Trying to find the right mix of Practice Management Software, Electronic Medical Records, and Outsourced Billing can be very confusing. Most practices would rather not hire a full-time billing person or deal with the hassles of billing and collections themselves. If a practice feels this way, what are their options? The answer is to integrate your Electronic Medical Records (EMR) software, Practice Management (PM) software, and billing services.  It can be very hard to integrate disparate software and systems, so a number of options are being sold to practices today. It’s increasingly common to see vendors offering billing and collections services as a part of their EMR or PM software packages. Some vendors who do not provide billing services with their EMR or PM software will refer you to outside billing companies that have connections with their software packages.  And finally, some vendors integrate all of it; the EMR software, with the PM software, and the billing and collections processes.

Most practice management solutions allow data to be retrieved quickly through high-speed internet connections, which gives vendors access to the data that allows for the billing process to proceed. Where once there was papers records, mail, faxes, and couriers, and tedious data processing, now there is immediate access to the data that is needed to prepare bills. Even if a practice does not have EMR or PM software, practices can enter charges manually into on online form to submit the information to the billing service. Once the billing service receives this information through EMR software, PM software, or an online form, the billing service checks the coding and submits the claims to a clearing house. Clearinghouses are important so that practices and software vendors don’t have to create a connection to every payer, letting the clearinghouse sort out the details through their automated software and systems. Once a claim is processed by the payer, Electronic Remittance Advice (ERA) is sent back to the submitter describing the actions the payer took on each claim; amounts paid, claims it denied, and responses it adjusted.  

Collection services will be needed in cases where a patient did not have proper insurance, or where insurance coverage did not fully pay the charges. At this point the collection services begin by sending out patient statements. Most PM software enables  a practice to print and mail their own statements and may even contain a way to interface to third-party patient statement printing companies. This is the point where practices have to be extremely careful selecting the right combination of software and service providers for their billing and collections, because not all billing services are created equal.

A billing service can make a real difference in how effective you are in collecting bills. Most companies can submit claims and get 85% collected by concentrating on maximizing first-pass acceptance rates, but a great billing service will work hard to collect the other 15% that is not collected easily. Great billing services know that most small practices are not good at handling claims denials and self pay balances, and know that if a receptionist or scheduler is out for some reason, that the practice’s billing person will be pulled to fill the gap. Also, since you have the EMR software and PM software integrated with your billing services, you can now see exactly what your billing service is doing for you. No more outsourcing your billing service and then having to wait a month or more to know the results. When all of these services are integrated, the entire process is transparent to the practice at any particular time.  

Technology continues to change how medical practices’ operate and the pieces of the billing puzzle can be confusing. At TCI, we provide PM Software, Billing services and integrate your favorite EMR to our Practice Management System. But where TCI really differentiates itself from other vendors, is by operating, ECP, TCI’s own national medical claims clearing house. Each service can be used separately and all of our solutions work in a seamless fashion together because we handle them all in house. There will be no he said, she said between third parties when working through a integration issue. Please contact us today if you need some advice.