Medical billing software solutions

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Medical billing software that will simplify your admin

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Congratulations - you are a role model for other practices!

Your score speaks for itself - you clearly know your stuff & your practice management processes are well optimised. Have a look below to see how you did in each section.

Congratulations - you are on your way to having a well-run business!

It's clear you have invested in your practice management processes & although there is still room for improvement, you're doing a great job. Have a look below to see how you did in each section.

Well done - there is a lot that you are doing right!

You are on the right track with your practice management processes, however there are still some key areas you could focus on to ensure that your practice thrives. Have a look below to see how you did in each section.

Great start - although there is a lot more you could still be doing.

You seem to take an interest in your practice management processes however, there is still a lot that you can do to ensure that your practice thrives. Have a look below to see how you did in each section.

Oops - there are some easy technologies that you should consider implementing straight away!

It's clear you have an interest in your practice management processes however, there is still a lot that you can do to ensure your practice thrives. Have a look below to see how you did in each section.

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Section 1: Patient Management

1. How do you capture & store patient information?
You indicated that you are still using paper patient files to store sensitive patient information. Paper systems are not only costly (think about all the storage space you need), but it is also risky. Files can easily be lost or destroyed due to fires, floods, &/or theft.
Here are some of the top reasons why your practice should be storing patient information in the cloud:

Access information anywhere & at anytime
Better safety & security
Reduced costs
More physical space
Enables new Telehealth capabilities
Improves collaboration between healthcare teams

To learn more about the benefits of storing patient information using cloud technology, click here.

1. How do you capture & store patient information?
You indicated that you are storing patient data on a desktop. You clearly have an understanding of the benefits of digital patient files however, having your practice data stored on a desktop is risky & inefficient. What happens if your hardware crashes, your laptop/computer is stolen or destroyed by a natural disaster? All your data will be lost. In addition, desktop applications require IT staff to do system updates on-site which is typically inconvenient & interrupt your workday.

Here are some reasons why your practice should be storing patient information in the cloud:

Anywhere, anytime access
Better safety & security
Reduced costs
More physical space
Enables new Telehealth capabilities
Improves collaboration between healthcare teams

To learn more about the benefits of storing patient information using cloud technology, click here.

1. How do you capture & store patient information?
Congratulations! Your answer indicated that your practice is using cloud technology - a secure, always accessible & easily manageable way to store & capture patient data.

For more information on what to look out for when storing your patient information using cloud technology, click here.

2. How do you verify that patient demographic & medical aid information is captured correctly?
You indicated that your practice does not verify patient information ahead of the patient's appointment. Waiting until a patient arrives for their scheduled appointment to verify their medical aid information is too late.

Collecting payments in full & on time starts by ensuring that you have complete & accurate patient & medical aid information when they make the appointment.

A simple & straightforward way to fully pre-register patients before their appointment is to perform a Family Check using your practice management software. Family Checks validate medical aid membership for all dependents & because details are automatically imported, you are always working with the most current & accurate information should you need to discuss payment or co-payment with the patient.

To learn more about Family Checks, click here.

2. How do you verify that patient demographic & medical aid information is captured correctly?
You indicated that your practice uses a directory to validate patient information. While we commend you on your efforts, we wonder if this is not wasted effort? Logging on to different platforms takes time & energy that could be used better elsewhere. We recommend that you use a Family Check tool. A good Family Check tools will be integrated into your PMA system so that the patient's information is automatically checked as soon as they book their appointment.

To learn more about Family Checks, click here.

2. How do you verify that patient demographic & medical aid information is captured correctly?
Congratulations! You indicated that your patient information is validated when the appointment is made. This is the best way to validate information & ensure a smooth collections process as any discrepancies can be discussed & managed prior to the patient's appointment.

3. How do you manage appointment bookings?
You indicated that you only service walk-in patients. While this may have worked well in the past, patients like control & are used to making online bookings that fit in with their life & schedule.

To learn more about online booking trends in South Africa, click here.

3. How do you manage appointment bookings?
You indicated that you take appointment bookings via phone &/or email. However, our research shows that although patients are accustomed to reaching for their phones for everything – from booking appointments to paying for purchases to accessing customer support - they're not using their phones to make calls to do any of those things – in fact, voice calls are almost exclusively reserved for emergencies.

