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Essential Elements of a Medical Billing Software

With the advancement of technology today the Healthcare industry has grown by leaps and bounds. The cumbersome task of data management claim submissions, follow up protocols, insurance verification, and coding practices are a simple click away. According to CNBC, the average American household expended $5000 on health care costs in 2019. The rise of medical billing and scheduling software has greatly reduced the revenue cycle management turn over time. Putting a providers mind at ease and allowing them to focus on individualized patient diagnosis and treatment options.

Practice Management Software (PMS) is a one-stop solution for providers to micromanage copious amounts of data. Reducing administrative issues while perfoming daily job duties like appointment scheduling, submitting bills, following up on claims and managing patient records. Incorporating reliable and diversified medical billing software for your practice can amplify managed patient care for the long-haul. This is where the need for an amazing PMS (Practice Management Software) comes in.

Thus for potential buyers to choose the best medical billing and coding software vendor many functionalities have to be looked into. These may include claims submissions process, reporting and benchmarking, clearinghouse services and appointment scheduling. This reduces the hassle of unnecessary paperwork for medical billing providers. The tedious task of insurance verification, claims management and medical coding practices are better managed through a multi-dimensional medical billing software company.

With millions of dollars at stake, it is plausible for doctors to find it increasingly challenging to streamline their daily medical billing and coding operations. Electronic systems are therefore a much more viable option for medical billers than manual input. The use of an EHR is patient-centric when dealing with vital information seamlessly at the point of care. Medical billing software pricing can vary according to the features required, patient volume, size of the providers’ office, and desires of the heath care provider.

Medical Billing Essential Features

E-Prescribing for Long Term Care

E Prescribing (Electronic Prescribing) in this digital world is a secure and computerized way for physicians to avoid any paperwork or use of faxes. This means generating prescription orders directly to a pharmacy. This speeds up the delivery time of medications for patients to receive urgent care with no hurdles. It has garnered great imminence in today’s demanding health care industry. This includes sending out bulk medication refill orders to connecting with thousands of pharmacies globally. Decreasing the gap between prescribers and pharmacies in a swift manner. It also creates pricing transparency that is economical and ethical.

Appointment Scheduling

It is crucial to keep track of the dates of services for patients. This necessitates the need for an automated calendar system that tracks all appointment scheduling. It has further options for appointment reminders to both patients and providers. It serves to be a virtual diary of daily, monthly and yearly health check-ups including waiting lists. Inpatient data management through an integrated EHR System ensures fewer missed appointments. Bogged down doctors are looking for a respite from menial tasks of mundane paperwork to a more tech-savvy and time saving solution.

Clearinghouse Backup

Clearinghouses serve to be intermediaries between health caregivers and insurance companies to relay claim information on a timely basis. Evaluation of claim errors is integral to avoid any discrepancies in claim submissions for any medical billing and coding company. It keeps a check and balance on payment verifications ensuring meticulous claim scrubbing practices.  Promoting cost-effectiveness and timely processing of huge amounts of information. Being organized is the top priority of every health care provider today. This leads to harnessing a smoother day to day operation for any health care facilities, and large hospitals.

Real-Time Insurance Eligibility Verification

Various coverage benefits, co-insurance, deductibles and insurance policy plans can be monitored directly through this feature. Real-time insurance eligibility assists in maximizing revenue for any medical billing company. It ensures lesser slip-ups, cost-effectiveness and cross-checks vital patient information online. This includes patient name, residence, identification numbers and date of birth of each patient. It helps identify HMO, PPO, Medicare and Medicaid coverage policies. This leaves no room for mistakes while sending electronic verifications to medical coverage payers. This can be customized to fit the needs of each patient.

Intelligent Reporting Dashboard

The need for a robust dashboard that can smartly analyze critical health care information is the backbone of a great medical billing company. It assists in communicating with patients on time. This is the best way to disintegrate large chunks of data into actionable insights by a mere click. It reduces the time spent on tasks that need elaborate attention. This boosts productivity through charts and graphs signaling the overall performance of any medical billing or coding company. Fostering superior patient engagement through automated workflows. These tools help synchronize the digital bookkeeping of all processes involved in medical billing today.

EHR (Electronic Health Record)

It is imperative for a practice to not deter from providing ongoing value-based solutions through a sophisticated EHR System. The issue of profit margins and overhead expenses are a grueling stressor for any health care provider. EHR (Electronic health records) market has seen a huge boom around the globe. There’s a surplus of practice management software and multispecialty support EHR systems available in the market today. EMR (Electronic Medical Record) is antiquated compared to the modern-day EHR system.  While EHRs help in sharing patient information with hospitals, clinics and several providers with cloud-based integration.


The inception of telemedicine aims to facilitate patients 24/7 through online medical advisory by health care providers.  It supports patients who need to travel a long distance to receive critical health amenities or treatment. Medical billing and coding companies have leverage by offering quality medical services through online solicitation. Telemedicine is the use of technology as an omnipotent tool by qualified health care providers for the pressing medical needs of patients. The use of video conferencing, specialized medical apps, E-Portals and real-time interactions empower doctors to reach millions of patients in no time. The advantages of telemedicine are increased revenue, maximized patient follow-through, chronic disease management, and timely reimbursements.

HIPAA Compliance

The privacy and security measures that uphold the integrity of patient health care information fall under the umbrella of HIPAA Compliance. Medical billing and coding companies must be aligned with the latest regulations and laws for the ethical processing of bills. The exchange, transfer, and maintenance of sensitive patient information must be protected under HIPPA Guidelines. This safeguards the interest of both health care providers and medical billing software programs. As violations lead to severe penalties.  This refers to the various measures laid out by HIPAA to validate a medical billing service provider’s policies as legally undisputed and updated. This includes using the right ICD-10 diagnostic codes and updating accurate NPI(National Provider Number) issued by health care providers in the US by CMS (Centers for Medicare and Medicaid Services).

GreenSense Billing has over 20 years experience of providing medical billing and coding services in the healthcare industry. With consistent round-the-clock support, reliability, efficiency, and transparency, we provide remarkable medical billing and coding services to health care professionals. We pride ourselves in providing medical billing and practice management software solutions. Our medical billing expertise include comprehensive revenue cycle management tools, patient engagement portals, medical billing software, analytics and value-based care solutions for both the patient and health care providers.

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