It happens very often forservices to fail because of their founders. Most of the times, these founders are so called technicians that choose to start a business without having the slightest hint about how successful businesses run. And so it happens that when technicians have their own electronic medical billing system, instead of learning to work with what they have, they carry on the work that they are skilled at. This way, not having access to solid technology, they find themselves in the impossibility to progress. Electronic medical billing is very complex and difficult mainly because of coding (which is rather complicated) and payer adversity. The number of codes and rules alone creates such an environment that doesn’t allow the coder to perform in a consistent manner.
Unfortunately, there are times when such billing complexity makes problems: it can create opportunities for providers to commit fraud, but also, it can allow some payers to take advantage at the expense of the providers. An in-house electronic medical billing system alongside a naïve outsourced billing office owner seems to be helpless when facing insurance companies. This happens because insurance companies have the following advantages: solid business strategy, well-documented processes (that are professionally dealt with as well) and leading-edge technology. This is why you might find useful researching the following categories of electronic medical billing software programs: Encoder is a software that prints a list of codes after being familiarized with a procedure name or problem description. It helps staff improve consistency. The Revenue-Cycle Management role is to manage the claim payment cycle. What differentiates this from the encoders is that the Revenue-Cycle Management’s data base cannot be updated by research alone. The last one is called Artificial Intelligence. The human-computer interaction is based on intuition, mainly because the language it uses is a natural and easy one. This kind of tool take in electronic medical records and return coded bills that enclose diagnosis and procedures as well.