The Complete Guide To Medical Billing Software Development

The healthcare industry is experiencing digital transformation, and with this patients are opting for online payments due to its varied advantages. Around 38 percent of consumers preferred online payment for medical bills through hospital/doctors’ website, and 17 percent of people opted for health plan website for payment.

Integrating a medical billing software in a healthcare organization ensures simple billing process, cost amortization, and better payment efficiency. Medical billing software proves to be beneficial as it automates payments, manages invoice, and claim submissions.

Why to Use a Medical Billing Software?

1. Cost Reduction

According to a research report, administrative expenses account for 25 percent of healthcare spending. Incorporation of medical billing software can help to decrease these numbers and ameliorate the overall revenue cycle.

Further, with software automation eliminates the need for hiring employees to run the billing and insurance claims processes. A medical billing software is equipped to handle the financial aspect of a healthcare organization, thus reducing overhead and hiring costs.

Integrating medical billing software in an EHR (Electronic Health Records) allows analysis of billing data and helps to find services that may not give a good return on investment. Further, this software can update and give access to patient billing information from anywhere.

2. Minimal Human Error

As per the Change in Healthcare 2020 Revenue Cycle Denials Index results, the third quarter of 2020 showed 23 percent rise in total medical claims denials, as compared to 2016 results.

Mistakes or errors in medical billing process is one of the reasons for these denials, which results in inflated medical charges. Erroneous medical bills surge costs and siphon money away from insurance companies. Inconsistencies or administrative errors while billing compel people to pay more or less upon discharge.

Automation in medical billing software leaves no room for errors and it operates around the clock, without falling sick or giving away to work pressure.

3. Efficient Process

Billing software automates coding and payment verification, leading to faster financial procedures. It also eliminates repetitive manual tasks and eliminates time consuming work.

Automated billing procedures ensures minimal chances of duplication, errors, and document typos. Further, financial reporting in billing software identifies gaps in financial functions, and helps to correct these along the way.

Why Choose Custom Development of Medical Billing Software

While there are a number of medical billing software solutions readily available in the market, there isn’t a one-size fit all approach when it comes to healthcare software.

Often times critical functionalities may be lacking in the basic software because of which users either have to compromise on their user experience or have to pay additional money for custom features to be added. Off the shelf software is developed for public usage, rather than individuals.

Software modules are designed for development purposes. These systems are easily integrated in current systems, for example office suites, warehouses, email clients etc.

Custom development of medical billing software helps overcome all these limitations. Custom software development is undertaken to address the specific needs of a company or organization.

The medical billing software thus developed is designed to work seamlessly with the existing software that your healthcare organization may be currently using such as appointment scheduling software, EHR/EMR software, hospital management software etc. This results in greater interoperability and optimal utilization of software features.

Pros of using custom software development include scalability, greater return on investment, better interoperability, uniqueness, and assurance of high-tech security. However, custom development requires ample investment of both time and money.

Off the shelf software development is cost-efficient, quick to operate, ready-to-use, and offers more functionalities. However, it may not be ideal for all clinics or healthcare facilities, as its not designed for individual or company usage.

Main Features of Medical Billing Software

Below is a non-exhaustive list of medical billing software features:

1. Patient Billing

Patient billing feature tracks payments, generates invoice, stores payment history, and all other information related to billing. Automated billing tasks helps providers to get paid faster, keep patient data updated, and improve workflows.

Electronic billing cuts down on paper, and creates a smooth workflow for crucial processes. Ease of payment gradually enhances patient experience, thereby impacting retention rate in the long-term.

Further, medical billing software gives a better idea of patient billing data and makes this information more accessible, which is also secured and accurate.

2. Claims Management

Healthcare facilities can eliminate the need for dedicating a team of people to verify claims and insurance coverages by incorporating medical billing software. This also includes both walk-in and scheduled patients, who wait for their insurance data to be checked.

Claims management feature verifies insurance coverages automatically. Therefore, speeding up patient admission, making more time for patient care, and decreasing denial rate.

This feature can be developed to easily deny claims and guide patients through timeframes and processes needed for resubmission of claims. Inconsistencies and errors in claim documents can be highlighted as well with this feature.

3. Patient Registration

Patient registration improves the intake and onboarding process of a healthcare facility.

Complicated administrative tasks and data collection slows down workflow. Hence, collection of patient data before appointment, through registration process helps to organize complex data, and creates higher patient satisfaction.

Patient registration includes data such as eligibility checks, payment history, medical benefit checks, etc.

