Medical Billing

What is Medical Billing?

What is Medical Billing?

Medical Billing Helps You:

  • Get paid faster
  • Improve efficiency
  • Keep patient information current

Reduce billing errors

Medical billing involves the filing of claims with insurance companies in order for the healthcare provider to receive payment from their patients.

First, a medical coder will generate a superbill which is an itemized form that names each service the patient received. After that, the medical biller sends the superbill to a clearing house where they scrub the form for any issues. Finally, the claim is submitted to the health insurance company; the patient is billed and the healthcare providers are paid for their services.

The process can be complicated and lengthy, as it can take between 50-90 days for the healthcare provider to receive payment. To optimize the process, medical billers can leverage medical billing software that provides a variety of tools and features to help limit the number of billing errors. Prior to an appointment, the system verifies the patient’s insurance information to ensure successful collection of payment. Before you submit an insurance claim, the documents are scrubbed of any errors that could cause payment delays, or in some cases, missed reimbursements.

Billing templates are configurable to fit with specific practices and multiple specialties. Patients may manage payment plans and any upcoming bills online. The software can notify them of any upcoming payments due, limiting the number of missed payments. Below are a few tools used in medical billing solutions to help reduce the number of billing errors.

  • Insurance Eligibility Verification
  • Claim Processing
  • Electronic Remittance

Get paid faster

One of the primary advantages of using medical billing software is how quickly it allows you to collect payment and reimbursements. These solutions can send out automated notifications to remind patients of upcoming payments or overdue balances.

As we mentioned, medical billing systems provide tools to help reduce the number of billing errors. The assurance of accurately filled-out claims helps provide a higher first-time acceptance rate, and as a result, your organization gets paid faster.

Medical billing provides you with a risk assessment regarding a patient’s payment history. Risk assessments can give your staff insight into the likeliness of a patient paying their medical bills. If you need to speed up the payment process, look for some of these tools:

  • Payment Reminders
  • Reimbursement Tracking
  • Electronic Superbills

Improve efficiency

Automating the medical billing process can save your staff a considerable amount of time. Nurses and medical assistants have reported spending over 20 hours per-physician per-week on administrative tasks such as patient check-in or insurance verification. Billing software allows your staff to focus their efforts on what they do best, providing healthcare to their patients.

Digital billing and payment prevent the possibility of misplaced or damaged paper payment confirmations. It also assures accuracy when documenting patient information and allows your organization to get reimbursed faster. Another benefit of going digital is the ability for patients to fill out their intake forms prior to arriving at the office; this saves everyone time and improves doctor-patient relationships.

Here are some standard features that typically help improve productivity as well as operational efficiency:

  • Patient Scheduling
  • Workflow Dashboard
  • Clearinghouse
  • 24/7 Accessibility

Keep patient information current

Medical billing functionality typically integrates with an EMR/EHR system. This allows any updated patient information, such as demographics, insurance information, medical history and more to be easily accessible from any department. A patient’s insurance can be verified automatically, and payment plans can be set up in advance.

Once a patient’s information updates, the system automatically transfers that data to the EHR/EMR platform. Physicians and other staff members can spend less time documenting and looking up patient information and reallocate their time to patient care. These features help ensure patient information is accurate and up to date.

  • Real-Time Data
  • Patient History


How Does Medical Billing Software Work?

A variety of health organizations and medical specialties use medical billing solutions for both inpatient and outpatient care. These facilities rely on software to streamline their billing and payment processes, automatically manage insurance claims and reduce the number of billing errors that occur. Medical billing almost always integrates with an EHR or EMR solution; this allows health organizations to share data between multiple departments, giving all staff members up-to-date, accurate patient information.

How Do I Know I’m Ready for Medical Billing Software?

There’s no magical formula that can determine how much you’ll benefit from implementing software. However, there are some clear indicators that your organization is ready. Here are just a few:

  • Experiencing rejected or unqualified claims
  • Reimbursement takes a long time
  • Noticing errors
  • Missed revenue due to unverified insurance
  • Spending large amounts of time with manual billing

How Do I Select a Medical Billing System?

Just like any software selection process, adopting a medical billing software system is challenging and time-consuming. There are so many options available and it’s important that you choose a system that suits your unique health organization. For example, you will need to consider factors such as the size of your facility and the number of clients you provide for. However, keep in mind that some software systems are designed to address a specialty.

An in-house evaluation of your organization’s requirements is a great way to ensure you find the best fit, and it’s a good idea to involve all staff that will be using the software. Take a look at our Medical Billing Software Features and Requirements or our Top Five Cloud Medical Billing Software Solutions to get started with your selection process.

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Medical billing articles are written and edited by:

Zachary Totah

Content Manager

As SelectHub’s Content Manager, Zachary Totah leads a team of more than 35 writers and editors in their quest to provide content that helps software buyers find the right system for their company.

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Ryan McElroy

Content Editor and Senior Market Analyst

Ryan McElroy is a Content Editor and Senior Market Analyst at SelectHub who writes content on EHR, EMR, home health, telemedicine and construction scheduling.

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Riya Jamble

Technical Content Writer

Riya is a Technical Content Writer at SelectHub. She writes content for the company’s construction scheduling and bidding, and medical billing categories.

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Thought Leaders

SelectHub has sought out and invited thought leaders to contribute to our medical billing industry articles and resources. These thought leaders ensure we deliver quality content with the most accurate information, focusing on what matters most. No thought leader is compensated for their contributions, but shares our belief that information should be democratized so everyone can make the best decision.

Sapan Desai

Sapan Desai

Chief Executive Officer, Surgisphere

Dr. Sapan Desai, a board-certified vascular surgeon and lean six sigma master black belt, has received international recognition for his work in healthcare quality, machine learning, and data analytics.

