Definition of a Medical Billing System

Coding

A medical billing system is equipped to assign numerical (and in some cases alphanumerical) codes to a patient's diagnoses and procedures. These codes are submitted to the insurance company to help determine the amount of reimbursement the health care provider will receive.

Insurance Claim Submission

Medical billing systems also offer the ability to process and submit claims to payers at regular intervals. In most cases, claims can be sent directly from the provider's medical billing system to the insurance company over the Internet for payment processing.

Billing and Collections Tracking

A medical billing system should be able to track all accounting processes, such as accounts payable, accounts receivable, and payments received and processed. Additionally, the software should be able to bill individual patients regularly, view charges on any patient's account and print statements as needed.

A Growing Role

Many medical billing systems are now combined into a bigger software packages that run the overall business. This means many medical software systems not only provide billing services but also assist with patient scheduling, integrate with electronic medical records and offer a variety of reports.

Choosing a Medical Billing System

Physician office staff or health care providers should determine the functions their organizations need before selecting medical billing systems. Providers need to be aware of cost, how the system is installed, the amount of training and support provided, how easy is it to use, and whether the system can be customized. Medical billing systems are computerized systems that allow physicians, hospital business offices or other health care providers to track charges and payments for patient care. They assist in billing insurance companies and patients for care provided.