The use of electronic health records (EHRs) has soared over the past decade. EHRs are digital documentation systems that allow healthcare providers to record and access patient health information electronically, rather than using traditional paper files. This move from paper to digital has transformed the healthcare industry in many ways. One of its major impacts is on the medical billing process.
Saving Time and Money
EHRs and electronic medical billing software have helped streamline financial and administrative tasks for healthcare providers. Instead of manually entering patient encounter data and diagnostic codes for billing, this information can be automatically pulled from a patient’s EHR. The time savings are significant. EHR-integrated billing systems also reduce costly errors that result from duplicating data across paper and digital formats. Their ability to cross-check complex fee schedules and insurance details further minimizes inaccuracies.
Simplifying Coding
Another way EHRs assist billing staff is through coding tools and prompters during record creation. Doctors can quickly search for the correct diagnostic code right within the patient file. These prompts help provide accurate codes the first time around, minimizing claim denials down the road due to improper coding. Some medical professionals will also use diagnostic code lookup tools like Find-A-Code.com for further clarification. EHR data can also be used to ensure the right level of coding complexity is applied to the services rendered. This reduces the need for manual auditing and code corrections prior to claim submission.
EHRs Link Coding to Better Billing
The coding enhancements from EHRs not only increase billing accuracy but also boost reimbursement rates. Complete procedure and diagnosis details entered during record creation allow providers to select higher complexity codes as applicable. This results in higher value billings better reflecting the full patient encounter details. Additionally, some EHR platforms feature integrated fee schedule analysis. Coding suggestions are tied directly to reimbursement rates for the patient’s insurance plan. This takes the guesswork out of code selection to maximize reimbursement. With advanced clinical decision support and automated coding tools, EHRs enable providers to capture optimal procedural and diagnostic details upfront to fuel the downstream billing process. Rather than billing being an isolated down-stream activity, it is connected to enhanced clinical documentation for better revenue.
Compliance and Analytics
Digital records have made medical billing operations more transparent and compliant too. Billing staff have better visibility into patient documentation and care details when generating claims. EHR systems can be used to set permissions on who views and edits records. They also provide extensive tracking and audit logs should records be questioned later. Additionally, data analytics tools allow staff to assess claim trends, revenue cycles and billing productivity like never before. Such actionable insights help drive operational goals and targets.
Considerations in Adoption
For those medical practices and hospitals still relying on paper-based documentation, integrating EHRs with billing processes requires significant change management. Transitioning to an entirely new health record system and data environment can affect nearly all staff roles. Providers often need workflow redesign and system training. IT infrastructure upgrades may also be required to manage the digital volume.
Conclusion
While shifting from paper to electronic systems does demand effort, most find this move vital to keeping pace with industry change. The efficiencies and streamlining capabilities EHRs introduce to activities like coding, compliance reporting and data analytics make them a smart long-term investment for supporting medical billing goals. Their ability to fully automate charge capture alone makes them a valuable update for stronger revenue cycles. Those seizing the initiative early will be best positioned to thrive in the modern digitally driven healthcare landscape.
