Efficiencies in operations and administration
Implementing electronic medical billing as part of broader mobile-first initiatives can help medical practices save time and money by streamlining administrative processes and gaining other operational advantages:
Compatibility with existing medical billing and practice management platforms
Electronic billing events instantly update the patient’s electronic medical record, which reduces the need for manual data entry and results in a more complete profile for the patient.
Improved safety, backup, and storage
Billing documents kept manually must be safeguarded against loss, damage, or destruction due to the inevitable risks associated with keeping paper records. (e.g., fires and floods). Digital files may be safely archived and backed up both locally and remotely.
More Comprehensive Documentation
Electronic billing allows business administrators to integrate billing information with existing accounting systems and provide individualized reports.
Improve Coding Accuracy
Access to patient information from EMR billing systems might help doctors submit more accurate insurance claims. This data transmission eliminates human errors such as incorrect code entry and re-entering expenses from billing sheets.
Satisfaction among patients has risen.
Even though nobody likes getting a medical bill, patients now expect to pay some of their care out of pocket. Patients anticipate this procedure to be digital and mobile, thus the fact that it is available online might boost their experience and pleasure.
With electronic billing, doctors and patients may exchange proactive communications and bills can be seen on any device. Due to the ubiquity of electronic billing systems, customers often simply need to click once to make a payment.
Seventy percent of patients claimed they don’t understand their medical bills, and 72 percent said they don’t understand their benefit explanations. By clicking on a link sent to them through text message or email, patients who are enrolled in electronic medical billing may learn more about their bills and payment options, enroll in payment plans, and submit payments.
Increased Brand Awareness
Healthcare facilities that facilitate more digital interactions (such as electronic billing) are viewed as more efficient and “modern,” especially among younger patients. Maintaining this image is crucial for attracting and retaining new patients.
Implementing Electronic Medical Billing: How To
When implementing an electronic medical billing solution, a medical practice may feel a range of repercussions. In the healthcare industry, there are a number of critical processes that must be considered simultaneously. Careful planning, resource allocation, and phase-by-phase monitoring will allow for an efficient rollout of electronic medical billing.
Controlling a Project
It is important to have a well-thought-out plan and timeline in place before beginning the transition to electronic medical billing. The plan must include the following elements:
Goal-setting and required outcomes establishment
Project primes and key players, such as the project manager, lead super-user (in-house specialist), and lead doctor, must be identified.
Construction of a timetable and identification of project dependencies
It is important to record and analyze current billing workflows to ensure that no steps are missed during the transition. Knowing current workflows is crucial for designing, testing, and modifying new procedures to support electronic medical billing.
Making a plan for financial support and sticking to it
It is important to anticipate and account for all of the project’s costs before presenting the plan to the business’s stakeholders. The project budget will need to be adjusted and updated on a regular basis.
Organizational Messages and Morale
Employee buy-in is crucial to the project’s success. Having a formal beginning and then regular updates will keep the whole crew interested and engaged. By using a role-based training approach, everyone involved will have a deeper comprehension of the new processes and their specific responsibilities.
Selecting and Judging a Provider
There are several steps involved in selecting a vendor, such as:
- Discussing it with other medical professionals
- Checking out potential suppliers
- In need of advice
- Negotiations of a Contract
- Developing and implementing a project strategy with the selected provider.
When approaching a market, be sure to get references and case studies. Vendors that have established long-term relationships with their clientele and who were early adopters of patient-centered outreach are more likely to have access to cutting-edge technology that can meet these needs and to be in tune with patients’ wants and desires.
Implementing the Plan
The solution implementation plan and a list of all necessary activities, such as those listed below, will be developed with the help of the selected vendors.
- Patient records from the previous billing system are being gathered and transferred.
- Checking the processes for accuracy and tweaking them if required
- Evaluating the system and instructing end users on its use
- Population-based testing.
- Going live and switching over the system
- Establishing Safe Practices
Protecting sensitive patient information requires documenting and adhering to stringent processes:
- Compliance with HIPAA regulations
- The development of safety policies and practices
- Planning for emergency situations
- Formulating a response strategy in the event of a data leak
Once the electronic billing system is live, it is critical to evaluate results against established benchmarks. Involving relevant parties is also essential. Are there problems that people using the system face? Has there been an uptick in business metrics (such practice income or collections)? How well does this solution work with other existing systems?
The billing system may be improved and optimized with the help of regular performance assessments.
Do you think electronic medical billing will alter the way you treat patients?
New medical discoveries, evolving patient expectations, and cost constraints are driving rapid change in the healthcare system. Technology in the form of the Internet “has the potential to transform medicine and the healthcare industry in a sustainable way,” as stated by Deloitte.
Electronic billing is an integral part of this development. When combined with digital patient data, electronic medical billing has the potential to improve a healthcare provider’s bottom line while also improving patient satisfaction.
The many benefits of electronic medical billing may be realized by healthcare providers that have not yet made the changeover if they plan and implement the transition with care.
Emma, the founder of The Info Book, started with a passion for Sports Blogging in 2013. He has continued his passion for Blogging and desire to improve his skills and wanted to share his journey and helpful knowledge with other like-minded individuals.
He launched The Info Book as an outlet for those interested in learning more about Sports in hopes they can take what they learn and apply it for themselves!