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Medical Billing Software Trends

Health Insurance Companies Process 1 in 5 Claims Wrong

 

I Hate My Medical Billing Software
Nearly 40% of Providers Surveyed Wanted to Replace Their Existing Medical Billing Software

If your medical practice is struggling to maximize billing efficiency, it’s possible your billing software is partially to blame. If so, you’re not alone. Based on a new report, an increasing number of practices are searching for a more ideal billing system.

Our friends at Software Advice, a leading medical billing software and technology research company, granted us early access to their latest survey about medical billing software trends. They randomly chose 385 industry participants, whose input may help to guide you on your own software buying journey.

Key Findings

The survey found:

  1. Nearly 40% of those surveyed wanted to replace their existing medical billing software.
  2. Roughly 1 in 5 professionals cited regulatory compliance as their top software concern.
  3. Mobile billing was the most requested feature, as noted by 21% of respondents.

Current Billing Methods

Why are so many physicians researching billing software options? Well, the reasons run the gamut:

  • 38% want to replace their current systems
  • 20% are starting a new practice
  • 13% are still using paper/manual billing methods
  • 13% are using a third-party billing service

 

Prospective Buyers’ Current Methods

Medical Billing BuyerView Current Methods

Focus on Compliance

The survey found that physicians are updating their billing software for many of the same reasons they previously mentioned for upgrading their practice management systems – namely, due to outdated systems or the need to integrate with other software.

But the top reason, as noted by 20% of those surveyed, is to achieve regulatory compliance. With major billing changes like ICD-10 on the horizon, practices are going to need a more robust billing software to handle the transition.

Remember how the diagnosis codes are skyrocketing from 17,000 to 140,000+? That’s a huge change that needs to be reflected in the billing software your practice uses.

Top Reasons for Replacing Existing Software

Medical Billing BuyerView Pain Points

Improving integration was a popular response as well, with 18% citing that as a reason for upgrading. Practices are beginning to understand how integrating billing applications with their EHRs can positively impact the practice – increasing billing efficiency and accuracy, and saving time.

The survey showed that 17% would like to completely eliminate paper billing from their practice. Another 15% said their current billing software was outdated, prone to crashes, or updated infrequently, leading to a loss in potential revenue.

Despite the outside pressure of ICD-10 compliance, few practices mentioned that as their reason for updating billing systems. The researchers concluded that may be due to the multiple delays already witnessed for ICD-10 implementation, so practices aren’t as worried about a looming deadline anymore.

Mobile Access

Features make or break a software package, and it’s no different with medical billing software.

And, just like with the rise in mobile accessibility for EHR systems, those in the front office are expecting the same benefits. In fact, 21% of those surveyed said having access to the billing software on the go was their most desired feature. Users are actively looking for software that is compatible with tablets and smartphones.

Top-Requested Medical Billing Software Functionality

Medical Billing BuyerView Functionality

Besides mobile access, billing staff also wanted software that streamlines the medical billing process. Sixteen percent cited claim scrubbing capabilities as the top feature they’re looking for, and 15% noted the importance of eligibility inquiries.

Since it’s estimated that more than $15 billion is spent each year in unnecessary administrative costs tied to claims processing, these two features represent significant time and money-savers. Claim scrubbers can quickly identify billing errors that have been missed by staff. And electronic eligibility inquiries offer a way to verify coverage within minutes, allowing office staff to obtain payment from the patient, if necessary.

Interest in Integration

Integration is a feature desired in many areas of the healthcare industry. From EHRs to billing software, integration is what buyers are looking for.

The survey found that 87% of buyers want an integrated billing suite – meaning the software package contains several applications that work together seamlessly. So, a software suite might include applications for data capture, coding, billing, scheduling, and EHRs.

Integration Preferences

Medical Billing BuyerView Deployment

Those buyers preferred an integrated suite over a stand-alone medical billing software, even when that singular software was considered “best-of-breed.” And just 1% of buyers prefer to use multiple products and systems.

It’s expected that medical billing suites will become more common because of the benefits for users. From streamlined information exchange to more efficient and accurate billing, having an all-in-one system makes sense for most practices.

Practice Demographics

Surveys are an excellent tool and way to gain insight, but they’re even more helpful when you know the backgrounds of the participants.

Approximately one-third of the respondents were office staff and 27% were physicians. And 23% were either practice owners or executives at large health networks.

Demographics: Prospective Buyers By Job Title

Medical Billing BuyerView Job Title

And there was a good mix of practice sizes too – virtually half and half. Fifty-three percent identified as a solo practice, while 46% identified as a practice with two or more physicians on staff.

Demographics: Perspective Buyers By Practice Size

Medical Billing BuyerView Size of Business

Final Thoughts

Software Advice researchers summarized the survey findings:

“Our data suggests that medical billing buyers, especially those from smaller practices, are looking for the best software tools to effectively comply with health care regulations, increase their billing effectiveness and keep more revenue within the practice.”

“Buyers we surveyed were seeking mobile medical billing options, functionality to address rejected insurance claims and the ability to integrate the system with their existing EHR software.”

“And most buyers were looking to replace the medical billing software they already had in place: evidence that medical billing professionals are increasingly considering how software can be used to address their practice’s needs.”

You can see Software Advice’s full survey results and report here.

What do you think of the survey results? Please tell me in the comments below!

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is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

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7 Responses to Medical Billing Software Trends

  1. I agree with Alex and also recommend that practices if outsourcing to choose a reputable company. Cheaper is not always better. I hear so many practices making decisions solely on the price. It’s not always apples to apples. Interview billing companies to make sure what you want and what they offer is a good fit. List the things you prioritize out of your billing needs (i.e., does this company do actual phone follow up, etc.) No one will ever care as much about your practice as you do; however, with the right company and good communication you can avoid the obvious pitfalls.

    • Well said Rebecca.

      We have taken over from other billing companies charging less than what we do yet were able to collect more money for the practice. The additional revenue not only paid our fee but gave the practice more money to keep.

      So the lower fee they were paying the other billing company was actually much higher when you factored in the lost revenue each month.

  2. As a health IT consultant, I suggest most of my customer to hire the third part services for billing. If you outsource the medical billing, you will become more focused towards your practices which ultimately result in higher revenue. Outsourcing will help to increase the cash flow of your practices, so you have more money in your pocket. Also your overhead will be removed, which occurred in the shape of medical coder salaries and training.

  3. You can’t totally depend on software for billing as sometimes you need lots of expertise and time to manage the software. I think outsourcing is much more reliable.

    • I agree outsourcing cuts a lot of overheads and with the right team and effort it pays off well. We work with lot of third party medical billing companies as their partner and our and their clients are merrier and happy.

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The analysis of any medical billing or coding question is dependent on numerous specific facts -- including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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