Providing options like an online appointment booking platform with automated appointment reminders will not only help increase patient satisfaction, but it will also reduce admin, as staff no longer need to manage phones for patient appointments. Furthermore, SMS reminders will help cut down on no-shows, which will improve revenue flow while improving your patient communications.

To learn more about online patient booking platforms trends, click here.

3. How do you manage appointment bookings?
Congratulations! Providing an online appointment booking platform will not only help increase patient satisfaction, but it will also reduce admin, as staff no longer need to manage phones for patient appointments.

4. Do you check that patients have funds available before their appointment to cover the consultation?
You indicated that you don't check patient benefits. Did you know that most patients don't really understand how their medical aid works & what it covers. A lot of patients are usually (unpleasantly) surprised to discover that their medical aid will not cover the full consultation. You can help them avoid any unexpected expenses on the day by notifying them of any potential shortfalls that may incur. Patients who are fully informed prior to their appointment are more likely to pay at the time of service.

You can get an estimate of patient liabilities by performing a Benefit Check using your practice management software. Patient benefit checks will let you know how much funds a patient has & again, allow your staff to communicate the information with them should there be a shortfall. Sophisticated practice management systems will automatically perform a benefit check (automated benefit checks) when you schedule the appointment & then again, a couple of hours prior to the patient’s scheduled appointment.

To learn more about Benefit Checks, click here.

4. Do you check that patients have funds available before their appointment to cover the consultation?
You indicated that you call medical aids to confirm patient benefits. Not only is this inconvenient, but it is also costly in terms of time & telephone bills. Did you know that you can get an estimate of patient liabilities by performing a Benefit Check using your practice management software. Patient benefit checks will let you know how much funds a patient has & again, allow your staff to communicate the information with them should there be a shortfall. Sophisticated practice management systems will automatically perform a benefit check (automated benefit checks) when you schedule the appointment & then again, a couple of hours prior to the patient’s scheduled appointment.

To learn more about Benefit Checks, click here.

4. Do you check that patients have funds available before their appointment to cover the consultation?
You indicated that you confirm patient benefits by logging on to websites. Not only is this inconvenient, but the information can become outdated without you knowing. That is why sophisticated practice management systems will automatically perform a benefit check (automated benefit checks) when you schedule the appointment & then again, a couple of hours prior to the patient’s scheduled appointment, so you always have the most up-to-date information.

To learn more about Benefit Checks, click here.

4. Do you check that patients have funds available before their appointment to cover the consultation?
Congratulations! Automated benefit checks are the best way to know how much your patient will owe & enables your practice to have upfront payment chats.

Section 2: Claims management

1. How do you get the billing instructions to create claims?
You indicated that practice staff are reading the doctor's notes to create claims. It’s an easy & common mistake to leave out important information when creating a billing instruction this way. You could forget to bill for consumables or your instructions might quite simply be illegible. Unless staff or the billing company are able to clarify the billing instruction with the doctor directly, a claim can be submitted incorrectly & rejected as a result.

Using an Electronic Medical Record (EMR) system that integrates with your practice management software is an easy way to send billing instructions directly to your billing company or admin staff. This practice mitigates the risk of illegible or incomplete information & ensures that the claim is correctly captured - saving time, boosting efficiency & improving the likelihood of being paid for services on time.

For more information on how an integrated clinical & billing solution can help, click here.

1. How do you get the billing instructions to create claims?
You indicated that the doctor creates the claim. Every doctor will agree that time is of importance. For easiest claiming, you should be using an Electronic Medical Record (EMR) that will convert your billing instructions into claims seamlessly & directly from your digital notes. In fact, a good EMR will also enable you to to send a claim directly from the system, straight to the medical aid. Saving time & ensuring accuracy.

For more information on how an EMR solution can help, click here.

1. How do you get the billing instructions to create claims?
Congratulations! Claims generated directly from your billing instructions is the quickest & safest way to create a claim whether you are sending it directly to the medical aid or to your staff for validating.

2. How do you submit claims to the medical aids?
You indicated that you are a 100% cash practice. We understand that medical professionals can become frustrated with having to deal with multiple medical aids but there are considerable benefits to contracting with the right medical aids. Benefits such as reduced bad debt & an increased patient base.

To find out if perhaps you are missing out, click here.

