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Improved Income with Billing Software

Medical Billing Software Can Significantly Improve Practice Income

Given that its objective is to provide quality patient care, it is easy for an outsider to forget that private medicine is also a business. Like other businesses, its continued activity is totally dependent upon generating a revenue stream that is both adequate and consistent enough to meet all of its expenses. Unlike other businesses, however, the bulk of its income does not come directly from its clients, but must be claimed from medical aid funds.

Claiming requires compliance with strict protocols that are subject to frequent change, and are best managed with the help of specialised medical billing software rather than relying on a spreadsheet programme or a generic accounting package.

When tackled without the aid of a suitable computer programme, claiming reimbursement from healthcare insurers for services provided to their members is a process that, because of its complexity, can be prone to errors. At best, an error could delay payment while details of the claim are corrected and re-submitted. At worst, it could result in a repudiated claim and no payment for the service provided. Such errors, however, are easily eliminated when details of treatment and diagnostic coding are handled by a professional, medical billing software package.

Whereas a medical aid fund will very often cover the full cost of a member’s treatment, this is not always the case. For each form of treatment or item of medication, the contribution agreed to by a fund has a fixed limit, and, on occasions, this may prove to be slightly less than what is actually charged by the healthcare professional or establishment for a given service.

Some service providers require an up-front payment to cover such contingencies, while others agree to wait for any co-payments that may be due from their patients. Whichever option they may choose to adopt, collections are the sole responsibility of the service provider, and, once again, these can be dealt with far more efficiently by employing specialised billing software.

Doctors, dentists, and others engaged in providing various health-related services are all specialists in their particular field, as are accountants. Just as, for obvious reasons, one would not call on an accountant to perform an appendectomy, there is no reason to expect that a healthcare professional has the necessary skills to handle the financial affairs of a practice.

As well as medical aid claims, practice accounting typically involves four further areas. Firstly, it is essential to settle creditors promptly, so as to preserve any existing credit facilities, and ensure the practice is adequately stocked. While this alone may be something that could be handled by a receptionist without recourse to medical billing software, when combined with the other tasks, access to an automated solution can be invaluable.

Other financial responsibilities of a practice might include managing the staff payroll, and, of course, the mandatory requirement to provide the reports required by the South African Revenue Services, on time, and in the required format. The last of these tasks and, for many, the most difficult, is collecting payments from patients. It is one that requires total accuracy, which is only possible with automated medical billing software, as mistakes in their accounts are most unlikely to promote patient loyalty or encourage them to recommend a practice to friends or colleagues.

When payments from patients are overdue, dealing with collections can be an onerous task that requires a careful balance between tact and understanding, and the need for a successful recovery. Many practices choose to outsource this task rather than conduct it internally, believing that it is best handled by a specialist in such matters. In practice, it can be undertaken in-house, both tactfully and successfully, with a suitable medical billing software package.

Studies suggest that every year, South Africa’s healthcare professionals are forfeiting millions of Rands as the direct result of their inadequate accounting practices. The loss is due to the combined effects of non-payments by their patients, and for which there has been no attempt at recovery of the non-payments or underpayments by medical aid funds that result from late or incorrect claims submitted by practitioners.

These findings alone provide a compelling reason to consider automating practice accounting with the help of a dedicated medical billing programme. Surprisingly, the transition need not be expensive. V Professional Services requires no upfront purchase of our world-class software, but, instead, offer secure access to its benefits via a simple web browser and broadband connection.

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