Choosing A Good Medical Claims Processing Software

Posted by Ecareindia on October 14th, 2011

We are going to discuss now, about the features that good medical claims processing – the medical billing software should possess. Well, most of us would have already chosen a software that suits our needs or at least learnt to survive with a software that’s chosen in rush. Some of us may even be in look out for good medical billing software as well. Whatever be the case, we should know the latest advancements that different medical claims processing software companies have introduced in the recent years. Is it really important to spend time in analyzing the features to choose suitable medical claims processing software? Certainly. Experienced medical claims processing professionals would have realized that medical billing software plays a major role in healthcare revenue cycle management process and aids in every step towards collecting money. The better the features are, you will get maximized benefits. But, it is tough to find all advanced features in the same software. The best option is to go for user friendly software that has the most essential features. Let’s analyze the importance of medical claims processing software & review the vital features.

How medical claims processing software helps in enhanced process/ collections?


  • Different medical billing software have their own features that will enable you to do certain function that other software doesn’t. This will give you the competitive edge over others, resulting in enhanced reimbursements.


  • Certain software will enable you to perform the entire process with the same medical claims billing software, acting as a one stop shop for your medical claims billing needs. This will avoid discomfort arising from switching over to multiple systems at the same time.



  • Software that can give you proper insight about your process & performance will aid in revenue improvement, whereas other software may not provide this insight and requires human intelligence to find things out, thereby wasting valuable time which could have been spent in doing productive work.


Features that help in medical billing process enhancement:


  • The depth of report that can be provided for appointment scheduling can make the practice more profitable.


For an instance, when a particular patient books for but often skips appointments can be easily tracked and be fined, since the physician is booked for that period & the patient didn’t turn up resulting in waste of time in which the physician could have treated another patient. Features like this will give you better idea about how your appointments are doing & eliminate messy appointments and will make your practice more manageable right from the beginning.


  • Good medical billing software should control errors in charge entry. The review screen with visual editing features for charge entry will enable the charge entry professionals to have a look at final screen and eliminate errors. For recurrent appointments the complete patient encounter information should be updated to avoid data entry again.


  • Denial management reporting features that provides exhaustive report on denials can be useful to a great extent. It will enable AR analysts to manage denials efficiently and save time as well.


Advanced Features:


  • EMR/ EHR: EMR/ EHR implementation is talk of the nation now. We need to implement it before 2015 to get along with industry standards. We need to therefore look for medical claims processing software that can integrate with EMR/EHR. EMR software with inbuilt medical claims processing software will be a good option.


  • Document Management System: This is an essential feature that would contain complete repository of vital documents mapped to the patient accounts. This will help in handling denials effectively since analyzing will be easy with all important information together. Moreover, if the card copies of patients are scanned and uploaded to the system, it will help in verifying insurance and eliminating errors due to improper insurance eligibility verification


  • Manipulation restrictions: Medical billing and coding fraudulent activities are becoming common these days. Since the medical billing software is the claims processing medium, it is good to choose software that is secure as well as restricts manipulations in system.


  • Backup Management: Software that has backup management features will help in information management even at times of emergencies


  • Dash board features: Dashboard feature is a smart functionally that will give a snapshot of all metrics, to-do list, revenue performance etc., in the ‘startup’ screen itself. This will give an idea of performance and your activities in a glimpse.


  • Work flow allocation: Some medical claims processing software enables work flow allocation which is an important segment of handling task. The assignee & the director would get alerts regarding task and the status would be automatically updated. This vital feature organizes workflow and provides better results.


About the Author:

Tanya Gill is the Public Relations Manager for ecare India based in Chennai, India. She has wide knowledge and experience in the medical industry. ecare India is a leading medical billing company offering end-end medical billing services and is backed by extensive domain expertise, latest technology and dynamic compliance norms. ecare is HIPAA compliant and is the first Indian medical billing company to get ISO 27001: 2005 certified for information security management. ecare is also ISO 9001:2008 certified for quality management. By providing outsourced medical billing services, ecare makes it feasible.

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Joined: June 20th, 2011
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