Doctors in the United States lose an estimated $125 billion every year due to poor billing practices. If you run a healthcare organization, you need to do everything you can to stay on top of billing.
Choosing the right billing system for your organization to use is essential if you want the billing process to go smoothly. There are several different types of systems that can be used, so it’s important to understand them and recognize how they differ.
Here’s everything you need to know about the different billing systems in healthcare.
The Importance of Healthcare Billing
Healthcare billing systems allow healthcare providers to collect and track patient information. Billing records will contain many types of information on a patient. This includes treatment histories and patient services.
A billing system can help staff ensure that patients get all billing details. It can also help them communicate with insurance companies properly.
Healthcare billing systems are at the center of a medical organization. They’re absolutely essential for helping a practice operate successfully.
Healthcare billing helps providers handle medical purchases and services in a streamlined way. A billing system will help ensure that all parties understand the details of the services provided. It also helps them understand the payment that will be required for care.
Types of Healthcare Billing Systems
There are 3 types of billing systems that healthcare and medical organizations use. Here’s what you should know about them.
Closed Billing Systems
A closed billing system is a billing system that is closed off to transfers and focuses only on a single medical practice. This type of system doesn’t foster collaboration between healthcare facilities. Instead, it’s focused inwardly.
Closed billing systems can be beneficial because it will be easy to find and keep track of all patient information. A healthcare organization that uses this type of system has more control over records and billing.
With closed systems, records are kept closed and are held by the clinician that uses the system. Electronic Medical Records (EMR) serve as part of a closed system and provide a digital way to manage medical records. These records function in the same way as paper charts.
EMRs can be shared within a practice easily. However, they’re closed and not shared with other healthcare facilities and doctors.
Open Billing Systems
As opposed to a closed billing system, an open system allows medical records to be shared. Patients, providers, healthcare organizations, and other professionals will all have access to the medical information of a patient. They can review it and edit it as needed.
As opposed to EMRs, Electronic Health Records (EHRs) are used in an open billing system.
Although the terms EMR and EHR are often used interchangeably, they’re not the same. Unlike EMR systems, EHR systems are collaborative. They allow for the sharing of information between medical facilities and providers.
The increased collaboration in an open billing system often leads to better care. Despite this, there are some difficulties with these systems as well.
Open systems can be more difficult to work with due to the need to follow HIPAA regulations. It will be necessary to handle sensitive patient information in a safe and compliant way.
Isolated Billing System
An isolated billing system is a billing system that a patient maintains. It’s not maintained by a medical organization or healthcare provider.
Patients manage an isolated billing system through the use of Personal Health Records (PHR). PHRs are not connected to any practice or physician. They are instead managed and maintained by a patient.
PHRs don’t replace EMRs and EHRs. They simply serve as a supplement that a patient can use to keep better track of their health.
PHRs aren’t legally acceptable for use by medical providers and healthcare professionals. Yet, they do offer some big benefits to both patients and the healthcare professionals they see.
With an isolated system, a patient can maintain a clear view of their medical treatments and their conditions. This can also help providers when a patient shares a personal health record with them as well.
Choosing a Billing System
The type of medical billing system that your organization decides to use will depend on a variety of different factors. It’s important to think about your organization’s needs and strategy for operations. This will help you get a good idea of which type of system and medical records you should use.
Generally, closed billing systems are a good choice for basic medical practices that are standalone. This includes practices that don’t have many stakeholders are providers. It’s important to note, however, that with a closed billing system, you won’t be able to outsource billing services to a third party.
An open billing system is better suited for a larger medical organization. It’s suitable when there are many departments and other organizations to share information with.
When working with a third-party billing provider or other outsourced firms, an open billing system will be necessary. This helps ensure easy communication between different parties. If you’re an EMS agency, for example, you may want to look for emergency medical specialists billing services.
Because isolated billing systems are for patient use only, using them isn’t an option for organizations. The only acceptable legal options for medical organizations are closed and open billing systems.
Improving Billing in Your Healthcare Organization
To ensure your practice is effective, you should consider the different types of billing systems that are available.
Closed billing systems can allow for more control. On the other hand, open billing systems allow for better collaboration with other providers.
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