10 Must-Have Features to Look for in Medical Billing Software

The best medical billing software includes a host of features that make it easier to track payments, access patient records, and create custom reports.

To help you choose the right billing software for your medical practice, we’ve compiled a list of 10 must-have features to look for before you make a decision. By comparing pricing, features, and system architecture, you’ll have all the information you need to ensure you get the right software to streamline your billing process and deliver an excellent patient experience.

10 Features of Medical Billing Software

1. Cloud-based vs. Hosted Software

Medical billing software comes in two different types—cloud-based and hosted software. Cloud-based software is provided by software-as-a-service (SaaS) companies for a monthly fee or on a per-transaction basis. Meanwhile, hosted software is built in-house and managed by the medical practice. Typically, cloud-based software services provide all the training, licensing, and equipment needed for you to get started using medical billing software. If you opt instead to use hosted software, your practice will be responsible for purchasing any starting equipment, developing training, and maintaining and upgrading the software.

Generally speaking, small and medium-sized practices, specialists, and other firms will find it easier and less costly to use a cloud-based service. On the other hand, large practices such as hospitals and provider networks may benefit from the extra control offered with hosted software. Whichever option you choose, you’ll want to make sure you understand what goes into integrating either type of software into your existing suite of technology applications.

2. Pricing

The pricing of medical billing software varies according to the type of software, number of features, and size and scope of your practice. Hosted software incurs more upfront costs than cloud-based software, and can cost anywhere from $8,000 to $25,000 to implement. For especially large medical practitioners such as hospitals and network providers, the cost can grow to more than $50,000. In addition, hosted software incurs annual costs for maintenance and repair of equipment and software, training costs for new and existing users, and IT services to fix software bugs. Typically, these annual costs range between $1,500 and $3,500, although they can be higher for a larger practitioner.

Meanwhile, cloud-based billing software incurs lower upfront costs but higher recurring costs. Most medical billing SaaS companies offer a combination of free options, monthly subscriptions, and per-encounter billing. Across the industry, monthly subscriptions can range from $25 to $500 per month per user. In addition, many cloud-based software services charge an additional $2-$3 fee per claim submitted through their software application.

3. Technical Support

Even after you purchase your medical billing software, you’re going to need ongoing support to make sure you can resolve any bugs or issues that occur. If you opt to use hosted software, you’ll be responsible for hiring an IT professional to provide support for your medical practice. Costs for professional IT services differ according to the industry, job location, and security and licensing requirements. On average, you can expect to pay around $200 per hour for professional IT consulting.

Meanwhile, SaaS medical billing companies provide you with ongoing technical support as part of their agreement to serve your practice’s billing software needs. Be advised that support hours may vary by company and that you’re not guaranteed to get the right level of service that you need to resolve any issues that arise in a timely manner. As a general rule, you’ll want to check out online reviews about the support a SaaS company provides to its users before you make a decision.

4. Software Training

You will need to teach your in-house medical billing staff how to use the new software. Training costs can vary dramatically depending on the complexity of the software, the size of your practice, and the number of users that need to be trained to use the application.

For hosted software, expect to pay from $1,000 to $3,000 per user that needs training. It’s also important to build training costs into your annual budget to accommodate for software upgrades, patches, and staff turnover. As for cloud-based software, most services include software training during the initial setup phase of the software rollout. Training costs will be included in the one-time startup fee, which is normally $500-$1,500 dollars. Many companies will provide you with online resources and additional training materials to ensure your billing staff has the information they need to do their jobs.

5. Eligibility Verification

To operate efficiently, your billing software must be able to ensure patients are eligible to submit claims for medical treatment with their health insurance provider. The best medical billing software can offer your billing staff instant verification of a patient’s health insurance coverage. With real-time confirmation alerts, you can let a patient know if a procedure, visit, or prescription medication is covered under their plan. Instant verification saves you time, as you no longer need to call the insurance provider to verify if a client’s claim is eligible for coverage or reimbursement. And by saving patients time, you can deliver a more enjoyable experience for them. This in turn translates to more revenue as you improve the reputation of your practice with effective and efficient billing services.

6. Payment Processing

No billing software would be complete if it couldn’t accurately collect patients’ financial information and process payments. Even run-of-the-mill medical billing software will provide multiple methods for patients to pay via credit card or electronic bill pay. In addition, any billing software worth consideration will be able to save patients’ financial details for easy retrieval and send out automatic reminders if a patient misses a payment.

Meanwhile, top-notch applications will offer additional features such as smart billing. Smart billing automation enables billing staff to quickly code procedures and fees while also checking for mistakes. Such a feature reduces the possibility of rejected claims and improves the patient experience. The best applications also enable you to create electronic superbills that break down the services a patient received in crystal clear detail. This feature is especially useful if your practice employs multiple doctors with unique specialties and billing codes.

7. Claims Management

Another essential aspect of medical billing software is robust claims management integration. Electronic claims processing reduces errors, saves time, and allows you to easily track the status of a claim or resubmit a rejected claim. Good medical billing software will include an easy-to-use interface that makes processing claims simple with drag-and-drop codes. In addition, it will alert you if you make an error before you submit the claim, which will save your practice time and money.

Search for applications that make it easy to track claims and allow you to quickly sift through claim histories. Finally, if you see numerous patients who need the same treatment, try to find an application that lets you submit multiple people on a single claim to save time and money.

8. Custom Reporting

Reporting is the backbone of any medical billing software and should be front and center in your mind as you search for a serviceable application. A well-organized and effective reporting system can help you keep track of the financial health of your patients and your medical practice.

When choosing software, spend time investigating what integrations it offers to help you generate the reports you need. In particular, prioritize applications that let you create custom reports and display information by payer. Opt for software that allows you to generate real-time reports and view information including open claims, late payments, and revenue streams.

9. Robust Recordkeeping

To get the most out of your medical billing software, pick a system with plenty of recordkeeping storage and features. In particular, electronic records management (EMR) is one of the must-have features you should look for in an application. EMR allows you to store patient healthcare information along with billing information. This makes it easier to accurately code patient data and reduce errors when processing claims.

Additionally, try to find an application with electronic remittance advice (ERA) capabilities. ERAs contain a detailed history of a patient’s claim history and required payments. Some software can make this information available to insurance providers, which can save you time in posting payment information.

10. HIPAA Compliance

HIPAA governs how medical practitioners protect their patients’ sensitive health information from being accessed without their knowledge or consent. Thanks to HIPAA, every medical practice must have written procedures that outline how they ensure the privacy of their patients’ data.

With medical billing software, you can improve your compliance with HIPAA and thereby reduce the likelihood of breaching the confidentiality of patient health information and incurring the ire of the federal government. Before you choose your billing software, take time to explore what security measures it features to protect your patients’ information. Tools such as end-to-end encryption, multi-factor authentication, and firewalls should come standard with the best medical billing software.

Why Choose Medical Billing Software

Medical billing software can save your medical practice time and money by reducing errors, streamlining payments, and integrating your payment and record management systems into a single application. Look for software that gives you the most value for your investment by balancing price along with claims management, payment processing, recordkeeping, and reporting features. If possible, try to test a system before you buy it to see if it's right for your medical practice. That way, you’ll know if an application has all the features you need to provide your patients with a delightful service experience.