Medical billing is a crucial process for any healthcare organization’s financial well-being. However, as anyone who has worked in healthcare in the US can attest, it’s complex, time-consuming, and has traditionally been managed manually. As with many inefficient administrative processes, new technology and tools have emerged in recent years to help make tasks associated with medical billing¹ more accurate and streamlined via automation and other sophisticated technologies.

What exactly does medical billing software do, and how can it improve the day-to-day operations at your practice? Let’s take a closer look at what this kind of software is capable of, and the important benefits these capabilities can deliver to healthcare organizations of all shapes and sizes.

What are the key capabilities to look for in medical billing software?

There are numerous medical billing solutions available on the market today. Some vendors deliver services using an outsourcing model, essentially performing the manual work that would otherwise be done in-house on behalf of clients. This approach can alleviate some burdens in the short-term but is fundamentally unscalable and doesn’t provide the significant benefits delivered using innovations like automation.

Some medical billing tools are integrated within larger healthcare IT platforms alongside strong capabilities around electronic health records, patient engagement, and other revenue cycle management tasks and functions. These types of platforms tend to deploy innovative, emerging technologies (like artificial intelligence and machine learning) to automate elements of the billing process and often provide additional medical billing services alongside these technology tools to help clients scale operations and manage staffing resources.

When considering different medical billing software, be sure to look for these general capabilities.

Ability to maximize revenue capture

Your medical billing software should optimize payments at every stage of the revenue cycle. It can do this by, for example, helping to confirm insurance eligibility and identifying potential denials before a claim is submitted.

It should also make it easy to bill and collect payments from patients. For that reason, it’s beneficial for the billing function to be integrated with patient-facing tools like a patient portal. This kind of integrated medical billing software should also provide transparency into billing activities and overall revenue cycle performance.

Ability to reduce operational burdens

One of the most important aspects of your medical billing software is that it should alleviate many of the inefficient, time-consuming tasks that make the billing process so arduous and complex. To achieve this, look for a partner that offers a combination of automation-driven technology tools alongside services to take on certain time-consuming tasks, like eligibility checking and claims denials.

The right platform and services provider will also offer excellent servicing, staffed with support personnel who have deep knowledge of payer-specific coding and billing requirements. This industry knowledge can help an organization navigate the billing process more efficiently and with better rates of revenue capture.

Ability to stay ahead of industry changes

As with any technology tool, the way the software is built is important. Look for a platform that is continuously updated to reflect industry and regulatory changes, a characteristic most associated with cloud-computing technology. For instance, multi-tenant enterprise platforms are typically updated frequently and seamlessly, with no disruption to users.

Finally, look for a medical billing software that provides support for multiple payment models so your practice has the flexibility to leverage various value-based care programs alongside the more common fee-for-service approach. The industry continues to embrace value-based care, and organizations who are equipped to test new models and programs will be best-positioned to succeed.

What are the top operational benefits of using a medical billing software?

Using a medical billing software offers several operational benefits for healthcare practices. Here are some of the top benefits:

Increased efficiency: Medical billing software automates many manual billing tasks, such as claim submission, payment posting, and denial management. This streamlines the billing process, reduces errors, and saves time for staff, allowing them to focus on other important tasks.

Improved accuracy: Manual billing processes are prone to errors, which can lead to claim denials and delayed payments. Medical billing software helps minimize errors by automating data entry, performing real-time eligibility checks, and ensuring accurate coding and documentation.

Faster payments: With medical billing software, claims can be submitted electronically, resulting in faster processing and payment from insurance companies. This helps practices improve cash flow and reduce accounts receivable tasks.

Enhanced revenue cycle management: Medical billing software provides comprehensive revenue cycle management tools, including tracking claims, identifying and resolving denials, and generating reports for financial analysis. This helps practices optimize their revenue collection and identify areas for improvement.

Compliance and regulatory support: Medical billing software should be designed to comply with healthcare regulations and coding standards. This helps practices stay up to date with changing regulations, ensures accurate coding and documentation, and reduces the risk of compliance issues and audits.

Improved patient experience: Medical billing software is often integrated with patient portals or other online payment options, allowing patients to view and pay their bills conveniently. This can improve patient satisfaction and reduce administrative tasks for staff.

Cost savings: By automating billing processes and reducing manual tasks, medical billing software helps practices save on administrative costs, such as staff time, and even paper and postage expenses. It also helps minimize claim denials and rework, which can result in significant cost savings.

Overall, using a medical billing software can significantly improve the efficiency, accuracy, and financial performance of healthcare practices, while also enhancing the patient experience and ensuring compliance with regulations.

athenaOne for medical billing

athenaOne is a comprehensive healthcare IT platform featuring robust capabilities around electronic health records, revenue cycle management, and patient engagement. athenaOne is built to help healthcare organizations deliver outstanding care while maximizing revenue.

athenaOne's medical billing capabilities offer healthcare practices a range of benefits. With streamlined revenue cycle management, practices can focus on patient care while automating tasks such as claim generation and denial management. The platform ensures accurate and complete claims, reducing errors and rejections.

Practices can submit claims quickly and seamlessly, resulting in faster reimbursement. Real-time claim tracking provides visibility into the status of claims, allowing proactive issue resolution. Comprehensive reporting and analytics enable practices to make data-driven decisions and optimize their billing processes.

athenaOne support personnel help customers stay ahead of industry changes and consult on best practices for revenue cycle management generally, and for areas like value-based care where additional expertise is needed. Dedicated support and training are provided to maximize the system's benefits.

The platform also includes an integrated patient portal with online payment options, as well as additional tools to help capture patient balances.

In short, athenaOne's medical billing capabilities enable practices to optimize their billing processes, enhance financial performance, and prioritize patient care.

Deliver outstanding care while maximizing collections

Medical billing software is a must-have for healthcare organizations that want to maximize collections while staying focused on what matters most—delivering outstanding, patient-centric care.

Consider using an integrated, comprehensive platform like athenaOne to help maximize the amount of revenue you capture, reduce the burden of time-consuming and error-prone operational tasks, and keep your organization on the leading edge of industry changes and evolving best-practices.

Read the articles below to learn more about how athenaOne helps healthcare organizations of all sizes collect more of what they’re owed.

1. RevCycleIntelligence, Exploring the Fundamentals of Medical Billing and Coding, Feb. 2022; https://revcycleintelligence.com/features/exploring-the-fundamentals-of-medical-billing-and-coding