What Are The 3 Different types of Billing Systems in Healthcare?

Medical billing is the most important part of the entire healthcare industry. It is essential in the same way it is complicated. It is manageable in-home or another way is to outsource to certain medical billing specialists and this is what most of healthcare providers prefer to do.

Due to the significant cost reduction and the knowledge that you won’t have to worry about the efficiency and accuracy of the simplest to the most complex procedures, most hospitals and other healthcare facilities opt for healthcare BPO services.

There are a lot of things related to medical billing that most people do not know including monitoring the revenue cycle, optimization of business processes, operational and financial performance audits, system migration, and conversion of data. These are just a few things, there are a lot more that people do not know about.

If we consider it on an overall basis, so there are three different types of medical billing and credentialing services in the industry of healthcare. Here in this article, we have provided you with a better understanding of these three types of billing services. This will make a lot of things clear in your mind with better appreciation to the medical billing industry.

Open Medical Billing System

All over the healthcare industry, an open medical billing system is the most commonly used. This type enables multiple healthcare providers to have access to the patient’s records. Also, it allows healthcare professionals to transfer the data to a lot of numerous specialty practices or facilities. Each of the patients gets assigned an EHR number that is an electronic health record number that is also known as an EMR, electronic medical record.

This is the system in which any doctor seeing the patients gets followed by the patient’s medical history electronically. All the doctors are allowed to update the record and healthcare providers that are part of the network can easily review the notes. But the point is that it is only possible if it is in conjunction with the medical care provided to the patient. Most of the compliance issues should get adhered to in this type of system that does not let anyone accessing the records review and check it without apparent reason.

Even if this system seems the same or way too similar, still the software used to access this system is highly varied. The medical billing department needed to have software that is effective enough to communicate with other software applications using the open system.

The complexity of this type of system is that why many medical care providers and hospitals opt for outsourcing their billing services, especially in highly populated areas. Some best medical billing companies consider using proprietary methods to use this type of system that is an open system. This enables them to boost their efficiency of healthcare providers and profitability factor. Also, this system is approved by HIPPA that is a great help to protect the privacy of patients.

Closed Medical Billing System

Certain patients like and appreciate some security and privacy for their medical records. Such types of people could be athletes, celebrities, and some people who are the part of big business community not wanting their medical records to ever get accessed by someone having prying eyes.

The closed medical billing system has the same working way as an open medical billing system, however, there is just one big difference. The medical records and the medical billing information just gets limited to a single medical practice and is not allowed to share or get access in between several healthcare providers or network.

Still, this system does not give 100% of privacy but it dramatically eliminates the chances of patient’s records getting revealed to anyone not authorized.

Isolated Medical Billing Systems

A closed medical billing system is not sufficient for everyone to secure their records. However, there are still some people like influential government officials who need to consider using isolated medical billing systems for their ultimate privacy.

This type of system does not let any medical records go for maintenance to any healthcare facility or medical practice. This system has the rule of the individual patient holding all of their medical records. Only doctors and other healthcare providers can update and manage those records. But the physical records are always under the possession of patients and no one can access them without their permission.

Medical professionals using this kind of system must need to have certain software that enables them to update patient’s records without getting the information leaked or retained.

Final Words

All in all, each of these systems has its own pros and cons. The best thing for the healthcare providers is to consider using a system that enables them to interact with all these three types of billing and credentialing services. This is the reason most doctors make use of professional billing services to be confident about the privacy concerns of patients and it is getting managed properly. In the meantime, the providers do also focus on the provision of the best care possible for their patients.