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Medical Claims Processing: How to Pick the Best Medical Claims Processing Software

By the year 2024, nearly $1 out of every $5 will be spent on healthcare in the United States. If you’re a healthcare professional or part of a medical association, you’ve likely struggled with the most effective way to handle your billing.

You’ve also wondered how to grow your business. 

The right medical claims processing software can help to streamline every aspect of your business. How do you know if you’re selecting the right option? 

Here, we’re sharing with you the top 5 things your medical claims processing software should be able to do for you.

1. Meet The Needs Of Specialty Practices

83% of adults have met with some kind of a healthcare professional within the past year. Of course, how to properly handle the billing, payment, and claims of these visits feels like a full-time job.

If you’re a specialty practice or office, these claims can often get even harder.

The right medical claims processing software needs to be flexible.

It also needs to offer customizable options that best fit with the operations and services of your practice. It needs to have the kinds of templates, options, and tools that save your employees time.

Let’s say you work in workplace risk/health management.

Can your software optimize travel authorizations, recall schedules, and also send out automated replies and notifications? 

Is your staff is spending several hours each week tailoring the software to fit their needs? If so, it’s not a good use of company time.

2. Make The Case For Why Their Company Is The Best Option

Your patients aren’t coming to you because your practice or organization was the first name they stumbled across in their phonebooks. They’re coming to you because you offer unique, specialized, and great services that your competitors or other nearby practices don’t. 

The same should go for your medical claims processing software. 

Make sure the options you’re considering are CMS-approved.

Also make sure they’re  in accordance with compliance laws.

This means that their price point is fair, that they’re committed to patient and practice security, and that they have lots of references from clients.

Also, make sure your software can spot medical billing errors.

If they don’t, you might need to pursue other options. 

3. Get A Firm Count of Licensing Limits

You could be looking at the best medical claims processing software in the world. But if only two of your employees can actually use it, then is it really that great? 

When you’re trying to decide which software option to go with, make sure you’ve had a serious conversation with the company about licensing limits. This will not only make sure that you’re not hit with any surprising costs. It will also tell you about the kind of customer service you can expect to get from your software. 

Don’t get strung along. Ask right up front how many licenses (basically, how many people or devices in your office will be allowed to use the software) are included in the total price you’re being given. 

If you need additional licenses, look around at different costs before you say yes to a software company. 

Finally, be sure to ask if the license is a “one time only” activation fee, or if these licenses are going to be renewed every year. 

Unfortunately, this is an area where a lot of software companies can increase the price and sneak in a few hidden operational fees. Make sure your practice isn’t getting fooled by these business practices.

4. Provide Expert Security Options

Hacking happens now more than ever before.

What is your processing software doing to protect you and your patients? 

Especially if you’re considering using software that’s cloud-based, you need detailed, point-by-point answers to this question. 

How does our software plan to guard against cyber attacks and information theft? If it does happen, what’s their plan of action? 

Ask questions about how frequently they update and install things like patches and fixes, and what kind of anti-virus protection they currently use.

Always ask if the software provider has been faced with an attack before, and how they handled the past breach. There’s no such thing as being too cautious or too detailed when it comes to protecting the privacy of your patients. Same goes for your employees. 

5. Include Training For Your Employees 

We get it: medical claims processing software can be difficult to understand. But when yours comes with so many customizable options, or if you’re transferring tons of data from an old system or even paper, figuring out the process can feel totally overwhelming. 

That’s why, when you’re in the process of selecting your new software, you should look for a program that includes support and training for yourself. Also make sure it helps your immediate staff and your operation as a whole. 

Make sure that your software also comes with the option of self-service, so your employees can get questions answered and problems handled as soon as possible.

This should include things like 24-hour online support, continued access to educational options, and live tech support. 

Also look to see if there are training videos and tutorials hosted by the software. Also ask about brief how-to ebook guides or postings. There should also be forums where your employees can seek answers from other users or troubleshoot.

Finally, be sure that the software company you’ve decided to go with is willing and able to help you install and set up the software itself. 

You’ve Got All The Information You Need To Pick The Right Medical Claims Processing Software

When it comes to providing the best services for your patients, you don’t take the easy way out. The same should be said of your software. Do your research, ask a lot of questions, and look into several different options before deciding on your final answer. 

For more information about medical claims processing, to get your questions answered, or just to educate yourself a bit more on what the right software can do for your business, check out our website or get in touch with us today. 

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Apex EDI, Inc.
556 E Technology Ave
Orem, Utah 84097
Support: (800) 840-9152
Sales: (801) 383-0388
Fax #: (801) 642-0333
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