A billing system is one of the pillars of any organisation, including the healthcare industry. It ensures financial transparency, which is crucial for both service providers and those who avail of the service. Without proper financial management, an organisation can not only lose its reputation and business, but also attract legal charges. Medical billing systems are one of the most regulated and necessary parts of healthcare service providers. The billing systems of this industry take care of the patient’s health records, fees, insurance claims, and the overall cash flow between patients, insurance companies, partnered providers, and the healthcare provider service itself. If a healthcare provider doesn’t have a proper billing system, everything is at stake, including the patient’s rights and the provider’s regular payment. Therefore, having appropriate healthcare billing systems is crucial for maintaining healthcare service providers.

 Now, there are three main billing systems: Closed, Open, and Isolated. However, each system has its own disadvantages, which can be overcome through outsourcing billing to third-party digital solutions of the third-party. The article will discuss in depth the medical billing system and the importance of outsourcing medical billing so that you can choose your Medical Billing Service in Birmingham.

First of all, let’s look at the key medical billing systems that are used by major healthcare service providers, including private practices. 

Major Types of Medical Billing Systems

1. Open Billing System 

As the term suggests, this billing system integrates with many external sources. The Open billing system of the healthcare industry integrates with Electronic Health Records (EHR) to produce an error-free bill for the patients. It also connects with other healthcare entities and insurance companies through its interoperational service. It provides comprehensive records with optimum security and accuracy. The installation cost of the open medical billing systems is medium and affordable. 

2. Closed Billing System 

Again, as the name suggests, these medical billing systems use limited external sources and keep the billing private. Used mostly by private practices, a closed billing system keeps the billing, patient records, insurance claims, and cash flow within the access of the doctor and the healthcare provider. It doesn’t partner with other medical professionals, third-party billing entities, except the insurance companies. A closed billing system also uses EHR to maintain the accuracy of patient details and billing. 

3. Isolated Billing System 

An isolated billing system provides patients the access to their details and billing. Undoubtedly, the isolated healthcare billing systems are highly secured and private with no external connections. This ensures proper functionality focus, privacy protection, and patient control. Usually, this billing system is used by patients through individual record-keeping software integrated with Patient Health Records and Electronic Health Records, to manage their own billing.   

The most recurring part in all the above medical billing systems is EHR integration. But how does an EHR-integrated billing system work? Let’s find out!

Benefits of EHR Integration

An EHR-integrated billing system is able to procure all the details and medical history of a patient and hence ensures the accuracy of the bill. Not only this, through EHR integration, the healthcare billing systems get details of the insurance claims of the patients, verify their eligibility, and ensure the reimbursements of the healthcare service provider. It is through this integration that billing systems are able to connect with different billing entities, healthcare providers, insurance companies, and more. EHR integration is beneficial and crucial for all healthcare billing systems. 

Disadvantages of the Medical Billing System

But are the healthcare billing systems efficient enough to ensure smooth workflow without any obstacles, including legal issues? There is no doubt that the healthcare billing systems automate the billing procedure, make the insurance claims and reimbursements of the healthcare providers smooth, ensure accuracy and privacy of patients’ details, and in some cases, build external connections with other medical professionals and insurance companies. The billing systems definitely reduce the administration work, ensure the financial flow and safety, and help the medical professionals to focus only on patient care. 

However, the installation of the system, training, lack of upgradation to new updates, human error by the one operating the system, and other technical issues reduce the efficiency of the medical billing systems. Apart from these technical issues, the types of healthcare billing systems have internal issues, too. Some are so open or vendor-dependent as to compromise the privacy of the billing and medical records of the patient. Some are too private to allow beneficial external intervention like proper EHR integration, connection with other skilled billing entities, medical professionals, and updates about the billing codes. This creates compliance issues and leads to fraud or legal issues. 

Benefits of Outsourcing Medical Billing

Therefore, the safest option to maintain the billing/finances of the hospitals without compromising anything is outsourcing the medical billing. Outsourced medical billing will be accurate, up-to-date, GDPR-compliant, integrated, secured, and, most importantly, cost-effective. The experts of billing that the third-party digital solution provides are not only field-specific (under the umbrella of health sectors), but also aware of the billing codes, GDPR regulations, and accurate automated billing, insurance claim, patient’s privacy, and the cash-flow of the hospitals. 

Through outsourced medical billing, the doctors and medical professionals are relieved of the burden of administrative tasks, billing, and financial issues, and can just focus on their job- patient care. 

Conclusion

Healthcare billing systems add core values to the success and prevalence of any healthcare service provider. No matter how good the services are, the administrative, technical, and financial management decides how smoothly the healthcare providers can function. Relying on the standard billing systems is not the accurate solution to improving and strengthening the financial aspect of a healthcare service provider. Considering the rise in the field of digital solutions making many manual tasks easier and more accurate, pursuing digital solutions for medical billing is a smart choice. 

So what are you waiting for? If you are a medical service provider, dealing with complexities wrapped with the different healthcare billing systems, and divided between administrative tasks and patient care, there is one solution to all your problems- a digital solution for medical billing. So, choose your medical billing service provider in Birmingham today.