Primary Care Medical Billing & Coding Software
Getting paid for the care you provide is essential to the health of your primary care practice.
Information flows seamlessly from the scheduling software to patient check-in, then to the EHR where the provider documents all the relevant details. Once it’s complete the information goes to your medical coders and billing team to finalize the claim and submit it to the payer.
Staff also do not need to upload or download information, or rely on shaky APIs to connect systems that were not designed to talk to each other. The result is accurate information from start to finish, and a higher first-pass claims acceptance rate. When claims go through faster, you get paid sooner.
Reporting and analytics can help your family medicine clinic thrive. AdvancedMD makes it easy to see how well your practice is performing and find areas for improvement. Quickly generate reports from the practice management platform to review with your team.
This improves patient care and safety by ensuring that the right information is always available to providers and staff. It also helps you coordinate all your patient’s care within your practice and with other specialists as needed. You get an accurate medical history and information about medications, allergies, recent results, and more without switching software programs, clicking through multiple windows or requiring multiple logins.
Disjointed practice management software can hinder your ability to provide patient care. Disparate systems require a lot of manual data entry or multiple APIs to connect and transfer essential health information. With AdvancedMD you can build a software system that matches up with the patient journey from start to finish: scheduling, intake, EHR, patient communication, billing and coding, payment collections, financial management, data analytics and reporting.
AdvancedMD medical coding and billing software maintains up-to-date information for CPT codes. Your billing team is always working with the latest information to avoid errors that result in delayed or denied claims. It also ensures that coders are always coding to the highest level of specificity and not over-coding or under-coding—actions that are against the law, and can be costly mistakes for a small or medium-size practice.
Coders also have immediate access to all the information in the patient’s chart through the EHR. That includes doctor’s notes and documentation from each encounter so they can find the relevant information required to back up specific codes before submitting.
The most common reason that a medical claim is denied is an error in the information submitted with the claim. When a claim is denied it requires a lot of time and effort from your medical coding and billing staff to find the problem, correct the information, and resend the claim within a very specific timeframe. According to MGMA, as much as 65% of denied claims are never resubmitted, representing billions of dollars in missed payments each year.
Patients are increasingly responsible for more of their healthcare costs. Your practices needs to be able to coordinate and track patient and payer payments accurately to bill the patient or the payer based on specific coverage details.
An insurance company may deny a claim because it’s not covered, or because the patient has not met their out-of-pocket costs for the year. Your team will need to coordinate to appeal denied claims that should be covered, or balance bill a patient for the portion that their insurance does not pay.
It’s important to get these detail right. Billing someone for costs that their insurance should have covered is frustrating to that patient and could jeopardize your ability to get them to come back for future care. However, not following up on billing for balances that patients owe for care their received is also costly to your clinic.
(name, birthdate, SSN, etc.)
Including information on any procedures performed
Reporting is one of the most important features of a medical coding and billing software program. Easy and accurate reporting tools allow you to quickly see and analyze important information about the financial health of your clinic.
Set up reports to measure key metrics that help you evaluate clinic financials and cash flow, including:
You can also create role-specific reports for each person within your clinic. For example, send a report detailing errors in insurance coverage that resulted in denied or delayed claims to your front desk supervisor. They can use that information to train staff on the importance of performing insurance verification at the time an appointment is scheduled and the day before the patient arrives for their appointment.
Administrators can generate key financial reports and have them sent automatically to providers and executives within your clinic. These reports can be set up at whatever intervals are appropriate for your physicians and stakeholders based on their roles.
For large balances paid out of pocket
And send follow-up statements
To a collection agency as needed
With one click using eStatements
Improve the financial health of your practice with better medical coding and billing. AdvancedMD software integrates seamlessly with your practice management and EHR to help you get paid in a timely manner, and get paid more of what you are owed for the care you provide. Find out how we can help improve your practice revenue by scheduling a demo today.
Jed Shay, MD
The Pain Care Center
Keith Berkowitz, MD
Center for Balanced Health
Estaban Lavato, MD
La Loma Medical Center
Raju Raval, MDRead the story ›