Cloud technology has upended the medical industry in recent years. Healthcare organizations around the world spend over $56.3 billion on cloud technology.
Cloud computing offers a number of important benefits for healthcare providers. One of the biggest advantages of cloud technology is that it helps make medical billing more efficient.
A cloud-based medical billing software program automates billing in order to help practices get paid faster, improve workflow efficiencies, help practice the IT solution for healthcare and keep patient information up-to-date. Moreover, it facilitates smooth digital workflows by reducing paperwork.
What Are the Benefits of Cloud-Based Medical Billing Technology?
Simply put, medical billing involves third parties in payment processes. As soon as the billers receive the necessary information, they prepare a claim for the insurance company. Managing claims, payments, and billing are all part of the billing cycle. Revenue Cycle Management is also known as RCM.
Medical billers and coders generally perform similar duties. In other words, their employment facilities are not as important as they once were. Patients’ diagnoses and treatments are documented with medical codes in clinics, hospitals, and physician’s offices.
The medical billing process can be very complicated. Fortunately, cloud technology has helped make it more efficient, as a recent report by McKinsey indicated. Some of the reasons that cloud-based medical billing technology is beneficial are that it reduces the need for an onsite IT infrastructure, it allows medical billers to seamlessly collaborate, can take advantage of machine learning technology and it has greater data security.
Medical billers can use cloud technology to do the following tasks more efficiently:
- Records of patients are read and scanned
- Code patient reports correctly
- Providers can be billed using codes (the providers can be connected to insurers through the same cloud infrastructure)
- Maintain accurate communication with physicians and assistants
- Ensure patient data is kept up to date over time (the cloud makes it easier to update data from any location)
- Keep detailed, coding-specific records (cloud technology makes it easier to store larger amounts of data, which allows for greater datail)
- Ensure the confidentiality and security of patient information (cloud hosting services can be much more secure)
- Search for information when coding is complex or unusual
- Analyze and reassess patient records and documents
- Examine and code the patient notes from the previous day
- Keep all codes up-to-date and active
The benefits of cloud computing for medical billing cannot be overstated. This is one of the many reasons the healthcare cloud computing market is growing exponentially.
What are the Medical Billing Processes that Can Be Completed with Cloud Software?
The medical billing process consists of a series of steps that are completed by billing specialists in order to ensure that the medical professionals will receive reimbursement for the services they have provided. As a result, it may take as little as a few days, or it may take several weeks or even months to complete this process, depending on the circumstances. Medical billing workflows can vary somewhat from practice to practice, but the following is a general outline of what can be expected in a typical medical billing workflow.
Fortunately, new cloud-based applications enable medical billers to complete these processes much more quickly. Some of the steps that can be handled through these applications that are hosted on the cloud include the following.
A medical billing flow chart begins with patient registration. Patients’ basic demographic information includes their name, birthday, and reason for visiting. A medical biller verifies insurance information, including the policy number and the name of the insurance provider. During the medical billing process, the patient file will be referred to using this information.
In the next step, we determine who is responsible for paying for the visit. By doing this, we can determine what procedures and services are covered by the patient’s insurance. A patient is informed of the financial responsibility for procedures or services that aren’t covered.
At check-in, the patient completes forms for their file or confirms or updates information already on file, depending on whether it is a return visit. During the appointment, identification and a valid insurance card will be required, as well as copayments. Medical coders translate medical reports from the patient’s visit into diagnosis and procedure codes once the patient checks out. All the information gathered so far may be compiled into a report called a “superbill.”. Providers and clinicians will be identified, as well as demographics, medical history, and information regarding the services and procedures performed, along with diagnosis codes and procedure codes that apply.
Once the superbill has been generated, the medical biller will use it to prepare an insurance claim for the patient. When a claim is created, the biller must check it carefully for compliance with payer and HIPPA guidelines, including medical coding standards.
The next step is to submit the claim once accuracy and compliance have been verified. Most health insurance claims are sent electronically to clearinghouses, which are third-party companies that connect providers and insurers. Medicaid, which accepts direct claims from healthcare providers, is the exception to this rule.
Monitor Claim Adjudication
By adjudicating a medical claim, payers assess its validity and compliance and determine whether a provider will receive reimbursement. There are three possible outcomes during this process: acceptance, rejection, and denial. Depending on the insurer’s agreement with the provider, accepted claims will be paid. It is necessary to correct errors found on a rejected claim and resubmit it. When a payer refuses to reimburse a claim, it is called a denied claim.
Patient Statement Preparation
In the event that there are any outstanding charges, the patient is billed once the claim has been processed. Patients should receive a detailed statement that lists the procedures and services they received, the costs of those procedures and services, the amount paid by their insurance, and the amount the patient is responsible for.
A medical billing process concludes with the payment of bills. If necessary, medical billers must send accounts to collection agencies when patients’ bills are delinquent.
Write about top medical billing technologies
There are several medical billing technologies and top of them are the following.
As a medical billing software system, Kareo Billing has been developed for independent practices and specialties with medical billing needs. There are many health organizations that use this type of solution in order to build relationships with patients, while at the same time providing the best possible healthcare.
