Best Practices for Electronic Medical Billing

Electronic medical billing (EMB) is a process through which healthcare providers digitally submit their patients’ bills and claims to the concerned health insurance company. The insurance company will then process each claim and will eventually pay the provider for his services. Alternatively, a claim might also be rejected owing to various reasons in which case the provider will resubmit it after making required corrections.

The advent of electronic medical billing has significantly increased the success rate of claims submitted by providers. At present, more than 95% of all claims submitted electronically are converted into payments for providers.

Therefore, the most notable advantages of electronic medical billing are healthy cash flows for practitioners and shorter billing cycles.

The electronic medical billing process starts once a patient’s medical record is updated digitally, including his diagnosis, treatment plan and other relevant information. The provider will then assign a procedure code to the patient through an available database.

This code reflects the level of service or an evaluation of care provided to the patient.
This will be followed by assigning another code to describe the diagnosis made by the provider and in most cases this code will be from the database listed in the ICD-10. Finally all of this information is transferred to the insurance company.

Several practices can help providers in ensuring a high success rate for claims made through electronic medical billing. Some of these include:

Visits by appointment only

Scheduling through appointments only will allow insurance verification before provision of service and will result in accurate recording of billing information.

Mistake-free claims

Accurate and error-free claims have a high probability of being successfully processed without the demand for additional information. Higher the number of clean claims, greater the revenue for the provider.

Utilize System Intelligence

Enhancement in EMR and EHR software means that several daily billing functions and data requirements are integrated within the system. Features such as auto-eligibility confirmation eliminate the need to hire trained staff to take care of the financial side of the practice.

Electronic medical billing therefore standardizes the claim submission and retrieval process, taking away much of the hassle practitioners conventionally face to remain in business.

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