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Medical Billing IT Services: Prescribing The Top Four Features

Published on 25 October 16
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For health companies to ensure continued operations and steady revenue, the right medical billing solution is critical. According to RevCycleIntelligence, the increasing complexity of medical claims has reduced the efficacy of manual billing processes, while inaccurate coding — for example, lack of ICD-10 support — can also impact the billing cycle. As a result, it’s critical that health agencies leverage solutions that embrace the top four features of medical billing tools: Let’s take a look.

Data Security

Health organizations deal with some of the most sensitive personal information available: If hackers get their hands on patient records, it’s possible for misuse and fraud to continue for years or even decades. Health service providers know all too well the temptation posed by personally identifiable information (PII), with numerous large-scale providers compromised over the last few years.

Bottom line? Your medical billing provider must make data security its top priority; this means encrypting information — not only during transit from local servers to off-site stacks, but also at rest. Look for a partner that includes both on- and off-site backups and data restoration services to ensure access to critical information — even in cases of natural disaster or hardware failure.

System Compatibility

When considering multiple providers, ask how the provider’s medical billing IT tools will interact with existing system infrastructure and software. Since many medical clinics and hospitals are still running legacy systems, one point of failure is the gap between new billing tools and older software solutions. If cross-system compatibility is possible, make sure data integrity and audit trails are maintained throughout the process to reduce the risk of lost or compromised data.

HIPAA Compliance

Ensuring HIPAA compliance is a top priority for any medical company, since damage or loss of data owned by your company is always your responsibility, even if third-party providers are in charge of billing tasks. It’s always prudent to ask for a copy of your billing provider’s HIPAA policies and procedure documentation to ensure it’s following the rules. As noted by EMR and EHR, the evolving market for medical billing means you should be able to find a provider that meets your specific needs: If you’re a radiology clinical or specialty surgical practice, don’t settle for generic billing tools. Instead, opt for solutions that offer both HIPAA compliance and full-service billing tailored to your market niche.

ICD-10 Support

As noted by Medicaid.gov, diagnosis code reporting recently shifted from the ICD-9 code set to ICD-10. Key differences in ICD-10 include the use of alphanumeric characters in all positions, 68,000 codes as opposed to ICD-9’s 13,000, and the ability to report laterality in diagnosis. It can also cause headaches for medical billing since there is no clear mapping between the two code sets. As a result, it’s critical to find an IT service provider that offers full support for ICD-10 code. This both increases the accuracy of your billing cycle and ensures industry compliance in the event of an audit or patient challenge regarding the amount owed.

Medical billing tools are evolving to meet current needs and reduce the risk assumed by health agencies. Finding the right partner means targeting four key features: security, compatibility, compliance and support.

Walter Slavnov is a Manager at Solid Networks, an IT solutions company with over 10 years of technology consulting experience, which offers a comprehensive range of IT services. Some of their solutions/services include: managed IT services, consulting services, data security, VoIP, and more.

For health companies to ensure continued operations and steady revenue, the right medical billing solution is critical. According to RevCycleIntelligence, the increasing complexity of medical claims has reduced the efficacy of manual billing processes, while inaccurate coding — for example, lack of ICD-10 support — can also impact the billing cycle. As a result, it’s critical that health agencies leverage solutions that embrace the top four features of medical billing tools: Let’s take a look.

Data Security

Health organizations deal with some of the most sensitive personal information available: If hackers get their hands on patient records, it’s possible for misuse and fraud to continue for years or even decades. Health service providers know all too well the temptation posed by personally identifiable information (PII), with numerous large-scale providers compromised over the last few years.

Bottom line? Your medical billing provider must make data security its top priority; this means encrypting information — not only during transit from local servers to off-site stacks, but also at rest. Look for a partner that includes both on- and off-site backups and data restoration services to ensure access to critical information — even in cases of natural disaster or hardware failure.

System Compatibility

When considering multiple providers, ask how the provider’s medical billing IT tools will interact with existing system infrastructure and software. Since many medical clinics and hospitals are still running legacy systems, one point of failure is the gap between new billing tools and older software solutions. If cross-system compatibility is possible, make sure data integrity and audit trails are maintained throughout the process to reduce the risk of lost or compromised data.

HIPAA Compliance

Ensuring HIPAA compliance is a top priority for any medical company, since damage or loss of data owned by your company is always your responsibility, even if third-party providers are in charge of billing tasks. It’s always prudent to ask for a copy of your billing provider’s HIPAA policies and procedure documentation to ensure it’s following the rules. As noted by EMR and EHR, the evolving market for medical billing means you should be able to find a provider that meets your specific needs: If you’re a radiology clinical or specialty surgical practice, don’t settle for generic billing tools. Instead, opt for solutions that offer both HIPAA compliance and full-service billing tailored to your market niche.

ICD-10 Support

As noted by Medicaid.gov, diagnosis code reporting recently shifted from the ICD-9 code set to ICD-10. Key differences in ICD-10 include the use of alphanumeric characters in all positions, 68,000 codes as opposed to ICD-9’s 13,000, and the ability to report laterality in diagnosis. It can also cause headaches for medical billing since there is no clear mapping between the two code sets. As a result, it’s critical to find an IT service provider that offers full support for ICD-10 code. This both increases the accuracy of your billing cycle and ensures industry compliance in the event of an audit or patient challenge regarding the amount owed.

Medical billing tools are evolving to meet current needs and reduce the risk assumed by health agencies. Finding the right partner means targeting four key features: security, compatibility, compliance and support.

Walter Slavnov is a Manager at Solid Networks, an IT solutions company with over 10 years of technology consulting experience, which offers a comprehensive range of IT services. Some of their solutions/services include: managed IT services, consulting services, data security, VoIP, and more.

This blog is listed under Development & Implementations Community

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