How to Find the Right Billing Solution for your Healthcare Practice

Written by teamlogik
13 Aug, 2020

Billing is crucial to the longevity and financial health of any medical practice. When organizations do not streamline their billing process, patient accounts become outdated resulting in lost revenue. An automated billing software is the answer to streamlining your billing process.  

Below we provide the key features you need to look for to find the right billing solution for your healthcare practice. 

  1. Enterprise Software Solution 

Regardless of the size of your practice, user-friendly enterprise healthcare software needs to be part of your billing solution. This allows users to streamline billing across large practices. Yet, small practices also benefit because an enterprise billing solution sets them up for future growth. An efficient framework provides for building the program to accommodate each global element of billing. For example, healthcare practices should be able to create departments, financial classes, providers, staff, levels of care, services, and payers. Once defined, an enterprise healthcare framework should also allow users to quickly create new business units, especially useful for practices who are expanding locations. 

  1. Escrow 

Managing cash flow and payments throughout the revenue cycle is an essential part of operating a financially healthy practice. 

The best escrow features must allow:  

  • Users to move prepayments out of accounts receivable when they need to issue a refund or transfer funds  
  • Provide patients and their families detailed information about relevant transactions.  

It is imperative that the right billing solution have an escrow module that provides controls to monitor payments made prior to service. 

When patients contact a practice and agree to a specific care plan, they sometimes make payments as they go, regardless of their insurance coverage, or they agree to full cash payments. Problems sometimes occur when patients prepay or make recurring payments. The practice has their money, but the patients have not yet received treatment or other services. Healthcare practices need to know exactly how much they owe their patients based on their payments, and many states require separate accounts for prepayments.  

Not only do escrow features allow for good accounting practices, but they can keep practices out of legal trouble by keeping money a practice has not earned yet separate from accounts receivable. 

  1. Sophisticated Access Tools 

New software comes with a learning curve, even when it’s user-friendly. Having to pause critical tasks to find the answer to quick question can be inefficient, and so is having to search throughout the system for related information.  

The best billing solutions offer:  

  • One-click access to related information from anyplace within the system  
  • Time savings by allowing users from different departments or roles within a practice to easily access all information  
  • Instant access to an account’s financial history and claims for follow-ups or collections for late payment 
  1. Powerful Reporting Module 

A powerful reporting module is tantamount to the effective management of a healthcare practice’s revenue cycle. Decision-makers need accurate and reliable reporting.  

Reports reveal where holes and issues are in the revenue cycle and allow those in charge to direct attention to a specific area.  

For example, reports can reveal whether a practice needs to focus on patient collections or processing insurance claims. In other cases, a practice might be behind on submitting insurance claims. Failure to complete, or finish in a timely manner, the tasks in the revenue cycle potentially leads to lost revenue for healthcare practices.  

The best reporting modules allow:  

  • Users to schedule and catalog their reports  
  • Opportunity to subscribe to regular reports on a daily, weekly, and monthly basis 
  • Web-based access for added convenience 
  1. Flexible Pricing Mechanisms 

healthcare practices have varying sized networks of payors and self-pay clients. Sometimes practices need to adjust rates due to a rate increase or to offer a discount or other contractual allowance.  Ultimately, healthcare practices need the ability to adjust their pricing in accordance with the market. Some practitioners do not like to think about the economic aspect of pricing as it relates to Healthcare that people need and rely on. Yet, keeping a practice financially healthy allows organizations to continue helping patients. Flexible pricing mechanisms provide practices the tools to painlessly adjust pricing as needed.  

The right billing solution for your practice will: 

  • Simplify cash reserves – allowing users to instantly know their net revenue and net accounts receivable in order to make pricing decisions  
  • Allow users to easily create multiple variations of existing rate schedules from year-to-year or payor-to-payor through inheritance 
  • Allow users to customize rate schedules for any payor or multiple payors within specific business units, levels of care, or treatment programs 
  • Include case rates to control pricing for specific payors in individual admissions 
  1. Wizard-Based Processes 

Billing software requires continuous training. Once installed, current employees need to learn the new software and as new employees enter the practice, they must also spend time learning the system. Even when the learning curve isn’t that steep, training can be time-consuming and new users can make costly errors.  

A Wizard-Based process simplifies training by: 

  • Breaking complex tasks into manageable pieces 
  • Reducing the learning curve and lowering the number of mistakes made  
  • Generating charges straight from an outpatient scheduler  
  1. Quality Assurance Module 

Insurance companies go out of their way to decline claims based on technicalities and other dubious reasons, causing Healthcare practices to lose sizable amounts of revenue each year as a result of bad claims. Having a good quality assurance module will help you get the money you are owed, faster. 

Billing software with an effective quality assurance module will:  

  • Drastically reduce or eliminate bad claims and rejections caused by incomplete processes 
  • Introduce accountability and other quality measures into healthcare operations 
  • Allow users to define process checkpoints for events such as new admissions, new insurance admits, and discharges 
  • Allow software administrators to assign which users have permissions to sign off on checkpoints,  

and  

  • Choose whether to suspend billing when checkpoints remain unsigned  
  1. Electronic Directory 

The right billing solution for your practice also allows you to manage your contacts from within the software.  

With an electronic contact directory, users can: 

  • Record and input an unlimited number of addresses and associated contact information for universal use throughout the system 
  • Track relationships between contacts across the organization 
  • Reuse contacts as a patient, insurance, guarantor, emergency contact, or any other role 
  1. Configurable Admission Module 

The admissions process in healthcare has a lot of moving parts. The right billing solution must include a customizable and configurable admission module to manage those parts, so the process goes smoothly.  

An admission module allows users to: 

  • Define the types of roles they need to track for admissions.  
    • Examples include providers, staff, and other related parties 
  • Track referral sources, emergency contacts, therapists, case management specialists, social workers, and other critical people and organizations who are part of the admissions process 

Logik Solutions is here to help your healthcare business thrive. Our comprehensive billing solution removes the burden of billing, so your practice can continue to focus on providing patient care.  Contact Logik today to schedule a demo of MEDIK Online, the leading accounts receivable billing software for healthcare practices. 

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