Healthcare billing ensures accurate and timely transactions, resulting in better revenue cycle performance. Billing system issues can lead to low patient retention and impede medical provider performance. With so much at stake, how do you choose between the different billing systems in healthcare?
What Is Healthcare Billing?
Healthcare billing is a more complex process than everyday purchases. It involves multiple steps with various people. Once a patient has received care, the physician notes all services given on the patient chart. This chart is then given to a medical coder who translates the services into codes.
The medical coder passes the superbill to a medical biller who sends the right information to the patient’s insurance company. The insurance company then reimburses the practitioner. The rest of the bill is covered by the patient out-of-pocket by sending out invoices or calling the patient.
Types of Healthcare Billing Systems
A system is an assembly of processes integrated to form a network. Healthcare billing systems are parts of the larger healthcare system comprising healthcare facilities, patient care best practices, and a medical organization. The three billing systems in healthcare include:
1. Closed Billing Systems
Closed billing systems do not facilitate transfers and are designed for a single practice, such as electronic medical records (EMRs). These systems are considered closed since they do not support collaboration between facilities. Healthcare providers within the practice can share EMRs, which does improve the quality of care.
A closed billing system has the advantage of finding and acquiring all patient information quickly if all patient care is provided at one practice. This allows for more efficient care. The disadvantage of closed billing systems is if there are changes in the patient’s demographics, the information must be input manually.
2. Open Billing Systems
Open billing systems allow for collaboration and transfer, i.e., an open healthcare billing system allows transferring patient records beyond one practice or facility. This system enables all stakeholders within the healthcare sector access to patient records and information. Electronic health records (EHRs) are most preferred because users can review and edit information on the go. Open medical billing systems impact positive health results as they encompass complex details.
While collaboration among healthcare practices does allow improved care many times, an open billing system does have some legitimate concerns. Some facilities and practitioners worry about possible violations of HIPAA laws. Because sensitive patient records are coming from outside sources, there is an issue of security. Additionally, open billing systems require frequent data entry as each organization must input patient information into their own system.
If you are interested in an open billing system like an EHR, be sure your security measures will protect your patients.
3. Isolated Billing System
Isolated medical billing systems are designed to allow healthcare providers to bill patients directly. They also allow the insurer to compensate the patient directly. These billing systems ensure the non-involvement of the healthcare provider in insurance claim matters. Most organizations that use isolated medical billing systems offer services that insurance does not cover.
An isolated billing system offers the most security for patients. Patient records are safer in an isolated system than in an open or closed billing system. The disadvantage of this billing system is without outside support, improving the quality of care is much more difficult.
The Importance of Billing Systems in Healthcare
Many healthcare facilities and organizations in the industry struggle to remain financially viable. Billing in healthcare can improve this by cutting costs, saving time, and improving patient care and satisfaction. Healthcare billing systems are integral for the success of any medical organization because they allow healthcare providers to collect helpful information on treatments, interventions, and patient experiences and bill insurance companies accurately. The management and other decision-makers within the organization also rely on such records for accurate resource allocation and implementation of projects and processes that improve patient outcomes.
Billing systems in healthcare are not limited to hospitals. Medical offices and agencies, including third-party billing service providers, can also use them. The benefits of medical billing systems include faster revenue cycles, better patient payments, reduced costs, and improved patient satisfaction. Bottom line, billing systems improve healthcare performance.
What Is Best Medical Billing System for Your Organization?
Different types of healthcare billing systems have their advantages and disadvantages. You can use multiple metrics to determine the best billing system for your practice. In most cases, records are the best aspect of a medical billing system. After deciding on the billing system and record-keeping function, you can select software or keep what you have. An ideal medical billing system will also incorporate the outsourcing functions you need for your medical billing needs.
Each type of billing system is suited to a specific category of practice. As a result, a billing system might work for one organization rather than the other.
Healthcare Billing Systems and Where They Are Best Suited
Automate healthcare billing with medical billing systems for better performance. To find the ideal system, you must understand your billing needs. Select a system that helps healthcare providers schedule appointments, record patient information, and improve insurance acceptance rates.
Closed billing systems are best for single or stand-alone practices and fewer providers or stakeholders. Suppose you have a closed billing system and want to outsource your revenue cycle management function; you must upgrade to an open billing system.
Open billing systems are more suited for large healthcare firms with several departments due to their flexibility. Healthcare organizations that outsource medical billing must use open billing systems to facilitate access to information. The facility can transfer records to the outsourced firm and share information with multiple stakeholders, including the management.
Isolated billing systems are for patient use. Organizations with these systems must comply by using only EHRs and EMRs.
Bottom Line
Now you know the different types of billing systems in healthcare. You can make better decisions about the ideal healthcare billing system. The system you select impacts organizational performance. If you need clarification on suitable medical billing systems, consult experts in healthcare billing. You can also outsource medical billings from a third party who will advise on the system that suits your organization’s needs.
