3 Different Types of Billing Systems in Healthcare

28 April 2022
Types of Billing Systems in Healthcare

The process, from claims submission to regular follow-up with the insurance companies to settle the pending amount to the healthcare provider for the various medical cares provided to the patient, is known as medical billing. Medical billing plays a vital role in ensuring that the provider receives timely reimbursement for the rendered services, optimizing their revenue cycle performance. Delayed submission of bills strains the healthcare provider's revenue and becomes a significant threat to patient retention. If the modus operandi of late submission of bills needs improvement; it is above time to consider the medical billing systems.

Medical Blling Systems For Healthcare

Overlooking the medical billing systems appropriate for precise healthcare setup plays a vital role in affecting the revenue. Let us discuss in detail the three different medical billing systems for Healthcare below:

1. Closed System:

A closed medical billing system uses digital tools to track health records and focus on a singular practice. Electronic Medical records (EMRs) are the highly preferred digital tools in this case. Complete patient information, such as the diagnosis done and the plans for the corresponding treatments, are contained within the EMRs. They are not for use outside the practices but, for the sake of better assistance, could be accessed within the practice through connecting several EMRs. However, they are just electronic medical paper charts from our good old days.

Unattached Healthcare with fewer physicians dramatically benefits from these closed medical billing systems. Surely it needs to be switched to an alternate approach if outsourcing the revenue cycle is required.

Suppose there are any changes necessary in the treatment plans, the EMRs aid in identifying the same. It efficiently tracks the patient's vital parameters consistently. These Electronic Medical Records are nothing but an electronic version of medical paper charts and help track the vaccination schedules.

2. Open System:

Unlike the closed system, this open medical billing system speaks much for a synergetic design. Here the complete health data of the patient gets transferred to more than one practice through Electronic Health Record (EHRs). This kind of billing system offers easy access to information to the providers, patients, chief stakeholders, insurance payers, medical billing teams, and even third-party vendors and more than one healthcare organization. EHRs contain exhaustive information compared to an EMR and allow editing when accessed by several healthcare professionals.

Open medical billing is widely opted, owing to the flexibility provided, for excellent Healthcare consisting of numerous departments. This system dramatically benefits an organization that has planned to outsource its medical billing to a different party.

Complex and complete details about the patient's health are stored in the EHRs. It primarily benefits a patient when they need to transition from the current provider to a different provider, thereby providing a complete picture of their medical history. It is pretty simple to integrate the EHRs with the software system if any is used. And mainly, the sensitive health data is safe and secured, ensuring they don't fall into any unauthorized personnel hands.

3. Isolated System:

Using Patient Health Records (PHRs) by the patient, this medical billing system is carefully maintained. The patient personally maintains these records by directly recording the details at their convenience. There are specific software tools for assisting patients in carrying out the same.

Beyond any doubt, PHRs cannot replace legally approved EMRs or EHRs. While registering, the patients can fill in the details by themselves. They can be brought on to the providers to clarify their past and present medical conditions better. If they seek the help of any software tools, they must ensure that open communication and transmission are possible.

BIS Knows What is Best For You:

Business Integrity Services has many years of experience in handling medical billing with an exceptionally knowledgeable team. They are well trained to efficiently handle sensitive information by using advanced software and tools which meet the HIPPA standards. Knowing what's best for you, we help you seamlessly to identify and manage the complex and intimidating medical billing to offer you excellent patient retention and help you focus on rendering excellent medical care. At the same time, you enjoy a healthy revenue cycle.