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You are Here: Home Case Studies Patient Billing and Coding Solution for Practice Management Software medical billing and coding software services from binaryspectrum

Patient Billing and Coding Solution for Practice
Management Software

The Task
To develop a comprehensive billing solution for US healthcare practices meeting CMS, NUCC, HIPAA regulatory standards and Insurance company's policies and processing requirements.
The Challenges
Support for both Government and Private multiple health insurance plans and in variety of ways including guarantor, co pay, primary/secondary/tertiary
Timely and accurate charge entry and claim generation
Electronic and Paper claims generation
Implementation and conformance to applicable standards including HIPAA, standard procedures CPT and illness nomenclature ICD.
The Solution
Binary Spectrum developed a comprehensive complete billing solution with the following features:
Charge Capture
New claim
Find claims
Paper claims conforming to NUCC
Electronic Claim Transmission
Payments Recording
Patient statements
Apply transactions
After every visit, the provider prepares a bill based on which a charge is created for the patient. Information on facility, case, accident, and co-pay is maintained. This application helps display details of patient account number, insurance profile, place of service, physician name, patient's illness, type of accident, state of accident, expected and actual co-pay. Additional details supporting this application consist of type of claim generated and CPT codes. The CPT codes helps in calculation of the charge that would be paid by the insurance company.
Claims are generated on NUCC 1500 format through paper or through ECT. These claims can be reviewed and re-billed in case of any issues found during the billing process. There are modifiers wherein the minor services rendered along with CPT are posted. The posted items can be modified and can be applied for refund if it's an insurance payment transaction. The payment entry can be done based on the type of transaction like insurance payment, credit or debit adjustment, write-off, denial or transfer.
case study patient billing and coding solutions for Practice Management Software
The Result:
The application helps doctors to get paid accurately and in a timely manner. It provides insight on the receivables which can be actively followed up.
Well if you are interested in outsourcing software development or would like to find out more about our services and offerings, please get in touch with us. A senior member of our Business team will get in touch with you within 24 hours.
patient billing services
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