Medical billing solutions are customized medical billing systems that automate the complete billing workflow from appointment scheduling to claims submission to payer companies. The success of medical billing management lies in the speed, accuracy, and efficiency of capturing charge entry, timely payment posting, AR management, and smart revenue optimization. The current concept of patient billing in the US is fragmented, with multiple workflows, lack of needful healthcare integrations, and seamless interoperability to break the data silos. Customized healthcare billing solutions help medical practices and hospitals to automate their billing process by replacing the time-consuming and paper-based medical billing solutions with automated medical billing and coding.
We understand that healthcare providers want to focus more on care delivery than tracking and sorting their billing process. Healthcare regulations and guidelines keep changing constantly, making medical billing management challenging for physicians. We understand your billing challenges and build tailored medical billing solutions that can take care of verifying patient insurance status, automate medical coding, and submitting claims for reimbursement from insurance companies. We strive to build scalable medical billing solutions to help reduce the administrative workload for physicians by automating invoicing, medical coding, and claims-processing.
The common bottlenecks which might slow down your business growth
Fragmented medical billing workflow slowing down the overall process with billing errors and claim denials.
Traditional and outdated medical billing systems with slow and time-consuming revenue cycle management.
Inability to integrate and share data among the required healthcare systems like EHR and claims management.
Provide episode-based payments for risk-based care delivery for Medicare & commercial insurers
Manual methods of billing causing multiple CPT code billing errors, increasing the claims rejections and denials.
Inability to manage patient claims data securely and under a HIPAA compliant billing system.
Facilitate the automation of medical billing management to capture more revenue and simply the medical billing process
Medical billing management requires a non-fragmented workflow. Workflow management requires multiple medical billing process tasks that move from one step to the next until the task is complete. Some of these billing tasks include the processes of patient’s insurance eligibility verification, pre-authorization, appointment scheduling, medical coding to ensure accuracy with the right ICD 10 codes, validation, and explanation of benefits posting, and more. Every care facility and hospital management system have their own set of billing rules that requires stringent management. OSP can learn about your current traditional billing system and its rules to bring healthcare automation through a billing and claims rule engine. We work to build custom-made medical billing solutions that simplify detailed data entry, complete charge capture, and the continual discovery and elimination of medical billing errors while boosting the speed and accuracy of medical billing solutions.
Automated appointment scheduling and tracking is one of the essential features of comprehensive and efficient medical billing solutions. Manual appointment scheduling is time-consuming and a process of hassle. A patient scheduling solution can save your time and take the hassle out of the task by automatically scheduling and tracking the patient appointments. Making appointment scheduling as a part of medical billing solutions, patient pre-registration is made simple.
We can build medical billing solutions as a healthcare cloud solution based on your requirements. Scheduling patients without verifying insurance eligibility can be hazardous to a clinic’s cash flow. Also, calling insurance companies to check a patient’s insurance eligibility is a resourceful task. We can build tailored appointment scheduling systems that can help automate insurance eligibility verification while setting up the encounter forms for procedure and diagnosis. You can also add scheduling rules based on physicians’ availability to make your medical billing management more efficient.
Medical billing and coding are a standard method through which standard ICD 10 codes are established to categorize patient information records and dictate medical billing towards the insurance companies. According to the CMS (Center for Medicare and Medicaid Services), medical coding errors have caused around $16.73 billion in improper payments in FY2019. Medical coding, if done manually, is a highly complex process and requires a workforce. Still, medical coding errors can break the cash flow and revenue management of a clinical facility or hospital.
OSP has experience building medical coding automation solutions that can add pre-defined ICD 10 codes to appropriate treatment procedures removing the chance for error and further denial of a claim. We can build tailored medical billing solutions that can help avoid billing inaccuracies and costly mistakes. These medical billing systems can identify and validate the right CPT codes and bring 100% accuracy in your claims for better case management.
Integrating EHR to the medical billing systems solves multiple challenges the providers face while maintaining their medical billing services’ optimum quality. Integrating the healthcare billing solutions with EHR reduces the risk of human error, leading to non-uniform data. Instead of being complicated and time-consuming, such patient billing can navigate and exchange data from your EHR system and vice versa. These billing systems can become interoperable and remain under one management system.
Medical claims management can be simplified with robust integrations to HIPAA compliant medical billing systems. EHR integration not only brings all the processes to a single platform but also helps to maintain the much-needed transparency in medical billing service. The medical billing solutions with EHR integration can eliminate the lost superbills and electronically generate superbills and then bill the insurance carriers. With an integrated EHR, healthcare providers are no longer required to devote their time and effort to fill out forms and process medical claims. The reduced billing workload gives the healthcare staff more time to focus on providing quality patient care.
