Electronic medical records (EMR) contain all the necessary information on patients created at one clinic. This could include allergies, immunizations, medical histories, previous diagnoses, and so on, helping providers know patient conditions better. Moreover, the provider can also make notes to the EMR during consultations about the patient’s condition. This is later used to code the doctor-patient encounter and bill for services rendered. The number of EMR applications in medical billing is numerous, and such a platform optimizes the overall functioning of a medical center.
EMR or EHR systems integrated with broader health information systems make it easy to exchange necessary data securely. This streamlines everything in the billing and financial management activities to boost productivity.
Important Benefits of EMR in Medical Billing
Although investing in EMR applications and their subsequent integration might seem expensive, it will pay off in the long run. Numerous studies, surveys, and research have concluded that providers are better off having a medical records solution than not. Let’s look at some major benefits of EHR applications in medical billing.
1. Higher Rate Of Reimbursements
Reimbursements from payers form the bulk of the revenues that individual providers and larger hospitals receive. Denials or rejections from insurance companies could result in expensive delays or even lost payments. However, an EHR integrated with electronic medical billing software lowers the chances of denials.
After a patient’s clinical visit, coding it and generating claims is an important step in the entire medical billing process. Thanks to the adoption of automated healthcare solutions, EMR applications have features for coding faster based on the data in the medical records. This data from medical records is directly transferred to billing software, thereby increasing the coding process’s speed and minimizing the chances of errors. These could include missing patient details, invalid entries, etc.
Errors in coding are some of the biggest reasons for claim denials and rejections. Reduction in denials ultimately leads to more reimbursements and better medical billing management.
2. Streamlined Administration For Providers
EMR applications in medical billing stem from integrating EMR systems with medical billing solutions. This provides a single system for providers and front-office staff to use and facilitates seamless data exchange. Moreover, a broad, integrated health information system that connects medical records with billing, lab testing, and radiology platforms ensures that all departments can access the necessary data faster and work better.
For providers with private practices, an EHR integration means they can see patients and carry out billing activities without hassle through one interface.
3. Streamlined Billing For Admitted Patients
Admitted patients often need extended or intensive care and would often undergo several tests, scans, and treatments. This could go on anywhere from a few days to even more than a week. The providers can enter their treatments and medications into their medical records. This information is important during their discharge while preparing the summary and generating the claims.
The billing staff can retrieve the necessary data about the treatment from the medical records with a few clicks and prepare claims faster. An EMR integrated with the billing platform optimizes the entire revenue cycle management operations for large hospitals with many patients admitted. In other words, this makes billing fast and error-free.
Medical billing systems working with medical records software facilitate transparency in billing operations. Since the entire system is integrated and comprises of EMRs and other medical platforms, auditing is easier, faster, and automated to a large extent. This enables providers and healthcare centers to comply with regulations better and ensures complete transparency of operations. Ease of compliance is one of the most attractive EMR applications in medical billing for providers nationwide.
Important Features Of EHR Medical Billing Software System
An integrated healthcare software system comprising health records and medical billing applications streamlines revenue management. When providers do decide to invest in such a system, there are certain features that they need to look out for –
1. Document Management
Documents like bills and financial statements are vital for efficiently managing healthcare organizations. The larger the hospital, the greater the volume of such documents generated daily. So, one of the most important EMR applications in medical billing is a feature for document management.
Document archiving and management not only make it easy for revenue cycle management but also help with compliance. Viewing outstanding bills, analyzing operations, and processing payments are made easier with this feature.
2. Medical Coding
Coding is the cornerstone of the overall electronic medical billing process. So, an integrated medical billing software consisting of a medical records solution also includes features for coding. Each code indicates a service rendered, which is then used for preparing claims to be sent to insurance payers.
This feature makes it easy to carry out medical coding since everything is electronic. So, a clinical staffer can code a patient’s encounter with a few clicks instead of doing it manually. As a result, there is minimal chance of errors, lowering the chances of claim denials.
3. Claims Management
Providers earn reimbursements by claims sent over to payers. This forms a major portion of all revenues earned by healthcare providers. An EHR medical billing platform with a claims management feature helps providers generate claims from the data retrieved from the EMR. Not only does this feature automate most parts of claim generation, but in some EHRs, it also scrubs them. Claims scrubbing is nothing but checking the claims for errors. An error-free claim will fetch reimbursements faster.
The claims process flow also involves claim submission and tracking, highlighting no-response claims for detecting unpaid or underpaid bills. By streamlining and automating all or most activities surrounding claims, an integrated EHR medical billing solution improves revenue cycles.
Whether an EMR or billing software, interoperability enables them to work together seamlessly and exchange data. The billing staff can retrieve patients’ information from the EMR to prepare the codes and claims. The EMR, in turn, has all the information about the clinical encounter, like the tests and scans taken, along with other services rendered. So, when such an EMR is integrated with all other platforms, the necessary information for billing is easily accessible, along with patients’ health plans and payment history.
The benefits of interoperability extend to private practices too. EHRs integrated with practice management and telehealth solutions enable these providers to carry out billing for their services, in-person and virtual.
The healthcare industry in the United States is set to undergo major changes this decade. Increasing costs and inequities in accessibility are major issues plaguing providers and policymakers. Telehealth and IoT-enabled remote patient monitoring solutions are likely to revolutionize patient care. Whatever the changes might be, medical records software will continue to play major roles in these changes, further increasing the importance of EMR applications in medical billing.
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Written by Riken Shah linkedin
Riken's work motto is to help healthcare providers use technological advancements to make healthcare easily accessible to all stakeholders, from providers to patients. Under his leadership and guidance, OSP Labs has successfully developed over 600 customized software solutions for 200+ healthcare clients across continents.