Medical Billing System

Technology domains
Cloud Solutions
BPM+ Health COVID-19 Navigator
With thousands of COVID-19-related articles and studies being published every day, it's difficult for healthcare providers and individuals to keep up to date with the latest news, diagnosis, and treatment trends. Therefore, there's a strong need for a comprehensive database that would provide accurate and reliable information on coronavirus...
Value-Based Care Platform
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Care Management Platform
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Healthcare Predictive Analytics Tool
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Skin Analysis System
Despite a wide variety of beauty products on the market, most consumers have a hard time finding an effective skincare product that can help them address their skin problems, be it acne, dry skin, or wrinkles. The thing is that today most major skincare brands focus on making products suitable for everyone.It emphasizes the need for a solution that would help customers get personalized skincare recommendations to choose the products that meet their needs and, thus, save time and money...
Healthcare Document Management Software
More than any other office environment, hospitals, clinics, and healthcare companies are loaded with a massive amount of documents and therefore struggle to manage them effectively and hassle-free as well as comply with strict healthcare data security standards.Moreover, many healthcare providers already have healthcare document management software in place, but struggle with problems they create...
DietManager: Personalized Diet Plans Generation System
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EHR and Medical Billing Software
Medical billing and practice management have long been and still are a daunting and time-consuming reality of running a healthcare facility. Many providers suffer from a heavy load of administrative tasks and massive amounts of paperwork required for medical billing.This is where digital technology comes into play. A powerful integration of EHR solutions and medical billing software can help providers fully automate all daily time-consuming operations, ensure anytime, fast access to healthcare and billing information, and lower costs...
Medical Scheduling System
Trying to manage outpatient appointments, hospitals, clinics, and healthcare companies daily struggle with extensive paperwork, a massive amount of incoming calls, and increased frequency of no-shows. Long wait times and always busy phone lines result in a negative patient experience and low retention rates.Healthcare providers need an easy-to-use solution to automate the appointment scheduling process, optimize administrative workflow, minimize non-attendance, and reduce wait times to enhance care delivery and improve communication with patients...
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...
Automatic Reflex Diagnostics System
It usually takes several days or, in more complicated cases, several weeks from a doctor visit to the administration of treatment. This negatively affects the patient's health and delays treatment, which is especially dangerous in cases of serious diseases, when every minute matters.This is where unconventional diagnosis methods come into play. Powered by computer technology, they allow physicians to find hidden patterns in the human body that lead to disease and prevent serious conditions at the earliest stage possible...

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

To meet our Customer’s need for more sophisticated software we have developed a client-server Medical Billing System* that has enabled our Customer’s practice to 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 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.

* This is a custom solution we have developed for the specific needs of a particular Client. Does it look like it may be a good fit for you? Contact us, and we’ll build a custom solution tailored specifically to your business needs.

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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