Medical billing software should help you breeze through billing and give you confidence that you’re billing fully for your work. In this article, we’ll cover the basics of how medical billing software works, what features to look for and how much you can expect to pay for it
Medical billing software provides a fast and easy way for physicians to submit claims for payment to the Ministry of Health (e.g., OHIP, MSP, AHCIP), Workers Compensation Board and third party insurance providers. Billing software may also allow you to create private invoices for non-insured services.
Using software modernizes the billing process to eliminate time-consuming paperwork, code lookups and manual data entry. Beyond claim submission, more robust solutions can also help you optimize claims, track revenue and manage rejections.
Most solutions, like Dr.Bill, require no physical hardware or software. You simply download a secure app to your desktop and/or mobile device, connect your credentials and start billing.
Why should I use medical billing software?
Opting for software is a fast and flexible billing solution for physicians in many specialties and practice settings with a wide range of benefits:
1. It’s easy to use
Billing software is designed to guide you through claims intuitively, making it simple to select the right codes and submit claims without the need to become a billing expert.
2. It can move with you
A mobile billing app is ideal if you do rounds, locum contracts, or work at multiple locations and need a billing solution that travels with you seamlessly from hospital to clinic to LTC facility and beyond.
3. It keeps you in control
Billing agents know billing, but aren’t by your side as you work. Submitting your own claims can give you confidence that you’re claiming fully for what each visit and procedure entailed.
4. It saves you time
The best medical billing software reduces claim creation down to a few taps so you can submit claims in seconds and stay focused on patient care.
What are the top features to look for in medical billing software?
Medical billing software features tend to fall into two categories:
- Features that make billing faster and easier
- Features that make billing more accurate
1. Patient Label or Health Card Capture
Entering patient information shouldn’t be a manual process with medical billing software. Look for solutions that allow you to snap a picture of your patient label or health card to auto-populate patient details.
Other great alternatives include the ability to upload your patient list or to establish a direct data connection with your EMR.
Make sure your billing software has a mobile app and desktop option so you can manage billing securely from your phone, a central workstation or both. A mobile app makes it easy to take a few seconds to bill after every patient—that way billing doesn’t pile up and visit or procedure details are still fresh in your mind.
3. Built-in Code Database
Medical billing platforms should make it easy to find the codes you need by keyword so you don’t have to memorize codes or keep your Ministry’s fee schedule handy. Better still, the ability to favouite the codes you use most makes billing even faster.
Ministry of Health fee schedules are constantly changing. When shopping for a medical billing provider, ask how quickly Ministry code and dollar value changes are reflected in the software. You should be looking for near real-time updates for uninterrupted billing.
4. Default Settings
Modern medical billing software eliminates manual data entry and condenses claims down to the fewest number of taps possible. To that end, focus on solutions that allow you to set and forget claim details that will always stay the same, such as facility number, service location, frequently-used diagnoses and more. If you have multiple specialties or practice at more than one location, find a solution that lets you toggle between profiles effortlessly.
5. Team Functionality
If you practice as part of a team, look for a solution that makes it easy to collaborate with colleagues. EMR integration, secure claim sharing, role-based permissions and additional levels of financial reporting are common features to prioritize.
6. Premium Alerts
Premiums are an important part of your income and can be easily missed. Choose a billing platform that displays instant alerts when additional premiums might apply to your claims.
7. Built-In Billing Rules
Missed codes become costly, especially over time. When Ministry rules are built right in, it’s easier to bill accurately and choose all applicable codes for your claims.
8. Billing Agent Support for Coding
Sometimes you just need to ask an expert. If you’re new to medical billing or have complex billing needs, consider solutions that are backed by seasoned billing agents who can help you select all the codes that apply to your claims whenever you’re in doubt.
9. Automatic Rejection Resubmission
Physicians are so busy that they often let rejected claims go, but this missed income really adds up over a year (and a career!). Some medical billing providers include rejection management right in their service, which means a billing agent will triage, correct and resubmit rejections on your behalf.
10. Detailed Reporting
How much you’re making should never be a mystery. Choose a medical billing app that displays your successful and pending claims revenue front and centre. You should also be able to create detailed reports, sort your claims in multiple ways and drill down into individual claims in a few taps.
How secure is medical billing software?
When dealing with personal health information, security is paramount. Be sure to inquire about each vendor’s security measures, privacy standards and certifications before making a choice. Some key questions to ask include:
- Who can access personal and health information and for what purposes?
- Do you keep detailed access logs?
- How is patient health information stored and what are your encryption standards?
- How are your employees trained in privacy and security?
- How can you help if my device is lost, stolen or compromised?
Medical billing software is generally cost efficient, with prices ranging from around 0.25% to 2% of successfully paid claims. You may also encounter flat fee pricing based on monthly claim quantity.
Watch out for additional fees and stipulations from some providers, such as activation charges, cancellation costs or a minimum contract length requirement.
If you’re shopping for a team or group solution, make sure you enquire about group pricing options, which may be customized to your team’s size and needs.
While all medical billing software shares the same basic function of submitting claims, features and support can vary considerably—making the difference between a frustrating experience and an efficient one. Choosing the right software for your practice can not only save you (a lot of) time, but optimize your income too.
If you would like a demo of Dr.Bill, or just want to ask us our experts a question about medical billing, don’t hesitate to contact us. Dr.Bill is available in Ontario, British Columbia and Alberta, and is currently used by more than 8,000 physicians.
1 Research by the CMA shows that physicians fail to bill for at least 5% of the insured services they provide. $1.6 billion is based on the actively practicing 93,000 physicians in Canada earning an average gross salary of $350,000.
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