How does medical billing system work? Medical billing is the process through which the healthcare providers get the reimbursement of the services they have provided.  The billers act as a connection between the healthcare provider, payers, and patients.  Without medical billers, healthcare professionals could not get the reimbursement of the services they provide. Nowadays EMR software has made medical billing much easier. Since medical billing is a complicated and long procedure. EMR software helps in electronic bills generation easily and rapidly. In this article, we are going to talk about how does medical billing system work. Basically, there are eight steps of medical billing.  Those steps are: Steps of medical billing  Booking of the appointment Financial status evaluation  Check-in and check out Checking of superbill  Transfer of claims  Adjudication  Patient statement generation  Record keeping The above-mentioned steps of medical billing can be better explained as: 1. Booking of appointment The patient would book the appointment either online or on phone with a healthcare provider. If they have previously visited the doctor, they do not need to provide any information other than the medical record number. Otherwise, if they are a new client, they have to give complete personal details and insurance details for booking an appointment. They would not need to give their details again and again. Instead, it would be saved on the EMR software. 2. Financial status evaluation The financial status evaluation involves ruling out who will pay for the bill. The biller should rule out either the patient can avail of the service reimbursement or not. Medical billing perks vary according to different insurance companies and different packages. Like some packages do not involve the medicines or lab tests reimbursement. While some offer a whole reimbursement package. This strongly depends upon what kind of package you have opted for. If the availed services are out of the insurance package coverage, Then, in this case, the patient would pay it from his own pocket. The biller must inform the customer that they would have to pay it on their own. 3. Check-in and check out When the patient arrives at the doctor’s office, they have to fill a form and give their complete details upon the first visit. Moreover, when they check out, they will have to fill the form on which the doctor has written their orders, upon the first visit. They would not need to fill the forms on the next visits, because their information would be saved already. Also, they would require to show any identification document like a national identity card or a driving license along with a valid insurance card. Furthermore, they will have to pay a copayment at the time of the doctor’s visit or at the covered pharmacy medication. Co-payment is a small amount of money that you have to pay at the time of the visit. Then your insurance company would pay the remaining 100% money to the healthcare provider. When the patient checks out from the hospital, their report is sent to a medical coder. Where the medical coder turns it into a superbill. The superbill is a document that contains the detail about the patient, name of the physician, the procedure performed, diagnosis, history, and other medical information. Since this document contains the whole information, it helps in getting the claim. Moreover, the superbill is transferred to the medical biller. 4.  Checking of  superbill The fourth step of billing management includes the rechecking of the superbill. The medical biller transfers the superbill to the medical coder after transforming it into a paper claim form or through a billing management system. Medical billers would also include the cost of the procedures in the claim. After the creation of the medical claim, the biller is responsible for the authenticity of the prepared claim. He or she would make sure that the medical billing is done in a perfect and transparent way.  The medical coder is responsible for the efficient coding process. But the biller does cross-check to make sure that billable procedures are included in the bill. It totally depends on the patient’s insurance plan and insurance company about either the procedure is billable or not. This is because every plan has a different cost and different coverage. So the coverage of the procedures varies according to the type of plan you choose. 5. Transfer of the claims The claims are then transferred to the payer. This can be done either manually or electronically. But the manual transfer of claims has many drawbacks. Someone has to go in person to send the records. Also, it is time taking and not enough efficient. Electronic transfer of claims can be done in minutes and saves time for overall medical billing. 6. Adjudication The sixth and one of the crucial steps of medical billing is adjudication. After making the claims, they are reached to the insurance companies or the payer. Overt there, the payer evaluate the claims and check either the claims are billable or not. This process of rechecking the claims is known as adjudication. At the stage of adjudication, the claim can be either accepted, rejected, or denied. The accepted claim means that the claim made is billable. The insurance companies bill them according to the rules and regulations of the contract. The rejected claim means that the claim made is not billable. Or there is any information missing or any unbillable procedure is added. In this case, the payer sends it back to the provider. Healthcare providers can reclaim the bill by correcting it and sending back to the insurance company. The third type of medical billing claim is a denied claim. This means that the payer would not pay for the bill. This happens because there is any procedure or service that has not to be paid by the insurance company. Since the health service coverage strongly depends upon the type of package you have chosen from the insurance company. After the adjudication is done, the payer sends

How can EMR help in billing management system? EMR-Electronic Medical Record is a digital version of a patient’s details.  It stores health information in a digital format and allows the sharing of information across different sectors. It is a well-integrated system that helps in storing different types of data like disease history, medication history, allergies, hospitalization history, lab test results, radiology scans, vital signs, etc. It can also store billing information and greatly helps in billing management systems in healthcare settings.  It increases productivity and saves precious time and energy of the staff resulting in better patient care. In this article, we will discuss how the integration of EMR with a billing management system helps the healthcare settings. 1. Going paperless With EMR, the patient’s data can be stored digitally and the need of entering data on paper is greatly reduced. The valuable time and manual labor of the staff are decreased and it helps in increasing productivity. There is no need to fill out forms on paper thereby reducing the workload on the staff. Also, manual data entry requires time as compared to digital data entry, both, the staff and the patient’s time is saved. Minimizing errors Integrating EMR with a billing management system helps minimize the chances of human errors by reducing manual work. The patient’s data can be easily transferred from one place to another removing the need to copy charges from billing sheets. In this way, the chances of human error are minimized and help increase reliability. If a person would create the bills manually, there is a fair chance of overbilling or under billing. When it is done through the EMR system, billing is accurate and rapid. Transparency Furthermore, everyone wants to deal with institutions that have a clear and transparent billing management system. Integrating EMR with a billing management system helps in building an unambiguous workflow. It builds a transparent relationship with your stakeholders as well as patients. Since it helps submit cleaner