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John Nosta

John Nosta

Health Technology and Innovation Theorist

First and foremost, John is a thinker. A thinker entrenched in the world of science, medicine and innovation. John is the founder of NOSTALAB—a digital health think tank.

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Medical Billing Software Features and Requirements Template Checklist

November 16, 2023

A medical practice’s job is to care for patients, not keep track of and sort out billing. That’s why medical billing software exists! But what do you need to look for in software for billing? Do you need medical practice management software or electronic health records software? Do you have one of these and still need a separate medical billing software solution?

Bergen AdairMedical Billing Software Features and Requirements Template Checklist
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Key Medical Software Features And Requirements

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November 10, 2023

Medical software has become a staple of the healthcare industry in recent years. From EMR/EHR and practice management software to medical billing and patient scheduling, there are a wide variety of options as well as tools and features when it comes to medical software. These medical features offer a number of benefits to help with healthcare organizations from small specialty clinics to larger hospital systems.

Evan HeierKey Medical Software Features And Requirements
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Denial Codes in Medical Billing: A Comprehensive Guide

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November 9, 2023
Medical billing is a tedious process. The tricky part is submitting claims to insurance companies. It feels like they are Professor Umbridge from Harry Potter, just looking for reasons to make our lives difficult (rejecting claims with denial codes left and right). And denial codes in medical billing can be challenging to comprehend. But don’t worry. We are here to help you decode the complicated language of denial codes and how medical billing software can help you reduce denials.

Riya JambleDenial Codes in Medical Billing: A Comprehensive Guide
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Key Steps to Follow for a Successful Medical Billing Process

November 8, 2023
Imagine running your practice or company without billing guidelines. It would invite revenue losses, higher claim denials and federal penalties. Delivering quality patient care would become difficult. The medical billing process consists of multiple steps that play an essential part in optimizing your practice’s financial performance. And when paired with billing solutions, it helps you achieve revenue goals.

Riya JambleKey Steps to Follow for a Successful Medical Billing Process
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Top Healthcare Technology Trends For 2023

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October 31, 2023
Health information technology is constantly adapting to meet the needs of health care providers. Medical software tools and healthcare technology trends have evolved from a stronger focus on patient satisfaction to greater security of patient data.

Understanding which features and tools your organization will benefit from can take time and effort. Here, we’ll highlight critical current and future healthcare technology trends to help your facility stay ahead of the curve.

Samikshan SarkarTop Healthcare Technology Trends For 2023
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Do Offices Need Medical Billing Software and Practice Management Software?

October 27, 2023

A wise man named Forrest once said, “Life is like a box of chocolates: you never know what you’re gonna get.” While it may be fine to take that approach to your own life, you want to know exactly what you’re getting when you buy medical software — it’s responsible for other people’s lives! Understanding the difference between medical billing software and medical practice management software is a crucial place to start.

Bergen AdairDo Offices Need Medical Billing Software and Practice Management Software?
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Health Care Accounting Software: Does My Practice Need Better Medical Accounting?

October 26, 2023
Most health care organizations would rather talk about patients than administration any day of the week. Unfortunately, those seemingly small and insignificant back-office tasks need discussions time and again to make sure your practice runs smoothly. Thanks to medical software solutions, many of these tasks are easier to manage than ever before.

Kashish AroraHealth Care Accounting Software: Does My Practice Need Better Medical Accounting?
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Revenue Cycle Management: A Comprehensive Guide

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October 23, 2023
Along with delivering quality care, you also need to focus on evaluating the financial health of your medical organization. That’s where revenue cycle management (RCM) comes into the picture. It enables you to streamline financial workflows and simplify medical billing processes, helping you maximize revenue. We invite you to explore the revenue cycle journey with us!

Riya JambleRevenue Cycle Management: A Comprehensive Guide
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The Best Web-based Medical Billing Software

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October 18, 2023
Medical billing is a complex and time-consuming task, especially with the risk of errors that can lead to legal trouble and rejected insurance claims. Fortunately, there is a solution: web-based medical billing software integrated within EMRs and EHRs. They help you make billing operations a breeze and provide remote access. But how do you choose the right one?

Riya JambleThe Best Web-based Medical Billing Software
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Tips to Improve Patient Collections

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October 4, 2023
Collecting payments from patients is a tough job, especially from self-pay clients. According to the Crowe RCA Benchmarking Analysis report, the self-pay-after-insurance collection rate decreased from 76% in 2020 to 54.8% in 2021. Medical billing solutions provide revenue cycle modules to help you boost patient collections. If you want to learn other methods to improve collections, you’re at the right place!

Riya JambleTips to Improve Patient Collections
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Best Cloud Medical Billing Software Solutions

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We’ve all been there at some point — sitting in a not-so-comfortable chair, staring at the clock as your doctor’s appointment is running behind schedule once again. A trip to the doctor is the last way most people want to spend their day, and the time it takes — from filling out paperwork to simply waiting around — doesn’t help by any means. Healthcare providers understand this and are doing whatever they can to speed up patient visits and improve patient satisfaction. One of the tools providers are benefiting from is cloud medical billing software.

Evan HeierBest Cloud Medical Billing Software Solutions
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4 Ways Revenue Cycle Management Roles Have Changed

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Revenue cycle management isn’t what it used to be. Without a doubt, coding, submitting clean claims and tackling denials are still very important. These days, however, it takes more than smart claims processing to succeed at revenue cycle management – you need to prepare for some major shifts in how it works.

SelectHub4 Ways Revenue Cycle Management Roles Have Changed
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