New regulations and the changing healthcare scenario with its challenging mandates for providers and patients alike, is making the physician’s life a bit tough. Billing in the medical industry today is a tough process that can bring in profit or cause loss, if not done right.

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5 Tools everyone in the medical billing Industry Should Be Using
New regulations and the changing healthcare scenario with its challenging mandates for providers and
patients alike, is making the physician’s life a bit tough. Billing in the medical industry today is a tough
process that can bring in profit or cause loss, if not done right. Like it’s said, a bad carpenter always blames
his tools, so too, if the medical organization does not have the proper tools in place, the medical Revenue
Cycle Management (RCM) will be affected. This is something nobody wants, given if there are hospitals
and clinics going out of practice, then the Obamacare Act also known as the Accountable Care Act (ACA)
will defeat its very purpose of bringing in the millions of medically uninsured patients and making
healthcare affordable to them, and if there are no physicians to attend to them, healthcare will be in crisis.
Thankfully, technology has kept pace with changes in the healthcare reforms, thereby presenting a well
thought out and systematic workflow for all types of healthcare clinics from- small to large, specialty to the
integrated kind of organizations offering medical treatment. The tools required- all begin right from the
reception room , as their part in the billing process is very essential- the appointment setter, insurance
verifier, prescription safety, patient recorder, Practice management and Clinical documentation software,
are the five most essential billing features and to have this all within one system will ease the billing
process.
The Patient/Appointment Scheduler: Without this software tool, you could overshoot the number of
patients you see in a day and that could lead to problems, impacting the medical revenue cycle from the
word go!
Insurance Verification Tool: This is very essential before you even bill your patient. The patient’s insurance
coverage plans are essential to know and should be verified as it allows for an increase in revenues and
decreases A/R days by increasing collections of deductibles, copays and co-insurance ahead of the services
being performed and thus decreases denials of claims after billing, thus minimizing the impact on your
Revenue Cycle Management (RCM) process.

2. Call now 888-357-3226 (Toll Free)
info@medicalbillers.com
www.medicalbillersandcoders.com
Copyright ©-2015 MBC. All Rights Reserved2
Prescription Safety Toolkit: This is very rarely thought of as being part of the billing feature. But, the
toolkit provides extensive detail on where and how to reconcile medications at all transition points of care
and also how to implement a medication reconciliation process. An overworked staff could cause errors
which could lead to a major incidence and could also lead to several blocks in the A/R process.
Electronic Health Records (EHR): This is something that is now as important as the stethoscope seen
around the neck of the attending physician. Not only should you now have an EHR integrated within your
workflow, but it also needs to be a certified EHR, as it is essential to avoid the 1 percent Medicare Fee
Schedule cut by the CMS, which could cause an impact in your RCM process. Additionally, many insurers
are now insisting that they will deal only with digitized records and not paperwork, and payments will be
made accordingly. EHR is beneficial to both physician as well as the healthcare industry, as it helps to track
and monitor and also share information keeping the patient’s privacy intact.
Practice Management & Clinical documentation Software: This is essential to have a smooth workflow
process in your clinic or hospital. Given the increase in coding, and the focus on documentation required,
especially when processing claims- having a robust PMS and CDS system in place will be advantageous to
the practice. PMS tools can handle both billing and insurance claims and often have the added resource of
scheduling and EHR management. But without testing and understanding your workflow, one can go in for
either a single system or a multiplex of systems that integrate and is more suited to your practice and/or
specialty.
The above 5 tools are a must for any Medical billing organization to function to its optimization and thus
bring in the much needed and seamless workflow to help increase the revenues and decrease the A/R
claims, which could either make or break the Revenue Cycle Management (RCM) process.