Are you in the process of bringing your billing in house? Unless you plan on billing manually, the selection of your software provider is the single most important decision. At the very least, the software will need to directly correlate with hardware requirements, staffing needs, workflow processes and organizational design.
5 Steps to Finding the Right Billing Provider
Follow these steps to help you select the right software billing vendor:
- Meet with potential software providers and ask for an in-depth demonstration of their solutions. Ask for a list of current users.
- Develop the workflow and organizational chart to be conducive with the design of your software program.
- Prepare a list of your requirements and make sure it’s included as part of your contract, or at the least, have affirmation that your specifications are functional to the purchased solution. You will need to know:
- Volume of your business
- Ratio of billing based on payers
- How much insurance data will be collected by field personnel
- Scope of your collection efforts
- Include a minimum data set of features in your system requirements. If you use a software company that specializes in the EMS industry, most basic features should be included as part of the initial purchase. Look for the following program features as basic prerequisites:
- Electronic billing and remittance for Medicare and Medicaid
- Preferred vendor status with insurance clearinghouses
- Configurable forms for private and commercial insurance billing
- Detail accounts/receivable (A/R) reports, including customized reporting capability
- User-defined billing cycles
- Automatic secondary and tertiary billing
- Batch posting capability for cash application write offs
- Fully integrated database files maintained at the user level. Set up files must include data for physicians, hospitals, insurance carriers, diagnoses and procedure codes (HCPCS) with pricing
- List of additional products and applications that interface with the billing system, such as field data and dispatch
- Staff productivity tracking mechanisms
- Select a clearinghouse that partners with your billing software. It typically take six weeks to set up your account with the clearinghouse including payer registration and training. Payer registration should be completed prior to going live with your new billing software so that reimbursements are completed in a timelier manner.
What Else Should You Consider Before Choosing a Billing Software Vendor?
Your software provider should also furnish training, support and regular program updates, particularly for any changes mandated by your insurance carriers. The software must work within the guidelines of your compliance program to ensure all billing is proper.
After you select your software solution, you should have a clearer understanding of your staffing needs and workflow processes. You should also be able to have your software vendor provide you with the hardware requirements at this point in the implementation process.