How EHR Billing and Coding Can Improve Revenue Cycle

Billing is a vital part of medical practices, providing the funding that helps keep them operating.

Because billing is so critical, it’s useful to have help. Electronic health record (EHR) tools could provide such assistance.

EHR billing helps medical offices manage revenue, handle coding, and perform other operations in several ways.

Document appointments and other care

Electronic health records (EHRs) are, well, records.

It’s an obvious statement, but their name illustrates what they’re capable of doing. They’re capable of many things.

As records, they could contain extensive documentation of a patient’s history with a medical practice. Similar to medical charts, EHRs often include records relating to

• Appointment information, include dates of visits and notes
• Procedures, tests, and lab results
• Immunizations
• Allergies
• Medication
• Health-related references
• Other medical conditions
• Documentation from other medical providers

Extensive documentation of appointments on EHRs could help medical professionals see and record what happens when patients visit. This specificity could assist them with EHR billing and coding matters, helping them find and assign the right codes for each aspect of their care.

Access information

Storing information is important. So is accessing it.

A good EHR is easy to use. Medical practices often need to train staff members when they implement or update systems, but after some initial orientation, the best medical billing and EHR software is mostly or wholly intuitive.

Intuitive functions allow people to easily use software systems and extract and apply information from them. They also make it easy to add and store information for future use.

Billing, filing and tracking claims, and collecting revenue are just a few of the tasks that efficient and productive EHR solutions could enable.

Share information with patients

Medical professionals aren’t the only people interested in using EHRs.

Patients want their health information. With growing numbers of electronic devices and internet use, patients are able to retrieve and use it themselves.

Sharing information could start during their appointments. To facilitate this sharing, the authors of one study suggested that medical practitioners:

• Review background information in the EHRs before they see their patients.
• Greet and interact with patients to strengthen personal interactions.
• Allow patients to see aspects of their records, such as lab results or x-rays.
• Enlist patients to participate in the charting process.

Using this information, patients may be more informed about their conditions and their care. This knowledge could help them understand the billing process and work with insurance providers and others.

Integrate claims information with other documentation

Understanding conditions also helps arrange treatments and payment for them.

Many EHR software systems operate in the cloud, which means they’re stored and used through the internet. If one medical practice could use them, it makes sense that other practices and entities could as well.

So, if a practice needs to send a patient’s health information as evidence during the insurance claims process, it could use EHR and practice management systems to transmit it.

Of course, since it’s so easy to share information, it’s also easy to hack it. When using protected health information, medical providers are required to protect patient privacy. To protect it, they could follow Health Insurance Portability and Accountability Act of 1996 (HIPAA) guidelines.

Some HIPAA guidelines include:

• Sending the minimum amount of information needed.
• Encrypting health information, which is changing readable text into text that consists of random letters and numbers that requires taking special measures to decipher.
• Creating data safeguards such as using pass codes.

Taking such measures could help transmit information not only safely, but more efficiently.

Track and manage the claims process

When compiling, sending, checking, and resending insurance claims, keeping track of the process is vital.

Since it contains all parts of a patient’s health record with a practice, an EHR could help medical practitioners track what’s happening with a person’s claim.

As the claim moves through the billing process, office workers could make notes about what’s happening.

If there’s a deadline for taking certain actions, an EHR could inform employees.

Do insurance providers want practices to take additional actions or file claims in certain ways? Do offices or patients want to appeal a claim that the insurer has refused? Practices could apply the information contained in electronic charts or add information themselves.

Save employees’ time

Adding information to files and making data accessible also saves time.

It saves time for patients because they have the ability to retrieve and see all their information in one place.

Storing and using cloud-based EHR systems also saves time for medical professionals. Instead of sorting through page after page in a paper file, employees could use search functions to find insurance claim documentation and evidence that could support such claims.

EHRs also contain all of a patient’s information in one digital place, so offices can share it and are also less likely to lose it.

Reduce billing errors

Not finding information in a timely manner could delay claims, and so could mistakes.

There are thousands of codes that signify thousands of medical procedures. Each insurance company has its own codes. Companies add new ones or change old ones.

Medicine is specialized, too, so optometry EHR systems might list codes specific to that specialty.

The systems could list multiple insurance providers’ correct codes for each procedure. Because such files are easy to access, employees could change such codes or add helpful notes about using such numbers in the billing and claims process.

It’s easy to mix up a few numbers in a code or assign the wrong code to a certain procedure. But using EHRs to create and update handy, easily searchable lists and notes could reduce such errors.

Improve the claims process

Ensuring that information is accessible, secure, and accurate increases the claim acceptance rate.

Insurance companies might not accept claims if the supporting documentation is incorrect or incomplete. Medical offices then might need to spend extra time correcting and adding data.

Or, insurance companies might deny claims altogether, requiring practices to resubmit claims. This further prolongs the process and delays revenue payments.

To learn how EHR could help your practice’s coding and billing practices, contact us.