Questions to Ask When Evaluating Medical Billing Systems

questions regarding medical billing softwareMedical practices and medical billing services are faced with an overwhelming number of medical billing systems to choose from these days. This can make it extremely difficult to decide which system is the best medical billing software for your business.

When selecting the best medical practice management system, decision makers should focus on the following criteria:

Is the system prepared for ICD-10 which is due to take effect on October 1, 2014?

Do you prefer a cloud-based system which allows users to access the system from a wide variety of locations, or do you prefer to maintain your own server located in your facility?

Does the software include the ability to verify patients’ insurance coverage using a fully integrated Real-Time Eligibility feature?

Does the software help you avoid sending out claims with billing rule violations? In order to qualify as the best medical practice management system, the software should include a robust automatic claim scrubber to ensure that claims are submitted correctly the first time.

Can the system import data directly from your Electronic Medical Records or Electronic Health Records (EMR/EHR) system?

Are you able to send electronic claims directly from the billing system to the insurance companies or clearing house, or do you have to export the claims from the billing software and import them to a separate system?

Does the software automatically receive Electronic Remittances Advices (ERAs) from payers and/or the clearing house or do you have to leave the billing system to import the ERAs from the payers or clearing house?

Does the system give you the ability to choose whether to generate and mail patient statements yourself or to use a patient statement mailing service instead?

Are you able to work your Accounts Receivable directly through the practice management software without having to print out and mark-up paper reports?

Must you pay extra to acquire a top notch reporting module, or are a wide variety of customizable reports included in the cost of the software?

Is the system’s pricing straight-forward? Do you know whether there are additional costs associated with submitting Claims, receiving Electronic Remittance Advices and conducting Real-Time Eligibility inquiries?

How many system users can interface with the software?

Does the software provider assist you with payer enrollment?

Is training included in the cost of the system, or are there additional fees for training and enrollment assistance?

Will you be charged extra for system upgrades, such as those required when scrubber rules change or when new billing formats, such as ICD-10 take effect?

Does the software provider allow you to contact current system users to ask them about their experiences with the system?

These are just a few of the questions that one should ask when seeking the best medical billing software. The decision is an important one, and with so many different systems available on the market today, it is crucial to do your homework in order to make the best choice.

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