Dedicated Medical Billing Solutions
Why Dedicated Medical Billing Solutions are the Only Practical Option
That it would be unwise to attempt to repair a watch with a mechanics tool kit or to perform surgery with ordinary kitchen cutlery are assertions that few people would be likely to challenge. It is therefore somewhat surprising that so many healthcare professionals still choose to employ a standard accounting package in order to manage their practice finances rather than entrusting such a crucially important task to one of the dedicated medical billing solutions that have been compiled specifically for this purpose.
While a copy of QuickBooks or even an Excel spreadsheet might be quite adequate to record the transactions of an average small business or to help a family to control its monthly budget, such products lack the sophistication needed to automate the more complex yet crucial task of handling the submission and monitoring of claims made on the nation’s numerous medical aid funds.
Even more specialised programmes developed earlier may be unable to compete with the extent of the functionality now provided by newer products. For instance, where a member of staff might once have spent hours on the phone confirming patients’ cover details, these verifications can be performed automatically by most modern medical billing solutions. The time saved in this fashion means there is less delay in seeing patients, and so, there will be time for additional appointments on any given day.
The data protection act is designed to safeguard any personal details stored by a service provider, a requirement that is crucial to patient confidentiality. To maintain the necessary security, systems can be protected in a number of ways, such as the use of a firewall and the need for private credentials in order to access the system and define a user’s rights. The best protection against the attacks of hackers, however, is the use of a robust encryption algorithm to ensure that data remains protected during storage and transmission. Military-grade encryption provides a level of security for modern medical billing solutions that is unlikely to be attainable when a practice is relying on general accounting software.
Given the high cost of healthcare, few South Africans could afford it without the cover provided by a medical aid fund. When the time comes to settle up, however, the bulk, if not all of the payment, must be claimed from the patient’s particular fund. The submission process is a demanding one that requires the use of the correct codes to identify the practice, the condition treated, and each aspect of the treatment provided.
It is, therefore, a process that tends to be prone to human error, and this can result in delays to payment or even repudiated claims. Medical billing solutions can eliminate such errors with automatic selection of the appropriate codes and templates that simplify the entry process. Furthermore, some systems also have the ability to track the progress of submitted claims and to update income statements in real time.
The monitoring function also extends to the co-payments often due from patients when their fund does not provide cover for the full cost of treatment. The more comprehensive systems can detect overdue payments and automatically generate polite reminders or even initiate legal action to recover an outstanding debt if required. In this way, medical billing solutions can save both time and embarrassment. More significantly, they are an important means to avoid lost income, given that it has been estimated that, collectively, private practitioners in South Africa lose millions of Rands due to non-payment and unclaimed payments each year.
Not only do medical aid funds change their claim requirements from time to time, but governments also make periodic amendments to legislation governing financial reporting. Though it is necessary for healthcare professionals to comply with such changes, keeping up with them and updating their systems accordingly can be difficult and time-consuming, so while some developers update their medical billing solutions on their clients’ behalf, others might simply provide the client with a disc to perform their own update.
A well-designed system will also be able to handle the practice’s payroll responsibilities and to generate the necessary returns for SARS in addition to recording details of purchases and payments made by the practice to create a detailed balance sheet.
V Professional Services is recognised as a leader in the supply of medical billing solutions, and offers the choice of purchasing software, outsourcing the entire billing function to its dedicated bureau service, or accessing it as an online service.