Over a decade ago, healthcare organizations started the transition from paper to paperless and achieved outstanding results. In 2020, over 90% of US critical care hospitals had electronic healthcare records. Yet after healthcare organizations optimized record-keeping with software, the problem of interoperability arose.
To work smoothly and yield the best results, the EHR system must be integrated with other healthcare solutions, including billing software. When you connect electronic health records with billing solutions, it considerably simplifies accounting and claims processing. You reduce manual data entry, enhance reimbursement rate, and promote compliance. Handling patient claims and payments becomes much easier.
Learn how EMR and EHR in medical billing work and benefit medical practices in our post. We will also share the key points about the capabilities of medical billing and the electronic medical records systems.
What is an EHR and Medical Billing System: Differences and Things in Common
Medical billing and coding electronic health records are often used together. Since both systems leverage the same data to perform their functions, integration is a logical step. They also effectively supplement the functionality of each other. EHRs contain valuable patient information that increases the accuracy of the billing process.
At the same time, electronic health records and medical billing software initially serve different purposes.
- Electronic health records (EHR) solutions are designed to provide an electronic version of patient charts. These are centralized data hubs with patient information, such as health records visits, treatment plans, medications, allergies, immunization, prescriptions, etc. EHR software enables healthcare providers to access detailed data about specific patients for evidence-based decision-making. Apart from patient information processing, electronic health records software also connects different healthcare teams, supports scheduling, and automates other routine healthcare tasks.
- Electronic billing for medical records software looks how it sounds. It automates accounting and billing procedures within healthcare organizations. Electronic billing software runs insurance verification to verify patient insurance eligibility before the start of treatment. It also does claims scrubbing to audit claims and correct coding errors before submitting the documents for reimbursement. Finally, it tracks insurance claims to make sure providers complete the payment.
Generally, EHRs can operate as standalone systems. Healthcare billing services require integration with medical records. That’s why billing software is often provided as an EHR or practice management suite component.
Importance of Electronic Health Records and Medical Billing
Now when you know that healthcare billing solutions depend on EHR systems, let’s clarify why.
EHR software records and organizes patient information, and only then billing solutions use it for claim processing management. Simply put, without patient data collected, medical billing and coding electronic health records software won’t be automated. You will be forced to constantly switch between medical records and billing solutions to handle claims.
By integrating EHR and medical billing systems, you reduce manual tasks. Billing software automatically creates, checks, submits, and follows up claims processing EHR data. This translates to other tangible benefits detailed in the next section.
6 Key Benefits of EHR System Medical Billing
Although EHR and billing system implementation takes time, the investment quickly pays off. The healthcare organization enjoys much smoother billing procedures and other advantages:
1. Optimized data entry and claim processing
Manual data entry is frustrating. It takes time and makes medical staff more prone to making mistakes. Medical billing and the electronic medical records integration frees you from the need to enter the same data twice. The information from patient records necessary for billing claims (e.g., personal details, treatment history, and coding) is transmitted to billing software. Thanks to it, claim submission and processing also happens faster.
2. Improved reimbursement rate and revenue
Medical billing and EHR synchronization reduces the risk of coding mistakes or missing patient details. Hence, your billing claims are more likely to be satisfied. It increases the first pass claim rate, net collection rate, and other important medical billing metrics. Your revenue cycle management becomes more efficient and profitable.
3. Smoother user experience for healthcare providers
Since integrated EHR and medical billing is more convenient to use than two separate solutions user experience is also better. According to a recent Stanford report, 21% of primary medical specialties want better tools for billing administration and quality reporting. By connecting multiple services into one system, you can facilitate billing and meet their needs.
4. All data collected in one solution
When all systems within a healthcare organization, including EHR and medical billing, are aligned, you have a single patient view. Healthcare software integration also improves collaboration between teams and provides them with a single interface to manage services.
5. Better patient care and data security
Around 54% of patients report concerns about unauthorized access to their personal health information. And the more tools you use, the more vulnerabilities you have. When EMR and billing systems are connected, you can customize user roles to ensure only authorized access to medical information. Patients feel safer about their data and the actual security improves.
6. Transparency and compliance
Integrated electronic billing for medical records brings you a transparent workflow. You can see what has happened with a patient and conduct medical billing audits more easily. It also benefits compliance since transparent patient record-keeping and payments are at the core of most healthcare regulations.
What Should Integrated EHR and Medical Billing Software Include
Integrated EHR and medical billing software should include some additional features that are not available in standard electronic health records. Apart from the patient profile, test management, order management, it must have the next capabilities:
Patient Statements and Bills
Integrated EHR and medical billing software should store financial documents delivered to patients like statements and bills. It’s necessary for document management and archiving.
Medical Billing Coding
Make sure your billing solution includes ICD 10, HCPCS, or CPT codes, and authorized healthcare professionals can access and edit them. Codes are assigned to specific services and signify the amount of due payment. It’s an easy way to translate provided healthcare services into numbers to have them billed.
To operate well, EHR and billing solutions should have decent interoperability. Besides, you might need to connect your electronic health records with other medical software and devices. Secure APIs are currently the best option for medical software integration.
Automated Claims Creation and Management
To optimize the bills processing ability and minimize manual efforts, medical billing and EHR integration should automatically create claims based on source data. The software will do all the routine tasks, including claim submission and tracking. It will also mark no-response claims to detect unpaid or underpaid bills, which eat up to 7% of net revenue.
Financial Reporting and Auditing Functionality
To give the big picture of your financial affairs, medical billing and coding electronic health records should generate reports. It will enable you to provide documentation to regulatory bodies, monitor expenses, and perform healthcare billing audits.
How to Handle Your Patients Claims and Payments with EHR and Medical Billing System
To give you a better idea of how advanced EHR systems and billing solutions operate, here’s an example.
First, medical professionals enter information about the patient in an EHR. They include the name, medical history, coding details, test results, and other relevant data. When the treatment plan and related expenses are clear, it’s time to send a medical claim to the insurance provider. Before the start of the treatment, a billing system checks the insurance eligibility of a patient. This helps to avoid unexpected situations and ensure maximum reimbursement.
Then the billing system submits the claim and follows up on billing. It helps you to easily find billing records and achieve HIPAA compliance.
Consider Empeek as Your Trusted Partner
As a software development company, Empeek has launched both EHR and billing solutions for healthcare. We can design electronic health records and medical billing as separate solutions or make them integrated.
You can also decide to power a medical billing and EHR system with additional capabilities like we did for a US-based hospital. In this project, we integrated EHR with telehealth capabilities.
So share your ideas and business needs with our team, and let’s bring them to life together.
Healthcare organizations shouldn’t neglect an opportunity to use integrated EHR and medical billing systems. Such a combination simplifies regulatory compliance, optimizes billing processes, better connects healthcare teams, and brings other tangible advantages.
If you want EHR system medical billing tailored to your business needs, choose custom software development. With a dedicated engineering team like Empeek, you can design software from scratch or add the billing capabilities to your existing EHR solution.