Revenue optimization is the crucial goal of the RCM system. We build customized medical billing solutions that strive to maximize your clinical facility and hospital’s revenue optimization. Automated charge capture, timely payment posting, revolving credit balances in AR, seamless AR management, avoiding payment duplications, online statements, and payment plans can be incorporated while customizing medical coding solutions.
Medical billing companies determine what patients owe and what expenses the insurance companies cover. They process billing and send invoices to patients and insurance agencies, Medicare, and Medicaid to ensure they pay their respective expenses. The healthcare payment systems can be streamlined for revenue optimization and collection of payments through multiple digital payment modes, even e-Wallets. We can tailor medical billing solutions with a wide variety of functionalities like patient statements, bill generation, bill recording, billing rules engine, denial management, electronic superbill, payment reminders, and batch payments.
Medical claims management is the central process in a medical billing system. Healthcare claims management requires medical billing and coding, filing, updating, and processing medical claims. These medical claims are relatteed to patient diagnosis, medical treatments, and medications. Maintaining patients’ medical records, interacting with health insurance companies, and issues invoices for the rendered medical treatment is time-consuming and complicated.
OSP can engineer medical billing and coding solutions that can simplify the electronic claims processing and paperless claims collections. We understand the tour needs in detail and build medical billing solutions to streamline the medical billing process and prevent communications from being lost in the mail. We can build comprehensive medical billing management for you by adding insurance payment listing, electronic claims processing, claims scrubbing, claims tracking, managing claims history, claims reconciliations, and electronic remittance advice and alerts.
The goal of a healthcare claim management organization in California is to replace paper-based claims processing with an advanced automated billing & claims management system. The system required to be used across a broad-spectrum including doctors, nurse practitioners, and payers to manage the dental patient.
The challenge was to bring various individuals involved in the dental claim management process from a community center, dental health providers, medical coder & biller to payer and government under the same roof.
A US-based clearinghouse, managing millions of claims amounts every day, wanted to go paperless with an automated claim management software solution. They had a billing system connected to VersaForm practice management system that helps them to manage billing and claim data.
The need of the hour is to replace existing Microsoft Access based application with a web-based system hosted on the cloud server that can be accessed from anywhere, anytime.
The solution comes with-
A web-based software system that uses Versaform integration to support multi-specialty EHR for easy billing management for our client.
A solution that helps to manage the billing process and connects multiple provider EHR & Payer systems.
HIPAA-guided EDI solution that offers system connectivity and quick electronic data exchange to reduce claim denied ratio.
With claim audits, remittance and secondary claim processes, the system proves to be an end-to-end software solution.
A Texas-based mental health center wanted to reinvent the medical billing process and enhance approval rates which were 10% against 100 claims submitted.
It was challenging to manage multiple insurance providers for a large clinic set up for a health specialty that needs flexibility in billing, workflow automation, accurate claim scrubbing, and fill regulatory compliance gap.
The solution comes with-
A US-based client wanted a solution to get medical claim status for faster reimbursements and efficient analysis. The need was to replace manual paper-based claim data management system to a single and shared interface to track the rejected claims and documents automatically.
OSP offered an advanced application to manage the patient’s claim information in real time while maintaining the HIPAA compliance backed by AWS cloud hosting.
The solution comes with-
Specialty billing is complex, and we are experienced in managing specialty billing for multiple healthcare sub-industries. We can customize medical billing solutions for Medicaid Billing, Medicare billing, and mental health billing. We have closely worked with many care provider facilities to build healthcare billing solutions to cater to dental billing, hospital billing, hospice billing, and pharmacy billing. Our medical billing solutions can improve your revenue management efficiency multifold.
Payment posting in medical billing involves logging the payment into the clinic's practice management system or medical billing solutions. The payments instead of claims received from the payer and patients are posted in the client's medical billing solutions to reconcile the claim. A medical billing system can easily manage EOB management (explanation of benefits) or ERA (electronic remittance advice) towards a claim's payment. Payment postings on time help in revenue cycle optimization and better AR management.
Medical document management for a billing system is an incredibly important feature for medical practices. Practices can store documents, patient records, images, and lab information in the same digital files as patient information and payment history. They can access those documents any time, anywhere, and back them up to prevent data loss. Users save space, save time for finding important documents, and reduce overall confusion when consolidating into an electronic document management system.
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