2. How do you submit claims to the medical aids?
You indicated that your practice is still submitting paper-based claims. Not only is this time-consuming & prone to error, but the payment turnaround times can impact your cash flow & create unnecessary bad debt. We recommend sending claims in real-time. Real-time claims give staff a near-instant response of how much of the claim will be paid by the medical aid - even before patients leave the practice. If a claim is rejected due to a lack of funds or requires a co-payment, you can inform the patient immediately & reduce your risk of accumulating bad debt.

To find out more about real-time claims, click here.

2. How do you submit claims to the medical aids?
You indicated that your practice sends batch claims. The downside to batch claims is that patients are not invoiced at the time of service. And the longer it takes to invoice a patient, the less likely they are to pay on time & in full. We recommend sending claims in real-time. Real-time claims give staff a near-instant response of whether the claim will be paid by the medical aid - even before patients leave the practice. If a claim is rejected due to a lack of funds or requires a co-payment, you can inform the patient immediately & reduce your risk of accumulating bad debt.

To find out more about real-time claims, click here.

2. How do you submit claims to the medical aids?
You indicated that your practice sends claims daily. It's great that your practice is staying up-to-date with admin, but not invoicing the patient at time of service can impact your bad debt. Don't let patients walk out the door without paying. We recommend sending claims in real-time. Real-time claims give staff a near-instant response of how much of the claim will be paid by the medical aid. If a claim is rejected due to a lack of funds or requires a co-payment, you can inform the patient there & then. Once a patient physically leaves the practice, your chances of being paid drops significantly. You can proactively reduce bad debt simply by sending claims in real time & if necessary, collecting from the patient at the time of service, thereby increasing your likelihood of collecting in full.

To find out more about real-time claims, click here.

2. How do you submit claims to the medical aids?
Congratulations! Collecting payment at the time of service & before the patient physically leaves the practice drastically improves the likelihood of being paid & keeping bad debt to a minimum.

3. How do you manage claim rejections?
You indicated that you do not have a process in place for managing rejected claims. Rejected claims that are not fixed within a certain timeframe become stale & stale claims is like flushing money down the toilet.

We suggest that you use real-time claiming technology so that you will know immediately if the claim is rejected or not. Once you know that the claim has been rejected, you can work on fixing & resubmitting it immediately.

To find out possible reasons as to why a claim could be rejected, click here.

3. How do you manage claim rejections?
You indicated that you review rejected claims on a weekly basis. While it's great you are not letting claims go stale, if there is any co-payment required, you have missed the opportunity to invoice the patient at the time of service. And the longer you take to invoice a patient, the less likely they are to pay.

We suggest that you use real-time claiming technology so that you will know immediately if the claim is rejected or not. Once you have that information make the required changes & resubmit right away.

To find out possible reasons as to why a claim could be rejected, click here.

3. How do you manage claim rejections?
You indicated that you review rejected claims on a daily basis. While it's impressive that you are not letting claims go stale, if there is any co-payment required, your patient has already walked out the door. And the longer you take to invoice a patient, the less likely they are to pay.

We suggest that you use real-time claiming technology so that you will know immediately if the claim is rejected or not. Once you have that information, you can make the required changes & resubmit right away.

To find out possible reasons as to why a claim could be rejected, click here.

3. How do you manage claim rejections?
Congratulations! Fixing claims as soon as they are rejected is the best way to ensure you don't accumulate bad debt.

Section 3: Collections

1. When do you invoice patients?
You indicated that you invoice patients a day or so after their appointment. Did you know that studies have shown that patients are more likely to pay at time of appointment, particularly if any shortfalls or co-pays that are required are communicated beforehand, but also if they receive an invoice immediately. Don’t wait for the patient to leave your practice to email them retrospectively. Use your practice management system to send claims to medical aids in real-time. You will receive a response within seconds as to what will & won’t be covered. You can then generate an invoice for the balance & collect what’s owed from the patient.

1. When do you invoice patients?
You indicated that you invoice patients a day or so after their appointment. Did you know that studies have shown that patients are more likely to pay at time of appointment, particularly if any shortfalls or co-pays are required are communicated beforehand, but also if they receive an invoice immediately. Don’t wait for the patient to leave your practice to email them retrospectively. Use your practice management system to send claims to medical aids in real-time. You will receive a response within seconds as to what will & won’t be covered. You can then generate an invoice for the balance & collect what’s owed from the patient.

