Eight Questions to Ask Before
Purchasing Medical Billing Software
OVERVIEW
Medical claims and billing software typically will handle every aspect of
patient accounting including; electronic claims processing, payments &
adjustments, patient statements, and financial reporting. Programs can
range from a base of just under $1200 for general billing software
[generic CMS 1500 software], to over $8000 for a program that offers a
specialty specific EMR. Cost is typically based on how many licensed
providers the program tracks, and/or how many PCs [users] the software
will be licensed for.
BUDGET & FEATURES
Apart from establishing a budget, putting together a list of “must haves”
and “don’t wants” will get you closer to narrowing down the field so you
can look at individual programs. An easy way to accomplish this is to get
a consensus from your staff of likes and dislikes of key features in your
present software. Continue to sharpen this list as you evaluate each new
program. For cost comparison sake, take notes on specific features and the
cost associated with them. Software companies like to keep their prices
shrouded in mystery, so you have to be specific about the precise cost of
each feature; for instance, the ability to network, electronic billing,
reporting, scheduling, etc.
THE 8
QUESTIONS You should ask when considering a billing software:
1. Is the program WEB based or OFFICE based – does it require a Server, or
will it run on an ordinary PC? There are advantages and disadvantages to
both web based and PC based.
In a web based program, if your local internet is down, or the web-service
is temporarily unavailable, your office will be completely without access
to patient records during that time. On the other hand, web-based services
tend to provide an extremely low startup cost.
2. Are there MONTHLY or ANNUAL FEES associated with using the software?
The goal here should be to compare two to three year cost of ownership.
3. Does the software do ELECTRONIC BILLING? If yes, which clearinghouse do
they go through? Can it go direct to Medicare or Blue Cross if desired?
4. Is the CLEARINGHOUSE pre-chosen? Are the settings fixed (built into the
software), or can you use a medical insurance claims processor of your own
choosing? Many billing programs have a captive clearinghouse for electronic medical claim
transmittal -- meaning you’ll be locked into that specific vendor regardless of
their monthly subscription fees or quality of support. If this is the case, make sure you look into the track record of that
particular EDI vendor –or better yet, choose a medical billing software
program that allows the flexibility of a variety of clearinghouse choices.
5. TRAINING & SUPPORT: How much is training & support and how is it
accomplished – locally, or over the internet? How easy is it to reach
software support when it’s needed? What are the charges associated with
both?
6. CPT & ICD9 CODES: Procedural and Diagnosis Codes! Are they included, or
purchased separately? If purchased separately, what are the cost?
7. UPDATES: How often is the software updated and what is the cost? Are
there contracts? Are updates mandatory or optional?
What happens if you don’t update? (Some billing systems stop working if
the annual support fees are not paid.)
8. RETURN POLICY: Under what conditions can the software be returned – and
in what timeframe; and is the return fully refundable?
NEXT: Going Electric: How to Select a Good Clearing House
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