There is no doubt that medical claims processing software can do a lot in order to help you manage your medical practice more efficiently and effectively while attracting new patients and expanding your practice.
You likely know that hospital management and healthcare practitioners in the US are always in need of maintaining well-organized data like patients’ medical bills. You can use healthcare claims processing and management software to streamline and improve the medical claims process at your practice.
The trick, however, is choosing a software solution that has all the features that you need. It’s essential that you take a close look at your existing claims management and billing process in order to identify your pain points.
After that, you will be in a position to evaluate whether a specific software solution is best for your healthcare practice. It is worth noting that claims processing software platforms come in various sizes, levels of complexity, and types.
With the availability of so many options today, choosing the best claims processing software for your healthcare practice can be tricky and challenging, but we will make it simpler for you.
Table of Contents
Top Features to Consider
Here are some of the key features that your medical claims processing software needs to have.
Medical Claim Management
Did you know that managing claims and status can easily overwhelm your medical staff, causing a considerable delay in payments? The good news is that you can easily streamline their work and also make it easier and hassle-free to stay on top of medical claims by choosing the right medical claims processing software.
This will enable them to track all claims from the same place that they manage other aspects or areas of your medical practice.
To get the best results, it is advisable to choose medical claims processing software that provides:
- Electronic claims processing
- Claim history
- Claim tracking and claim scrubbing
- Insurance payers listing; and
- Claim reconciliation
This will not only help you submit medical claims without any hassle, you will also be able to track these claims and maximize the cash flow of your practice.
Automated Medical Coding and Claim Resubmission
Sometimes, even the best and most experienced employees can make errors. This is particularly true when they are coding lengthy lists of medical treatments.
There is no doubt that manual data entry leaves a lot of room for errors and mistakes. This is why it is best to choose medical claims processing software that features automated coding of medical treatments.
You would like ICD codes to populate all of your insurance bills automatically. This will minimize the risk that the medical claim will be denied and has to be rebilled and resubmitted. Also, if you do have to resubmit a medical claim, the software you choose should make resubmission simple and quick by automating it.
Collection Reminders and Follow-Up
The software should also provide timely updates when a medical claim moves to collections or requires follow-up at your end.
Security and Encryption
If you are a healthcare provider, you’ve a legal as well as an ethical duty to protect and safeguard your patients’ sensitive electronic medical records (EMR) in compliance with various HIPAA regulations.
This means that any claims processing software you consider needs to have the best security features. And you have to encrypt and protect all EMR that you collect, maintain, and store on behalf of all your patients.
Best Medical Claims Processing Software
WebPT
Perhaps one of the most popular EMRs in the medical space, WebPT’s incredibly low entry point pricing, and feature-rich clinical charting makes it one of the leading clinical documentation software.
You will be happy to know that for back-office medical claims management, WebPT also offers a well-known and reliable billing solution TheraBill. It is an integrated partner solution that the company acquired in 2015.
Waystar
The best thing about Waystar’s RCM (revenue cycle management) software is that it is a comprehensive system ideal for managing almost all elements of the medical revenue cycle. It is no secret that annual coding changes, changes in payer policies, and staff turnover mean that you will encounter many challenges when maintaining a predictable and consistent cash flow.
Waystar is excellent as it provides you with market-leading technology that unifies and simplifies the revenue cycle. Their amazing cloud-based platform improves financials and streamlines workflows for healthcare providers of all types, and helps bring more transparency to your patients’ financial experience.
Waystar also lets you stay abreast of the ever-changing and dynamic landscape of your revenue cycle. It does this by providing ongoing and actionable data, which is updated nightly. This highlights specific issues that impede reimbursement.
This feature is excellent as it lets you concentrate on those payers and claims that need attention in order to make immediate improvements, preventing the same issues and problems from resurfacing down the line.
NextGen Enterprise
It is worth noting that NextGen Healthcare offers you an integrated and comprehensive technology and services platform customized to fit your needs, especially if you run an ambulatory and specialty practice.
The provider powers national interoperability, and this lets you easily and quickly exchange patient data across various disparate systems. This makes claims processing and management a breeze. You can also access health information irrespective of where patients are treated.
RXNT Practice Management
You may know that RXNT is an integrated and reliable cloud-based healthcare software provider. The company offers a Practice Management solution with top-notch medical billing and medical scheduling tools for medical practices of all specialties and sizes.
Regardless of the products you choose, you will get the company’s commitment to your growth and success through mobile apps, free implementation, and training, frequent system upgrades, as well as ongoing support.
You can improve the efficiency of your practice with RXNT’s simple-to-use and tailored Practice Management software. You will enjoy features like:
- Automated workflows and tasks that eliminate errors, reducing your administrative burden
- Customizable and simple billing reports that give you the data that you need, whenever you need it
- Automatic claim scrubbing
Optum360
Optum360 is another excellent solution that sits at the center of the modern healthcare financial exchange. The software combines methodology, technology, and expertise in order to help providers and payers collaborate.
With this tool, you can optimize your claims processing. Also, its transparent and seamless revenue cycle capabilities bolster and sustain the provider and payer relationship.
Final Thoughts
Medical practices of the modern day need the latest software solutions to adhere to current healthcare regulations and legislation, as well as maintain an effective and profitable business. The above software makes medical claims processing simple and efficient.
There is no doubt that automating medical claims management can streamline and optimize the process through the whole lifecycle of medical claims submission. Note that whether it’s the convenience and simplicity of electronic data entry or timely validation through the effective use of technology, the benefits of claims processing software are endless.
These automated claims processing solutions can create satisfaction and improve efficiency among all entities in the modern healthcare industry via a reduced financial burden. It is crucial to make a careful and informed choice from the several options that are available to you to get the best results.
If you would like to outsource your medical billing to a reliable and experienced provider, you should visit www.ucontrolbilling.com.