This system helps to manage a wide range of daily operations within a clinic, such as scheduling, claims management, billing, payment processing, revenue management and a lot more. It is used by a wide range of specialty clinics. It is estimated that over 60 million patient records are being managed by this platform at present
As Praxis EMR learns from its users, physicians are not restricted by built-in templates but can practice medicine uniquely. The application has been known for providing consistent user satisfaction and faster charting as a result. Document management, knowledge exchange, patient portal, and more are all included.
The company is one of the fastest-growing healthcare solution providers on Inc. The magazine names them among its fastest-growing companies among America’s private companies. Providers and medical billing professionals can use it to manage the practice, create health records, e-prescribe medication, engage patients, and bill patients.
The IT Solutions and Android apps on mobile devices allow medical professionals to easily handle clinical and practice activities on the go.
A cloud-based and customizable EHR system, NueMD is designed for a wide variety of healthcare organizations. Medical specialties utilize the software to manage scheduling, reporting, billing, health records, and more in order to provide improved daily operations, as well as a rapid return on investment for their investment.
Behavioral and mental health facilities can use TherapyNotes as an EHR system that is cloud-based. It automates tasks, streamlines daily operations, and optimizes workflows to help treatment centers improve the quality of care.
Nextech automates and streamlines administrative processes and workflows for specialty practices. While maintaining compliance with laws, it seeks to enhance the patient experience while increasing productivity and revenue.
There are several solutions it offers, including EMRs, practice management systems, revenue cycle management systems (RCMs), patient engagement systems, and compliance systems. A patient portal and billing automation are some of the key features.
What are the most common denials in medical billing?
It is extremely frustrating and disheartening to have your medical claims denied. There is no doubt that revenue cycle management (RCM) is an important and important part of your business. With the right digital solutions in place, your RCM process can be automated and streamlined, so it’s easier for your team to catch errors before a claim has even been submitted. With all-in-one electronic medical record (EMR) systems like Raintree, you can get operational efficiency, reduce denials, and get specialty-specific clinical documentation, to name a few. Using an all-in-one EMR system like Raintree will help you meet all your operational needs.
It is important, however, to acknowledge and understand the reasons why claim denials occur if we are to address them. Here are the three most common reasons why you might be experiencing denials in your practice:
- Eligibility and registration
- The claims are not submitted on time
- Errors in medical coding
Why Are Denials So Bad for Business?
It’s not uncommon for an insurance company to terminate its contract with your organization if it receives multiple denials. Furthermore, an appeal can be an expensive and time-consuming process, so you should avoid getting denials as much as possible.
Insurance companies rarely provide explanations of benefits (EOBs) to help therapists understand why their claims have been denied, leaving them to research complicated coding criteria without much guidance. As a result of research time and the appeals process, payments can be delayed, extra duties for overworked office personnel are imposed, and sometimes even reimbursement deadlines are missed.
An RCM system that can generate an EOB with every claim can prevent therapy and rehab practices from losing income due to claim denials. You can ensure timely appeals of denials by using Raintree’s billing tools.
What’s Remittance Advice (RA)?
The remittance advice is a document that proves payment has been made by the customer to the business. It’s generally used by customers to inform businesses when invoices have been paid. A remittance slip is similar to a cash register receipt in a sense. Especially helpful when matching invoices with payments, they keep track of invoices.
As online payments become more popular, remittance advice slips are becoming less necessary. It is always appreciated to send a confirmation email after an invoice has been paid.
What should a remittance advice slip include?
The remittance advice slip must contain several key pieces of information. Among the most important information on the slip is:
- Details of your address and name
- Address and name of the supplier address and name of the supplier
- Payment method
- The amount of the payment
- Number of invoices
Your remittance advice slip should be printed on company stationery and include the contact information of a member of your team who can respond to inquiries from suppliers.
What is an EOB in medical billing?
In the medical world, “EOB” is a common abbreviation. The benefits explanation stands for that. A document showing how your health plan and you split your care costs arrives in the mail or to your secure online account. Your insurance provider may charge you out-of-pocket charges for certain services.
Your health plan will send you an EOB after you have had medical services or purchased equipment with your insurance card. You will receive an EOB when you receive a bill or bills, but it is not a bill itself.
What does HCFA 1500 mean?”
Health insurance providers use this form to bill healthcare providers. Medicare, part B, as well as Medicaid are billed using this form. In the United States, this form is maintained by the National Uniform Claim Committee (NUCC).
In the HCFA, you will find all the essential information needed to submit a precise claim. The healthcare provider must include the following information in this form;
- The demographic information of the patient
- An overview of the patient’s insurance
- Codes for medical records
- Service dates
- This form should contain accurate and factual information. Healthcare providers should be honest when filling out the form to avoid disputes. Insurance companies may refuse to honor claims if they detect irregularities.
Each health provider has a specific box. There might be different instructions provided by the payer on how to fill out some boxes. It is important for medical coders and billers to understand the requirements of certain payers.
If you’re interested, you may also read about the best HIPAA Compliant Scheduling Software for healthcare providers.
Cloud-Based Medical Billing Technology is Changing Healthcare
Cloud technology is changing the healthcare sector. One of the many benefits is that it helps make medical billing more efficient. The purpose of medical billing is to generate healthcare claims for submission to insurance companies for payment for services rendered by providers. Cloud-based medical billing software should be used by all healthcare organizations and individuals for the growth of their business.