Medical Billing

What is Medical Billing?

What is Medical Billing?

Medical Billing Helps You:

  • Get paid faster
  • Improve efficiency
  • Keep patient information current

Reduce billing errors

Medical billing involves the filing of claims with insurance companies in order for the healthcare provider to receive payment from their patients.

First, a medical coder will generate a superbill which is an itemized form that names each service the patient received. After that, the medical biller sends the superbill to a clearing house where they scrub the form for any issues. Finally, the claim is submitted to the health insurance company; the patient is billed and the healthcare providers are paid for their services.

The process can be complicated and lengthy, as it can take between 50-90 days for the healthcare provider to receive payment. To optimize the process, medical billers can leverage medical billing software that provides a variety of tools and features to help limit the number of billing errors. Prior to an appointment, the system verifies the patient’s insurance information to ensure successful collection of payment. Before you submit an insurance claim, the documents are scrubbed of any errors that could cause payment delays, or in some cases, missed reimbursements.

Billing templates are configurable to fit with specific practices and multiple specialties. Patients may manage payment plans and any upcoming bills online. The software can notify them of any upcoming payments due, limiting the number of missed payments. Below are a few tools used in medical billing solutions to help reduce the number of billing errors.

  • Insurance Eligibility Verification
  • Claim Processing
  • Electronic Remittance

Get paid faster

One of the primary advantages of using medical billing software is how quickly it allows you to collect payment and reimbursements. These solutions can send out automated notifications to remind patients of upcoming payments or overdue balances.

As we mentioned, medical billing systems provide tools to help reduce the number of billing errors. The assurance of accurately filled-out claims helps provide a higher first-time acceptance rate, and as a result, your organization gets paid faster.

Medical billing provides you with a risk assessment regarding a patient’s payment history. Risk assessments can give your staff insight into the likeliness of a patient paying their medical bills. If you need to speed up the payment process, look for some of these tools:

  • Payment Reminders
  • Reimbursement Tracking
  • Electronic Superbills

Improve efficiency

Automating the medical billing process can save your staff a considerable amount of time. Nurses and medical assistants have reported spending over 20 hours per-physician per-week on administrative tasks such as patient check-in or insurance verification. Billing software allows your staff to focus their efforts on what they do best, providing healthcare to their patients.

Digital billing and payment prevent the possibility of misplaced or damaged paper payment confirmations. It also assures accuracy when documenting patient information and allows your organization to get reimbursed faster. Another benefit of going digital is the ability for patients to fill out their intake forms prior to arriving at the office; this saves everyone time and improves doctor-patient relationships.

Here are some standard features that typically help improve productivity as well as operational efficiency:

  • Patient Scheduling
  • Workflow Dashboard
  • Clearinghouse
  • 24/7 Accessibility

Keep patient information current

Medical billing functionality typically integrates with an EMR/EHR system. This allows any updated patient information, such as demographics, insurance information, medical history and more to be easily accessible from any department. A patient’s insurance can be verified automatically, and payment plans can be set up in advance.

Once a patient’s information updates, the system automatically transfers that data to the EHR/EMR platform. Physicians and other staff members can spend less time documenting and looking up patient information and reallocate their time to patient care. These features help ensure patient information is accurate and up to date.

  • Real-Time Data
  • Patient History


How Does Medical Billing Software Work?

A variety of health organizations and medical specialties use medical billing solutions for both inpatient and outpatient care. These facilities rely on software to streamline their billing and payment processes, automatically manage insurance claims and reduce the number of billing errors that occur. Medical billing almost always integrates with an EHR or EMR solution; this allows health organizations to share data between multiple departments, giving all staff members up-to-date, accurate patient information.

How Do I Know I’m Ready for Medical Billing Software?

There’s no magical formula that can determine how much you’ll benefit from implementing software. However, there are some clear indicators that your organization is ready. Here are just a few:

  • Experiencing rejected or unqualified claims
  • Reimbursement takes a long time
  • Noticing errors
  • Missed revenue due to unverified insurance
  • Spending large amounts of time with manual billing

How Do I Select a Medical Billing System?

Just like any software selection process, adopting a medical billing software system is challenging and time-consuming. There are so many options available and it’s important that you choose a system that suits your unique health organization. For example, you will need to consider factors such as the size of your facility and the number of clients you provide for. However, keep in mind that some software systems are designed to address a specialty.

An in-house evaluation of your organization’s requirements is a great way to ensure you find the best fit, and it’s a good idea to involve all staff that will be using the software. Take a look at our Medical Billing Software Features and Requirements or our Top Five Cloud Medical Billing Software Solutions to get started with your selection process.

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Medical billing articles are written and edited by:

Hunter Lowe

Team Lead Editor and Market Analyst at SelectHub

Hunter Lowe is a Team Lead Editor and Market Analyst at SelectHub. He writes content for Construction, Inventory, Warehouse, and Supply Chain Management.

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Medical Billing Thought Leaders

SelectHub has sought out and invited thought leaders to contribute to our medical billing industry articles and resources. These thought leaders ensure we deliver quality content with the most accurate information, focusing on what matters most. No thought leader is compensated for their contributions, but shares our belief that information should be democratized so everyone can make the best decision.