4. Security

Data security in the medical field is crucial for protecting ePHI (Protected Health Information) and payment details.

HIPAA (Healthcare Insurance Portability and Accountability Act) compliance ensures security and privacy of ePHI, by imposing safeguards (physical, administrative, and technical safeguards) on healthcare organizations, providers, and other entities.

End-to-end data encryption and firewalls are means of protecting payment data, and avoid fraud cases and cyberattacks. Failure to adhere to HIPAA rules leads to penalties and charges, thereby affecting reputation of a healthcare facility.

5. Payment Reminders

Timely payments, is one of the responsibilities of patients, and to make them do it conveniently lies in the hands of healthcare organizations.

Payment reminders is one of the ways to influence patients to make on time payments conveniently. Automated reminders with a ‘pay now’ button creates a patient-centric billing software.

Further, a HIPAA compliant payment reminder increases patient loyalty. Alerting people ahead of due dates, offers them a more positive experience, and reduces chances of receiving a surprise medical bill.

6. Patient Information Storage

Storing patient information cuts down routine personal communication, surges admission rates, and improves patient satisfaction. It frees up staff to do work that’s more essential than attending phone calls for appointments or managing waiting area.

HIPAA compliant data storage helps to keep ePHI safe and secured in times of cyberattacks, and eliminates the risk of data breach. Consider developing automatic backup and storage process of patient information, in times of crisis or natural calamities.

Key Steps For Medical Billing Software Development

1. Planning and Research

A roadmap and a vision for developing a medical billing software eliminates confusion during development and helps to create product at a faster rate, with fixed deadlines and tasks.

Research defines needs of consumers (patients and medical staff) – what they require in terms of functionality, and any other particularities. It helps to capture target audience, by offering what they need.

Further, market research gives a fresh perspective on what competitors are aiming at, and plan to deliver to people. This helps to give a direction to medical billing software development. Planning also involves gathering a team – in-house or outsourced, whichever fits in the budget.

For development purposes, an outsourced team is preferred, as it cuts down overhead expenses and cost of hiring. Consider including budgeting under planning, as it allows to measure profits and ROI post product launch.

2. Creating MVP

MVP (Minimum Viable Product) helps to launch a product quickly, as at the initial stages of development it allows to focus only on core functionalities and features, thus speeding up the release process.

With MVP, developers can get a fair idea of features to be included, based on users’ feedback, saving time and constant iterations.

MVP allows to test billing software with minimum budget, as redundant features are averted, and focus stays on solving the main problem.

3. Acquiring Technology Stack

Once it’s clear what features are to be included in the software, its time to decide the technology stack. The goal is to pick the right technologies that deliver the best possible results and attain to needs.

Things to consider while choosing technology for medical billing software are –

a. Data security

b. Target audience

c. Integration with other systems

d. UI/UX friendly

Remember to not select a technology stack because it works well for competitors’ software or is in trend; instead select tools that work best for current needs.

To name a few popular tech stack are Mean stack (Node.js, Express.js, Angular JS), Ruby on Rails (Passenger, Rack, Rails, Ruby), and LAMP STACK (Php, Apache, Linux, MySQL).

4. Testing

Testing assures that software doesn’t carry any bugs or is incompetent of working. It also checks whether medical billing software is compatible with other healthcare solutions.

It’s recommended to carry out both manual and automated QA testing. Manual helps to detect bugs, whereas automation checks performance and security of the software.

5. Launch and Maintenance

Post testing, it’s time for launch, and maintenance. Regular updates, adding features, fixing security patches, attending to consumer calls or queries, and more, falls under maintenance aspect.

Without this, software may bot be able to keep up with its competitors and may become obsolete soon.

Cost of Developing a Medical Billing Software

Developers charge hourly or monthly rates (in case of long-term projects), regardless of hiring outsourced vendor or freelancers. The cost of medical billing software development depends on team, features and functionalities to be added, legal formalities, duration of project, etc. Below is an estimated cost of developing a medical billing software –

a. Pre-development Tasks: $6000 for over 100 hours

b. Core Feature Development: $6500 – $10,000 for 100 – 150 hours

c. Custom Feature Development: $16,000 – $20,000 for over 270 – 400 hours.

Despite of these numbers, cost for medical billing software development must be discussed with technical team or outsourced vendor. Ensure to state requirements clearly to get an accurate figure. Consider having certain amount to meet hidden expenses which can be due to overtime, travel, legal formalities, etc.

Arkenea is a healthcare software development company with over 10 years of experience in the field, and is known for delivering measurable results.