Medical Billing Software

ICD-10, the 10th version of the International Classification of Diseases (ICD), is a coding system used by healthcare entities to report diagnoses based on diseases, symptoms, social circumstances, complaints, or other internal or external causes of injury. Designed by the World Health Organization, the classification has been adapted by various member states to better suit their needs.

When different procedures and protocols connect to form a network, we call this synergy a system. In the medical billing domain, there are three types of health information systems:

1. Closed medical billing system: As the name suggests, in this type, patient information is restricted from being shared outside a single healthcare entity, such as a clinic or hospital. The data is typically stored in Electronic Medical Records (EMRs), which are digital versions of paper health records and are primarily used within a single provider's practice. This system does not support interoperability with external healthcare entities like labs, pharmacies, or other providers.
2. Open medical billing system: This system takes a more collaborative approach, allowing the exchange of health information across multiple entities, including labs, pharmacies, primary and urgent care, and other healthcare providers. Here, patient data is stored in Electronic Health Records (EHRs), which are designed for interoperability and can be integrated with tools like Revenue Cycle Management (RCM), Practice Management Systems (PMS), and Patient Portals. This system ensures accessibility for authorized users while adhering to regulatory guidelines like HIPAA (Health Insurance Portability and Accountability Act).
3. Isolated health information system: In this type, the data is managed independently by patients rather than by healthcare providers. Patients maintain their own Personal Health Records (PHRs) in a separate tool, distinct from EMRs or EHRs. PHRs are controlled by the individual and may not necessarily integrate with clinical systems used by healthcare providers.

RCM deals with financial processes in healthcare practices. It follows patients' experiences from when they schedule an appointment to when they make the final payment. RCM ensures:

• Bills are paid, and claims are submitted for reimbursement promptly.
• Providers receive timely and accurate compensation for their services.
• Healthcare professionals significantly benefit from RCM software by streamlining their payment processes.
• Patients also experience benefits through improved billing accuracy and the overall efficiency of healthcare delivery.

Our analytical KPI dashboards give you real-time updates on various metrics such as practice performance, financial health, and patient outcomes. These customizable dashboards support features like trend analysis, automated report generation, data analytics, etc.

Yes. Our RCM software is equipped with API connectivity, bidirectional data flow, and data synchronization. This allows seamless data exchange with multiple healthcare systems, including electronic health record (EHR) and electronic medical record (EMR) systems.

The benefits are endless, some of the most significant ones include:

• Automation of billing and coding processes
• Flawless integration with your existing system
• Comprehensive billing services
• Detailed analytics and reporting
• Efficient A/R management

Yes, we offer comprehensive Medicare/Medicaid billing assistance. From claim coding and submission to appeal management and compliance, we act as your all-in-one service partner.

We offer personalized training programs coupled with a comprehensive library of online resources to ensure your staff is proficient in using our RCM software.

Yes, we offer A/B cleanup as part of our services. Connect with us today to explore features like Legacy A/R Run-Down, A/R analysis, collection optimization, reporting, and monitoring.

We stay ahead and ensure compliance with dynamic regulations through continuous monitoring, software updates, and team training.