Medical billing software functionality: communications, task management, electronic remittance advice (ERA) tools, word processing, patient engagement, patient portal, patient kiosk, electronic prescriptions, electronic statements, appointment confirmations, unbilled claims/visits trap, inventory control, and dashboard.

Electronic claims using medical billing software: Is the software able to send electronics claims with any clearinghouse or is it locked to only one option?

When using the correct medical billing software, do you need to have claim scrubbing before it goes out to the clearinghouse or your printer? Claim scrubbing is a tool that cleans your claims before submission to improve denial rates.

Is the system open or closed accounting? Open accounting lets you add, modify, or delete the transaction data at any time. (Open accounting has its positives and many negatives, because anyone can doctor transactions, which causes inaccuracy and legal and financial risk). With closed accounting, once you save the transaction you can’t add, modify, or delete without an accounting trail.

What type of billing is the software designed for? Professional (837P) CMS 1500 02-12 format, Institutional (837I) CMS-1450 (UB 04), DME claims, pharmacy, ambulance, or labs.

Some systems may offer all of the options by using add-ons and third party software.  Others may have strengths and weakness in different areas.  Microwize can help find the right solution for your needs.

Database: If electronic medical records are included with the system, are both using the same database or different databases? Is the look and feel of the EMR the same as of the medical billing portion or not?

Is the software multi-tenant? This is when the same install of the software can handle different practices with different names, tax IDs, and financial accounts. This is helpful with billing services and independent practices sharing the same server and software.

Pricing model: Is the pricing by provider or by seat (AKA user)? Depending on the type or size of your business, this can make a big price difference.

Reports: Do you have the reports you need to manage your practice? What are your options to copy a report from a marketplace or another practice you know? What is needed to customize a report? How about reports related to incentives such as meaningful use, MACRA/MIPS, RVU, CCM, etc.?

Technology: Is it a fat client or, thin client, browser-based, or in the cloud? A fat client is a computer (client) in client/server architecture or networks that typically provides rich functionality independent of the central server. The name is contrasted with thin client, which describes a computer heavily dependent on a server’s applications.

A fat client still requires at least a periodic connection to a network or central server, but is often characterized by the ability to perform many functions without that connection. In contrast, a thin client generally does as little processing as possible and relies on accessing the server each time input data needs to be processed or validated. Similarly, software run in a browser or via a cloud application is using the server to do the processing, requiring less computing power on the device you’re using.