Sapan Desai

Sapan Desai

Chief Executive Officer, Surgisphere

Dr. Sapan Desai, a board-certified vascular surgeon and lean six sigma master black belt, has received international recognition for his work in healthcare quality, machine learning, and data analytics.

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John Nosta

John Nosta

Health Technology and Innovation Theorist

First and foremost, John is a thinker. A thinker entrenched in the world of science, medicine and innovation. John is the founder of NOSTALAB—a digital health think tank.

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Best Medical Claims Processing Software For 2020

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Insurance claims can be the most stressful and confusing aspect of running a medical practice. With the medical insurance landscape constantly in flux, it can be too much to stay on top of everything with a manual system. More physicians and practices are opting for medical billing software that incorporates patients’ electronic health records, patient portals, revenue cycles and clinical cycles to streamline the medical experience.

That’s where medical claims processing software comes in. The best medical claims management software should have great claims management functionality as a priority — but not all of it does. That’s why we made a list of the best medical claims processing systems on the market to help you make informed, empowered decisions for your business.

Bergen AdairBest Medical Claims Processing Software For 2020
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Medical Billing Software Features And Requirements Template Checklist


A medical practice’s job is to care for patients, not keep track of and sort out billing. That’s why medical billing software exists! But what do you need to look for in software for billing? Do you need Medical Practice Management software or Electronic Health Record software? Do you have one of these and still need a separate medical billing software solution?

Bergen AdairMedical Billing Software Features And Requirements Template Checklist
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Top 5 Cloud Medical Billing Software Solutions


We’ve all been there at some point — sitting in a not-so-comfortable chair, staring at the clock as your doctor’s appointment is running behind schedule once again. A trip to the doctor is the last way most people want to spend their day, and the time it takes — from filling out paperwork to simply waiting around — doesn’t help by any means. Healthcare providers understand this and are doing whatever they can to speed up patient visits and improve patient satisfaction. One of the tools providers are benefiting from is cloud medical billing software.

The use of medical billing software allows healthcare providers to spend more time on patient care and less time keeping track of billing. From scheduling an appointment all the way up through payment, billing software automates the entire billing workflow process, step by step. As healthcare becomes increasingly mobile and information is needed to be shared between facilities, cloud-based solutions are continuously becoming the preferred form of deployment for medical billing software, as opposed to on-premise. Cloud-based solutions provide all the tools and functions you need out of your billing software without any of the hassles.

Evan HeierTop 5 Cloud Medical Billing Software Solutions
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Top Technology Trends in Healthcare

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Health information technology is constantly adapting to meet the changing needs of healthcare providers. From a stronger focus on patient satisfaction to greater security of patient data, medical software trends and tools have evolved throughout the years. With continual disruption, it can be difficult to understand which features and tools your healthcare organization will benefit from specifically. Here, we’ll highlight some of the key current and future technology trends in healthcare to keep in mind to help your facility stay ahead of the curve.

Dan GreenfieldTop Technology Trends in Healthcare
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Medical Software Features and Requirements

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Medical software has become a staple of the healthcare industry in recent years. From EMR/EHR and practice management software to medical billing and patient scheduling, there are a wide variety of options as well as tools and features when it comes to medical software. These medical features offer a number of benefits to help with healthcare organizations from small specialty clinics to larger hospital systems.

Evan HeierMedical Software Features and Requirements
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Medical Accounting Software: Does My Practice Need Better Healthcare Accounting?


Most healthcare organizations would rather talk about patients than administration any day of the week. Unfortunately, those seemingly small and insignificant back-office tasks need to be discussed now and then to make sure your practice runs smoothly. Thanks to medical software solutions, many of these tasks are easier to manage than ever before. Charting software (EMRs/EHRs), medical billing software, patient scheduling software and medical practice management software all offer unique benefits to healthcare organizations of all sizes. However, the question that many find themselves asking is: does my practice actually need any or all of these different types of software? For example, do I need medical accounting software?

Bergen AdairMedical Accounting Software: Does My Practice Need Better Healthcare Accounting?
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Do Offices Need Medical Billing Software and Practice Management Software?


A wise man named Forrest once said, “Life is like a box of chocolates: you never know what you’re gonna get.” While it may be fine to take that approach to your own life, you want to know exactly what you’re getting when you buy medical software — it’s responsible for other people’s lives! Understanding the difference between medical billing software and medical practice management software is a crucial place to start.

Bergen AdairDo Offices Need Medical Billing Software and Practice Management Software?
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Best Web-Based Medical Billing Software

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An apple a day may keep the doctor away, but the billing process shouldn’t! Medical billing can be confusing and frustrating, but it doesn’t have to be. Medical billing software or billing modules within EMRs and EHRs can make the process a breeze. Plus, advances in cloud-based technology, you can have access to your software any time, anywhere. We’ve compiled the best web-based medical billing software programs to help you in your search.

Bergen AdairBest Web-Based Medical Billing Software
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