Medical Billing System

Technology domains
Cloud Solutions
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Medical Billing System Medical Billing System
Although medical offices are increasingly adopting digital technologies to automate daily processes and increase the quality of patient care, simply getting paid remains one of the biggest challenges for many practices. Healthcare providers daily struggle with denied claims, late patient payments, cumbersome filing of multiple claims individually, and constantly changing CPT codes. Whether the billing process is successful and smooth also depends on the software a practice has in place.The billing system of our Customer, a medical billing organization, lacked the necessary functionality, was unable to process claims quickly, randomly froze, and shut down. It was based on DOS and had not been updated since the initial installation. Therefore, our Customer’s employees, accustomed to Windows programs, found it increasingly difficult to work with...
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Challenge

Although medical offices are increasingly adopting digital technologies to automate daily processes and increase the quality of patient care, simply getting paid remains one of the biggest challenges for many practices. Healthcare providers daily struggle with denied claims, late patient payments, cumbersome filing of multiple claims individually, and constantly changing CPT codes. Whether the billing process is successful and smooth also depends on the software a practice has in place.

The billing system of our Customer, a medical billing organization, lacked the necessary functionality, was unable to process claims quickly, randomly froze, and shut down. It was based on DOS and had not been updated since the initial installation. Therefore, our Customer’s employees, accustomed to Windows programs, found it increasingly difficult to work with.

Solution

Softarex has developed a client-server Medical Billing System that helps manage the entire hospital billing process — from registration to payment posting — in one location.

The software provides the following features:

  • User authorization — provides access to the system for only verified users;
  • Role-based access control — divides users into two groups — administrators and managers — based on their access rights;
  • Multi-layer security — determines user privileges in the system;
  • Health data management — allows users to create and manage electronic medical data;
  • Insurance eligibility verification — enables users to update and confirm patient's insurance information;
  • Claims tracking — the ability to check the status of insurance claims and payments, as well as to monitor the office workflow;
  • Reporting — the opportunity to create comprehensive billing reports and custom claims reports;
  • Services and payments/insurance companies/providers/patients — the ability to create and manage information needed to fill out CMS-1500 claims;
  • Notifications & text messages — allows users to create pop-up notifications and send messages to remind patients to pay their medical bills.

Our Medical Billing System is fully compliant with HIPAA and HL7 standards, which coupled with multi-layer security and role-based access control ensures a maximum level of cybersecurity.

We also provided a technical support team to help our Customer’s staff easily implement and effectively use the developed solution. Softarex’s specialists were always ready to answer any Customer's questions, explained tech things in simple terms, and quickly fixed all the problems of the system.

Project’s results

Softarex’s Medical Billing System has produced the following benefits for our Customer:

  • Reduced paperwork and human errors;
  • Improved accessibility of patient data;
  • 30% increase in the number of clients;
  • Quick in-bulk claims processing;
  • 27% increase in the productivity of each customer’s employee due to reduced claim processing time.

Technical challenges

  • Ensuring a high level of the system's performance;
  • Training Customer’s employees on the new software;
  • Streamlining CMS-1500 claims submission and follow-up;
  • Development of a system fully compliant with HIPAA and HL7 standards.

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