‘All-in-One’ or ‘Specialized’ Medical Billing Software? Which is Best?

Medical Billing SoftwareWhich is the BEST kind of Medical Billing Software? “All-in-One” or “Specialized”?

When considering WHICH medical billing solution they should use, practices wonder which is best, an “all-in-one” solution or specialized software. Well, the following are a few important pros and cons to consider when making a choice between these solutions.

ALL-IN-ONE:
An “all-in-one” system tries to provide a single, comprehensive solution that offers functionality for the major areas of the practice—Practice Management (PM), Electronic Medical/Health Records (EMR/EHR), and Revenue Cycle Management (RCM)—accessed from one central point. It has features like clinical notes, patient information and history, diagnosis and treatments, scheduling, appointment reminders, reports, patient educational resources, as well as a medical billing section.

PROS:
• Most of what a practice needs is included in the system
• There is no need to be concerned with multiple integrations or vendors

CONS:
• Tends to have a higher ‘entry’ cost
• Usually designed for the “middle-of-the-road,” therefore sometimes doesn’t properly address specific needs of a practice
• Sometimes, the practice is left paying for additional customizations to fit their particular needs

SPECIALIZED SOFTWARE:
Specialized medical billing software, on the other hand, is particularly programmed to maintain billing details of tests, procedures, examinations, diagnoses, and treatments conducted on patients.   However, many specialized software providers extend their scope to include features like practice management, scheduling, and other administrative and clinical functions (that are generally a part of EHR software systems) by partnering with other specialty software companies—creating a “best-in-class” solution.

PROS:
• Integrating multiple “best-in-class” software packages—each taking a much more focused approach—creates an offering with much more in-depth capabilities
• Usually are more ‘nimble’ in responding to industry and regulatory changes
• More ’scalable’ in supporting the growth of a practice

CONS:
• Most of the time the practice has to deal with multiple vendors

 

CONCLUSION:
Where “all-in-one” solutions offer a wide breadth of capabilities across the business, they usually also lack focus, depth, and sophistication. “All-in-one” solutions are usually only efficient in one area, with the other areas tend to be ‘compromised’ and not fully developed. Then, when it comes to flexibility, they tend to be slow to adapt to changing practice needs.

Specialized software, however, typically offer a more efficient experience, with each ‘component’ streamlined and designed with a specific purpose in mind. Their focus on limiting the software scope makes them flexible and easy to use.

EZClaim—a leading software package in medical billing and practice management—has made it easier for the medical practice to have the benefit of a “all inclusive” solution. They have created the best of both worlds by taking on the responsibility of integrating the “best-of-breed” into a harmonized “best-of-class” offering that allows the practice to pick and choose for their specific needs. The seamless integration of partner products and services ensures the practice does not have to give up robustness and flexibility for a simplified “all-in-one” solution, and it further enhances the practice’s workflow.

As a specific example, one of EZClaim’s partners is TriZetto Provider Solutions (TPS), a provider that seamlessly blends claims processing with revenue management and analytics software, so the practice can get paid faster, and more accurately.

Today, the practice can get the benefit of all the power and ease of use of EZClaim’s medical billing software and all the access and security that is needed when dealing with personal records by using  TPS—which includes patient access, claims and denials management, patient financials, and advisory services.

The powerful integration between EZClaim and TPS efficiently adds functionality to the practice. Now the practice can gain deeper insight into the claim lifecycle, and take the proper steps to improve the overall health of the practice. The right ‘integrated’ solution makes all the difference!

So, if your practice needs more confident billing, after payments, and more informed decisions, put the power of EZClaim and TPS to work for your practice with the integrated suite of revenue cycle solutions.

In addition to TPS, EZClaim has tightly integrated a variety of of ‘components’ to be able to offer an “all inclusive” best-in-class solution for a medical practice’s needs: Electronic Health Records (EHR), Clearinghouse, statement and payment services, HIPPA compliance, claims scrubbing, appointment reminders, and inventory management. It has partnered with a variety of providers like QuickEMR, BestNotes, and PracticeFusion  [ Click here for an entire list of EZClaim’s partners ].

It is important to note that an “all-in-one” solution does not usually include the Clearinghouse portion that TPS offers. The powerful integration between EZClaim, TPS, and EZClaim’s EMR partners, efficiently adds functionality to ANY practice!

If you are considering the best course of action to meet your practice’s needs, consider using EZClaim by downloading a FREE TRIAL or contact one of their product specialists today to explore all the options for how to best solve your practice’s operational challenges, and grow your business.

For details and features about EZClaim’s medical billing software, visit their website.

Clearinghouses – Simply a Pass-Through Portal?

AMBA 2019 National Conference Session Recap

Written by Stephanie Cremeans of EZClaim – AMBA 2019 National Conference Session Recap

AMBA 2019 National Conference Session RecapI recently attended a breakout session of a seminar with a slide titled: “Clearinghouses are not Simply a ‘Pass-Through’ Portal.” With my role as a software support specialist, I immediately tensed up and thought about how inaccurate this statement is – I hear from clients that think that the software or the clearinghouse has changed their data, but that simply isn’t how it works. Well, kind of not how it works. You know that nothing in medical billing is as simple as it seems! Depending on how your practice management system works and depending on your understanding of how electronic claims are filed this may or may not be a valid statement. While I’ve always described a clearinghouse as simply a “pass-through” for your claims this seminar got me thinking about how much more a clearinghouse is! Let’s explore a little, starting from entering your claim into your PM system and clicking send.

The first piece of the puzzle is understanding what your PM system is (or isn’t) doing with the data. You’ve entered the claim data and you are ready to send your claims to the clearinghouse, but how is that data transferred?  There are 2 typical formats – Print Image or ANSI 837. All claims being sent to payers must be in the ANSI 837 format, following specific guidelines for submissions. Although some clearinghouses are no longer accepting Print Image files, some do. In this instance, the PM system creates a snapshot of a claim form which requires the clearinghouse to move data into the correct fields for claim submission to the payer via the ANSI 837. Preferably, your PM system can create the ANSI 837 file for submission to the clearinghouse. The biggest advantage here is that you can typically view the file and the clearinghouse will not be changing anything before submission to your payer. If your PM system cannot create an ANSI 837 file I would consider upgrading or find a new solution.

So that’s it, right? If you have a system that creates a Print Image the clearinghouse is more than a pass-through and they “change” your data. If you send an ANSI 837 file, it simply passes your file along. Well … while this may be true, it’s really only part of the story, and you are potentially missing out on some pretty amazing resources that are at your fingertips! In addition to submitting the claims to your payers, they can scrub claims for common errors, confirm batch receipt and acceptance, provide claim level updates of accepted/rejected claims, and provide electronic remittance advice for auto-posting insurance payments. In addition, many offer additional services (for an additional fee) that can integrate with many practice management systems like integrated eligibility, determine deductibles and co-pays, patient cost estimators, claim status inquiry, patient statement processing, and printing services for your paper claims.

I’m working hard to remove the phrase “just a pass-through” from my definition of a clearinghouse. Once you have submitted an 837 file, they are still doing so much more than simply passing along the file.

EZClaim partners with TriZetto Provider Solutions but is designed in such a way that it will work with any clearinghouse a customer would like to use. The white-glove support team is even there to help set up the connection if needed.

We hope you enjoyed this AMBA 2019 National Conference Session Recap by EZClaim. Click here to view our blog page for more interesting and useful articles. 

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