Have you ever wondered why there is no predefined time to prepare a bill? Patients receive their outstanding bills anywhere from 2 weeks to a few months. Patients even complain about getting surprise bills years later! This overlooked practice of sending delayed bills harms the healthcare organizations in more ways than meets the eye! The longer it takes to send a bill, the more difficult it gets to collect the money. This interrupts the revenue cycle of an organization. On the other hand, the administrative delay causes harm to patient loyalty. If you are trying to improve the practice, apart from the usual gaps in management, have you thought about checking your medical billing systems?

That’s right! There are different types of medical billing systems for specific healthcare organization setups. Administrators often overlook this aspect of change and miss out on a significant amount of revenue. This article will take you through the features of 3 different medical billing systems and how you can use them to your advantage.

1.Closed Medical Billing Systems:

A closed medical billing system uses digital tools to track health records with specific tweaks.

  • As the name suggests, a ‘closed’ medical billing system means that the billing charts and associated health records remain within the boundaries of a particular clinician.
  • The preferred digital tool for treatment charts is called Electronic Medical Record (EMR).
  • The EMRs contain all the information of the patient of a particular provider. They include all the data like the diagnosis and the treatment plans.
  • You can also connect different EMRs within the practice with each other for better support.
  • However, the EMRs cannot be used outside the practice boundaries. It is only for the assigned physician and the billing teams to handle.
  • Medical billing experts say that EMR is simply an electronic version of the good old medical paper charts.

Who can use it?

Closed medical billing systems come in handy for small stand-alone practices with a lesser number of physicians. But in case you need to outsource the revenue cycle management to a vendor, you will need to change the system to an open one.

How are EMRs used?

Many beginners get confused about the use of EMR in a clinic. If it is only an electronic form of the paper charts, is it conducive for the physicians? It turns out, EMRs can help the providers in many ways in a small practice setup:

  • Providers within a practice can connect multiple EMRs to comprehensively view the patient’s treatment plan.
  • EMRs help the physicians to track the due dates for a patient’s check-up or preventative screenings.
  • Providers also use EMRs to track the patient’s vital parameters over a period of time. This helps them to identify any need for a change of treatment plans.
  • EMRs can also be used to track vaccination programs.

2.Open Medical Billing Systems:

Open medical billing systems represent a more collaborative structure than closed ones.

  • In an open system, the health records of the patient travel beyond the boundaries of a single practice.
  • In this kind of setup, all major stakeholders in the healthcare industry- the providers, patients, billing teams, multiple healthcare organizations, and third-party vendors can access the information.
  • The patient’s health data is transmitted to different sectors of the system through Electronic Health Records (EHR).
  • EHR is a more comprehensive information chart than EMR since it can be accessed and edited by several healthcare professionals and the patient, not bound by the walls of a single practice.
  • According to professionals, EHRs ensure a better health outcome for patients since they consider a much larger picture and intricate details.

Who can use it?

Large healthcare organizations with multiple departments can benefit from an open medical billing system because it gives them flexibility. If an organization is thinking of outsourcing medical billing to a third-party vendor, it needs to switch to the open billing system. It helps them to transmit information to the outsourced medical billing professionals.

How are EHRs used?

EHRs have multiple uses which go beyond simply maintaining the paper-based treatment plans digitally. Here is how they become helpful for several stakeholders:

  • EHRs store vital intricate health details of the patient like demographic factors, allergic reactions, past test results, previous diagnoses, and past or ongoing medications. In short, the entire medical history of the patient is stored in the EHRs.
  • Within a single practice, different departments, and separate specialists can access the EHR at any time. It helps them to get a more holistic view of the patient’s health.
  • Any laboratory or imaging center can access the EHR when a patient is referred to them.
  • If the patient is making a transition from one provider to the other, the new professional can get a comprehensive picture of the patient and treat them accordingly.
  • The patients can look up any changes on their EHRs to better view their health. This indirectly also motivates them to follow the doctor’s advice and take the prescribed medications.
  • In case the organization chooses to outsource the medical billing procedure, the assigned team can access the health records to make the billing process faster.
  • EHRs also get integrated with any software system in case they use one.
  • The sensitive patient health information stays protected by federal law. HIPAA compliant medical billing companies make sure no unauthorized personnel gets access to the EHRs.

3.Isolated Medical Billing System:

Isolated systems do not traditionally participate in the medical billing structure, but they can benefit healthcare providers.

  • Isolated systems are maintained solely by patients, and not any organization or provider, through the Personal Health Records (PHR).
  • The patients enter their health information in these records to maintain them and refer to them according to their convenience.
  • They can also use software tools to maintain the PHRs.

Who can use them?

As mentioned earlier, isolated systems are only for the patients to use. Only EMRs and EHRs are legally accepted. PHRs cannot replace them at any point in time.

How are PHRs used?

Though PHRs are not legally acceptable, they can be of enormous help to the healthcare professionals and, therefore, the medical billing team.

  • Patients can use the PHRs to fill in their medical details when registering themselves in a healthcare organization.
  • They can also produce them to their providers to give them a better view of previous and existing medical conditions and treatment.
  • If they use software tools to keep the records, the software should provide a way for open communication and transmission.

We hope this article helped you to get an idea about the three different medical billing systems. There is no good or bad when it comes to using these systems. The only thing you should keep in mind is the feasibility of such a system in your own practice setup. Make sure you track down your parameters and evaluate the areas of improvement. In case you are struggling with your financial performance, you can get in touch with leading outsourcing companies that will analyze the data and provide a suitable plan.

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