Specialized billing software or EMR for billing, which should I choose?
- 3 min read
Billing is a complex administrative practice that can be done independently but is less stressful when supported by professionals. The decision between using specialized medical claims software versus a billing module on your Electronic Medical Record (EMR) is important, as there are advantages and drawbacks to both.
Specialized Medical Claims software (such as RMA billing)
Intuitive Claims Entry
The interface is designed to simplify billing. All elements are placed strategically to minimize user actions and only gather billing–specific information. These systems work best to handle complex claims such as those for surgeries, post-ops, impatient and on-call visits.
Cross platform compatibility
Web and mobile applications are available to fit any workflow or preference. The mobile experience is targeted at quick entry while the web application has comprehensive features to create, manage, view and report on claims.
Data validation, error prevention and revenue optimization
This software employs rules to prevent errors, inconsistencies, omissions and provides suggestions to optimize revenue in correspondence to the rules and requirements for payment for services.
Direct bills
Processing these claims differ from regular OHIP or out-of-province (excluding Quebec) claims. These claims require additional patient demographic information and third-party coverage documentation to develop an invoice. It is hard to find specialized medical claims software with essential accounts receivable functionality, but at RMA we have customized ours to allow efficient and transparent processing of direct bills.
Includes information of the complete claims' life cycle
From the creation of a claim, through the editions before submission to OHIP, all the relevant information on the life cycle of a claim should be available to the physician through the software. This includes corrected errors, actions taken and remittance results.
Upload supporting documentation
The software should allow physicians to attach and submit required documentation for manual reviews such as operative reports and notes, third-party patient insurance, or securely add any other relevant documents for the processing and payment of claims.
Designate other billing agents
Authorized billing agents should be able to submit and follow claims in this software. Physicians can decide if they want to fully designate entry activities to agents or if they prefer a hybrid model where they enter as well.
EMR (billing module)
Access to scheduling, patient notes and patient information – as the EMR houses most or all relevant patient information, it is beneficial to extend its use to billing. Leveraging this information minimizes the duplicate task of creating a patient profile.
Some EMRs in Canada offer a billing module. EMR billing modules can have some or many of the specialized billing functionalities described above.
RMA is here to assist and support all physicians in any way they decide to manage their claim submissions.
Please feel free to reach out to your Billing Advisor representative. They can help you with any further questions or provide assistance.
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