claims, people trust in the system. This helps in creating loyal and happy customers. Interoperability AN Integrated EMR system with a billing management system allows suppliers and customers to access information readily. This information can also be shared with anyone if needed. This reduces the chances of human errors and gives caregivers relevant information, thereby increasing efficiency. Everything that the healthcare providers use, they enter it on the EMR system. When the billing time occurs, all the things are automatically charged. You do not need a separate person to enter details of all the things used and charge them. This feature enables you to save time and a lot of effort. Easy Reimbursements Integrated EMR with a billing management system makes reimbursements a lot easier. Since all the information is already saved, it saves the staff’s time and manual labor to re-enter the information. Moreover, it prevents human error and makes reimbursements easier. Institutions like to collaborate with hospitals that have an easier and quick reimbursement system. This makes it easier for their staff members to avail of the services and getting the reimbursement of the charges. Legible documentation Since a handwritten billing system is manually written, many legibility issues can arise. Integrated EMR with a billing management system encourages a clear, legible, unambiguous documentation because everything is computerized and easy to read. This helps improve efficiency and patient satisfaction because everyone can understand and read the computer-generated bills. Improved patient care Integrated EMR with a billing management system saves the patient’s time and energy. They do not have to tell their details again and again because all the information is saved and easy to access. It also reduces the patient’s waiting time to get the billing done at the time of checkout. This greatly improves the patient’s satisfaction and reduces hassle. Conclusion EMR system has revolutionized healthcare systems greatly. It helps save patient’s information at one centralized place which is easy to access. Not only it saves the hassle of physically storing data, but it also saves time and improves productivity. It reduces the chances of human errors and promotes effective diagnosis and safer prescribing. The healthcare workers can easily access up-to-date patient’s information which helps in providing better care to patients, thereby improving the patient-provider relationship. Integrating EMR, which has endless benefits, with the billing management system makes things a lot easier. It saves the staff from frustrating manual work and saves both, the staff and the patient’s time, thereby improving efficiency. With advancing age, when everything is going digital, it should be encouraged that the billing management system is integrated with EMR to increase productivity. InstaCare is providing an efficient, safe, and secure EMR system, Through which you can manage all the clinical and financial operations.  For more information, please contact InstaCare.

Streamline your queue management through clinic management system We all have faced a lot of hassle and panic when visiting a doctor. Many people are gathered at the reception, with a state of panic. Everyone wants to enter the doctor’s office soon. Since the practice of a person managing the patient’s queue creates a lot of stress for the staff members. Therefore you should opt for a clinic management system with a queue management feature. The clinic management software helps a lot in the proper management of all the operations going on in the clinic. It saves all your patient’s data, creates a report about your business, reduces medication errors, and, helps increase clinical productivity. Among different features of the clinic management software, one is the queue management. In this article, we are going to discuss how can a clinic management system helps in queue management. Safe Managing the queue through a clinical management system is safe. This is because many people do not gather at a single place. It reduces the time of exposure by giving the tokens quickly. Since close exposure with each other in a hospital increases the chances of hospital-acquired infections. Therefore it plays a vital role by reducing the time of exposure to stand in a queue and get your token from a person. Online booking The clinical management system has made queue management much easier by letting people book their appointments online. People can book their appointments without going to the hospital. They just need to enter their complete detail or a medical record number that is issued by the hospital, to book an appointment.  Through this feature, the client can book their appointments without any hassle. This feature serves in improved customer satisfaction. Reduced missing turns Queue management through clinical management software enables people to look at the queue status. Since the number is represented on a screen, the screen informs the patient before they will be called. In this way, if a patient has to go for some other task in the hospital, they can do that.  Also, they can get an insight into how much time is left for their turn to be called. People would be vigilant when the computer calls their name, so they would not miss their turn. Rescheduling or cancellation By using the queue management system, people can reschedule or cancel their appointments on their own. They can do that through a mobile application, by sitting at the home. Or they can also do that by presenting at the self-service kiosk. People do not need to explain or talk to anyone about their appointment rescheduling or cancellation. A complete record Through proper queue management, the administration can get a complete insight into how much time is invested for a particular activity on each client. For example, it would give a piece of information about how much time a person withdraws blood sample from the patient in a laboratory. Or in how much time a pharmacist could dispense the medication. It will also give an idea about how many people are attended by the staff in a particular period. In this way, the administration can get know-how about the patient’s influx and business progress. Easy for all patients Queue management through a clinical management system makes life much easier for people of different age groups or with different conditions. Even disabled people, who cannot speak, or who cannot walk, can get their token on a single click from the self-service kiosk. It is also easy for old aged people to just get a token and wait. Rather than waiting and standing in long queues. Also, many people who present at the doctor’s office have some sort of difficulty. The queue management system reduces the standing time for all people. They can get the token quickly and easily. Hassle-free Queue management system reduces the overall waiting time, is hassle-free, and also reduces the workload of the staff members. You would not need a person to distribute tokens and call the names of a patient. Since when a person is managing the queue, it creates a lot of panic and chaos. Transparent The patient can easily access their appointment records through a queue management system. They can get an idea of how many appointments they have attended so far and how many of them are left. Also, they will get automated reminders through the clinic management system, which would reduce no show visits. Conclusion Queue management through the clinical management system helps in easy and peaceful movement of the queue. It reduces stress from the head of healthcare workers. It also saves their time, therefore they can focus on the clinical activity. Nowadays it is a must-have tool for every clinic. Since it is a patient complaint software and keeps their full record, it helps them during their journey with the hospital. InstaCare is providing a low cost and easy to use clinic management system, that would help you a lot in day to day clinical operations. For further information please contact InstaCare.