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Automated billing features for streamlined RCM

There are a lot of steps in the billing process, and AdvancedMD makes it easier to keep them all running as planned by automating many of the billing processes and tasks that used to require manual intervention from your staff members. We make it easier for you to get claims out the door that are accurate, reducing the chance of denials and improving your A/R metrics.

Insurance verifications

Automatically check to make sure patients’ insurance is accurate and up to date at the time they schedule the appointment, then again right before the appointment takes place.

Patient bill payment

Give patients the opportunity to settle outstanding invoices at the time they check in for their appointment with online check-in forms that show any current balance on the account. Patients can pay with credit or debit cards, FSA and HSA accounts, or set up a payment plan all online.

Coding updates

ICD-10 and CPT codes change all the time, but with AdvancedMD your staff doesn’t need to spend time trying to figure out if they are using the latest codes. We automatically keep it up to date and push out any updates directly to your software through the cloud.

Data transfer

Eliminate the need for manual data entry with AdvancedMD. We can pull in important information from external systems with APIs to ensure accurate billing and coding.

Simplified electronic claims submission

Most medical coding and billing software will give you the capabilities to submit claims online, but with AdvancedMD you get the most accurate billing and coding options to ensure that the claims you send are ready for payment. We offer several features for pediatric billing and coding that reduce errors and increase reimbursement rates.

Faster & easier coding

Find the right codes each time with our simple search features. Set up custom lists of the most commonly used pediatric billing codes, or find the codes you need with a quick search. We also have advanced algorithms and AI that combs the patient’s chart and encounter notes to recommend more accurate codes to avoid overcoding or undercoding.

Check every claim with our claims scrubbing

Our industry-leading claims scrubbing services provide you with one of the highest first-pass resolution rates. We check for millions of potential errors and flag anything that your team should address before sending claims on for processing. The software creates convenient worklists so your coding team can quickly find and resolve any potential concerns.

Simple worklists to minimize claims delays

Get your claims out the door faster with our worklist feature. It reviews all your current claims and helps staff prioritize the things they should be doing to get claims out to payers and avoid missing deadlines. This is critical to maximize reimbursement and avoid the need to write off bad debt that can’t be paid because of an administrative error.

Track claims from start to finish with ERA

Use our electronic remittance advice (ERA) tools to view and track every claim in your system. Collect all the necessary information to submit claims, including encounter notes or documentation, EOBs, and other essential documents with no scanning or manual data entry. Then scrub the claim, submit it, and get notifications if there are any delays that could impact reimbursement.

Optimized for Medicaid and CHIP

If you have young patients on Medicaid or children’s health insurance programs (CHIP), you can easily process these claims and get reimbursed with AdvancedMD. Our system includes specific tools to ensure that you fill out and include all the necessary information required by the payer to expedite the claim and avoid delays or denials.

Financial reporting tools

Stay on top of your practice health with all the tools you need to report on your finances. Send reports directly to the inbox of physicians, administrators, and other key stakeholders to keep everyone apprised of what’s happening with your practice finances at all times.

Choose from a database of the most commonly used financial reports to track all the key metrics of a pediatrics practice, including:

  • Patient encounters
  • Days in A/R
  • Claims denial rates (first-pass resolution rates)
  • Monthly receipts
  • Receipts per RVU
  • Charges and adjustments