Revenue Cycle Management Software

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athenahealth EHR Software

66 Reviews

Founded in 1997, athenahealth, Inc. is one of the largest public-listed EHR company in the US. The Massachusetts based company provides web-based Electronic Medical Records, Practice Ma.. Read more

eClinicalWorks EMR

59 Reviews

eClinicalWorks is an award-winning vendor offering integrated EHR, Practice Management, Population Health, and Revenue Cycle Management solutions and services to more than 130,000 physicians across US.. Read more

Cerner PowerChart Software

53 Reviews

Cerner is the leading US supplier of health care information technology offering a unified suite of digital solutions that streamline clinical and administrative workflows enabling providers to care f.. Read more

PrognoCIS EMR

45 Reviews

PrognoCIS, set up in early 2000s, is a healthcare company that is suitable for all sizes of practices and hospitals. It offers integrated modules for EHR, practice management, and patient portal appli.. Read more

EpicCare EMR software

44 Reviews

Epic Systems Corporation, or Epic, has been in the market since 1979 and employes around 10,000 personnel. Headquartered in Verona, Wisconsin, Epic has raked in numerous accolades and awards over the .. Read more

AdvancedMD EHR Software

41 Reviews

AdvancedMD is an integrated medical software suite for independent practices. Founded in 1999 and based in South Jordan, Utah, the vendor serves an expansive national footprint of more than 22,500 pra.. Read more

Allscripts EHR

40 Reviews

Allscripts has been in business for the past 30 years with presence across four countries; US, UK, Canada, and Australia. Over time, the company has transitioned from a core electronic prescribing ent.. Read more

Practice Fusion EHR

33 Reviews

Practice Fusion, an Allscripts company, founded in 2005 is the #1 cloud-based ambulatory EHR platform in the United States. It has partnered with some of the leading medical billing software companies.. Read more

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Buyers Guide

Revenue Cycle Management Software—Why You Need it and How to Identify a Winning Product

You entered the health care industry to help patients, but that’s not the only focus, right. Whether you’re part of a practice, a hospital or a clinic, you need to run a profitable business too. It’s the only way you’ll be able to keep providing your vital services. And the business aspect of health care is no simple niche.

With many factors at play, such as medical insurance, you need expert help. An ordinary accounting system won’t do. Only a revenue cycle management service specifically designed for the health care industry will suffice. 

But even narrowing the field to this group of software products gives you many to consider. We compiled need to know information to help you make the right long term decision for your practice. 

Why Do You Need Revenue Cycle Management Software

With so many people passing through your doors it can be quite challenging to keep up to date with everyone’s billing requirements. It’s more complicated than an ordinary business’ billing because of:

- Correspondence with health insurance entities where you need to validate the patient’s insurance.

- Complicated coding systems that need to be followed in order to claim payments successfully.

- The intricacies brought about by bills paid by two role players: Insurance agencies and the patients themselves.

Why waste time trying to manage it manually when software can help you? As a bonus these packages are designed to provide you with management features to help you maintain a profitable practice. 

If you want this for your health care establishment, discuss these aspects with potential service providers before signing a contract. 

The Characteristics of Quality RCM Software

No two products will be exactly the same, but for optimum results you should have these functions at your disposal. In some of these categories there will be different options, so pick the types that will work for you. 

It's Appropriate for Your Practice

For any EHR related software, always consider the size of your practice. Some programs are designed for small entities, while others are for hospitals. When you don’t discuss this with the vendor you may pay for features you don’t need. 

Mobile is Important

Since you’ll be facilitating payments (see below) and you don’t want someone to navigate away out of frustration. Your RCM software—if it has a patient portal—should be accessible via any computer and be mobile responsive. This is becoming more and more important: Your patients want to manage their lives via their phones.

Also consider: You’ll enjoy managing aspects of your practice more if you can do it via your cellphone too. Be informed no matter where you are.

Helping You Claim

The claims process is integral to ensuring your practice receives payment for services rendered. Much of the responsibility can be shifted from staff members to a quality RCM software program with automated features:

- Keeping patients’ insurance information on record.

- Verifying their information to ensure successful claims.

- Adding the proper codes (also see below) to claims, relevant to the type of visit.

- Managing denials.

- Allocating correct amounts based on co-pay guidelines.

- Sending bills to patients after integrating the claims’ amounts in their statements.

Tracking Your Patients

The only way you ensure your practice is as financially healthy as possible is by making sure each patient’s bills are settled correctly and timely. That means you need to track their visits and payments from the very first day.

Ideally you need this portal to allow an initial registration process. From then on—along with a scheduling system—you’ll be able to have updated information on each individual. 

General Accounting Features

Apart from the unique aspects of medical billing, your RCM software must still handle accounting activities expertly. Don’t waste time doing it manually, since quality vendors will provide:

- Features to process all forms of payment (Credit card, debit card and transfers) so your books stay up to date. Real time is the preferable option.

- A user friendly interface to help you track accounts receivable. Although the software will do the work for you, your staff must still have easy access to view the current state of someone’s account. 

- A statement feature should make it easy to view statements or send them to patients to remind them of due payments. 

Make Payments Easy

While an effective billing system makes life easy for you, it pays off to also make life easier for your patients. An RCM software package can add an online payment option to your practice’s features. For starters, it’s a selling point which may have patients flocking to you from other outdated practices. In addition, you’ll see your payment cycles become shorter, which means patients pay fewer penalties (if applicable) and you save money thanks to proper cash flow. 

Correct Coding Integrated

For many of the tasks mentioned above your software will make use of codes. The ICD-10 coding system is an important factor in making health claims today, but you’ll only receive payment from insurers if you use the correct ones. That means an ICD-10 integration (upgraded from ICD-9) is a non-negotiable feature. 

Monitor Financial Health

Here’s one of the main reasons this is a worthwhile investment: Thanks to all these functions mentioned above, but also specially designed tracking features you’ll always have information about the financial health of your institution. High-end programs will allow you to drill down to specifics so you also know where the problem lies if you notice your financial position is shifting contrary to your expectations. 

Conclusion

The biggest challenge in shopping for software products is aligning your needs and preferences with what the software provides. You don’t want to pay for features you’ll never use, but a too simplistic product won’t give you all the benefits that are possible in today’s technologically advanced world.

Start by making your list of requirements for YOUR practice. Then determine what your software should provide to overcome those challenges and afterwards discuss it with vendors. 

Soon you’ll enjoy the results.