Medical Billing Software

Written by Kimberly Clark
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Frequent changes in Medicare and Medicaid services and government regulations pertaining to health care, as well as the increasing complexity of filing private insurance claims and navigating through the extremely intricate managed health care organizations, have made it quite difficult for those in the medical billing industry to stay on top of the game. This is not to mention the fact that to file even the simplest of claims, the medical biller must be well versed in several different coding systems, which currently are comprised of over 10,000 codes. To further complicate the matter, these codes are updated and modified annually.

To successfully complete their daily tasks, the medical billing professional could keep on hand the latest editions of the Current Procedure Terminology (CPT) book, the International Classification of Diseases Ninth Revision Clinical Modification (ICD-9-CM) manual, and the Healthcare Common Procedure Coding System (HCPCS) standards. In addition, the medical biller also has to stay on top of all the updates to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). As an alternative, they could simply purchase or subscribe to one of the many medical billing software packages or services that are readily available in today's marketplace.

Utilization of the medical billing software can significantly streamline the medical biller's job. The software serves as a central location that contains all the necessary coding and regulatory information in one. Plus, it is generally the responsibility of the medical billing software company to regularly provide updates to include any modifications to the coding systems and/or amendments in the applicable government regulations.

Selecting Billing Software

When selecting medical billing software, it is important to choose one that contains all the CPT, ICD-9-CM, and HCPCS codes described above. You also want to look for one that regularly provides updates to the HIPPA regulations. Lastly, you want to find one that uses an electronic data interchange (EDI), which enables submission of medical billing and claims information electronically.


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