1. When do you invoice patients?
Congratulations! Invoicing patients at the time of service makes it more likely that they will pay what's owed immediately. Particularly if they’ve been informed of any shortfalls or co-pays beforehand, but also if they receive an invoice at the time of service.

2. How do you collect from patients?
You indicated that you do not collect any money owed by the patient. This is honourable but in the long run, it's putting a financial strain on your practice. Even if just R80 per patient is the shortfall, & you are seeing 20 patients per day, that is R35 200 of revenue lost every month. Over a year, that is over R400 000!

Having sophisticated but simple-to-use technologies in place means you can collect quickly & effortlessly from patients before they leave your practice. For a guide on what technologies you need, click here.

2. How do you collect from patients?
You indicated that you do not collect any money owed by the patient. While it may seem like more trouble than what it's worth, in the long run it is putting a strain on your medical practice. Even if just R80 per patient is the shortfall, & you are seeing 20 patients per day, that is R35 200 of revenue lost every month. Over a year, that is over R400 000! Having sophisticated but simple-to-use technologies in place means you can collect quickly & effortlessly from patients before they leave your practice. For a guide on what technologies you need, click here.

2. How do you collect from patients?
You indicated that you manually contact the patient for any money owed. Good job at working to reduce your bad debt however, with this strategy you may need to employ a full time debt collector.

Consider putting simple-to-use automated technologies in place to enable you to collect effortlessly from patients before they leave your practice. For a guide on what technologies you need, click here.

2. How do you collect from patients?
You indicated that you automate many aspects of your collection processes. This is great for those patients that slip through without paying directly after their consult. However, best practice is to collect from the patient directly after the consult.

Having truly user-friendly automated technologies in place, you can collect from patients effortlessly at the time of the appointment. For a guide on what technologies you need, click here.

2. How do you collect from patients?
Congratulations! By collecting from patients before they leave your practice you are not letting your hard earned revenue walk out the door.

Section 4: Reconciliations

1. How do you reconcile?
You indicated that you do not reconcile your remittances, but knowing how much you've earned vs how much has been accounted for is an important part of running a successful practice.

By automating reconciliations, your staff will be able to see at a glance, which consults have been covered & which still have money owing.

To learn more about automated reconciliations, click here.

1. How do you reconcile?
You indicated that a staff member manually reconciles all your remittances. While we are happy you know how much you've earned vs how much has been accounted for, this is still a burdensome, error-prone task.

By automating reconciliations, your staff will be able to see at a glance, which consults have been covered & which still have money owing.

To learn more about automated reconciliations, click here.

1. How do you reconcile?
Congratulations! By automatically reconciling remittances, you're not only saving time & preventing errors, you also always know what payments are still outstanding.

Section 5: Reporting

1. How often do you review your practice’s performance reports?
You indicated that you do not have practice performance reports to review. I'm sure you know the saying, 'you can't manage what you don't measure.' So while it might seem like effort, a good practice management system will generate easy-to-read, automated reports that will show you at a glance what you need to know.

To learn more about the type of reports you should be reviewing, click here.

1. How often do you review your practice’s performance reports?
You indicated that you have a general idea of what your revenue is. Revenue is important but there are other important metrics that you should be reviewing on a monthly basis that will tell you a lot more about your practice's financial health. The good news is that good practice management system will generate automated reports that will show you at a glance what you need to know.

To learn more about the type of reports you should be reviewing, click here.

1. How often do you review your practice’s performance reports?
Congratulations! Reviewing your practice performance reports monthly is best practice to spot monthly, annual & abnormal trends.

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Medical billing software solutions

Dr Pillay Paediatrician | 3204774

Angel & Nelisile of Dr NtetaDermatologist

Dr Phitela Social Worker

Dr Smith General Practitioner

Calendar with integrated benefit checks

Family check

Fully processed claiming

Proof of submision

Invoice

Auto reconcilliation

Inbox

SMS notifications

Financial reports

Global patient search

Global claim templates

Data cruncher

Automated reconciliations

Configurable pricing

Easy invoicing

Family check

SMS notifications

Claim tracker

Online payment portal

Claim reversals

Customised report packs

Business insights dashboard

Benefit checks

Fully-processed claiming

Automated reconcilliations

Business insights

Fully processed claiming

Electronic remittances

Dr Pillay
Paediatrician | 3204774

Angel & Nelisile of Dr Nteta
Dermatologist

Dr Phitela
Social Worker

Dr Smith
General Practitioner