If you run a gynecology practice, you know that managing billing can be a major headache.
Between processing claims, tracking accounts receivable, and staying on top of rejected or denied claims, billing eats up valuable time and resources. This prevents you from focusing on what matters most - providing quality care for your patients.
Fortunately, electronic medical record (EMR) billing services like Calysta EMR offer a solution. Read on to learn how outsourced medical billing powered by an EMR system can transform your gynecology practice.
EMR systems automate routine billing tasks like coding services with ICD-10 and CPT codes. Integrated practice management tools handle verification of insurance eligibility, benefits coordination, patient collections, and scheduling. This eliminates manual work that once bogged down your billing team.
Reports and dashboards within the EMR give real-time insight into accounts receivable, denials management, practice revenue, and other financial KPIs. Built-in workflows reduce overhead costs associated with billing operations.
The result? Your gynecology practice gains efficiency and your bottom line improves.
Inaccurate coding results in costly claim denials and delays in payment. EMR billing services overcome this obstacle in several ways.
First, automated coding based on clinical documentation helps eliminate human error. Your billers can review auto-coded charts instead of coding from scratch. This streamlines charge entry while boosting coding consistency.
Next, EMRs feature integrated coding references like ICD-10 and CPT that offer real-time feedback during charge capture. Clinical decision support also prompts doctors to document all diagnostically relevant details during patient visits. More comprehensive documentation equates to more accurate coding.
And then finally, specialty-specific EMRs include value-based reimbursement tools to optimize billing for services like annual well-woman exams. You get automated alerts for gaps in recommended screening or tests based on payor guidelines. Close those gaps, and you maximize reimbursement while improving quality of care.
A denied claim represents lost revenue if the reason for rejection isn’t addressed quickly. EMR billing services prevent denials through continual account reconciliation. Real-time claim scrubbing detects errors like missing procedure or diagnosis codes before submission. This avoids initial rejections that require resubmission.
Ongoing reconciliation reveals when payors do deny claims and why. Your billing team gets notified so immediate action can be taken based on denial reasons. Common scenarios like coordination of benefits with secondary insurers or requests for operative notes are efficiently handled to get the claim reprocessed and paid.
Slow payments from insurance carriers can wreak havoc on a gynecology practice’s cash flow.
EMR billing services accelerate reimbursement cycles through automation at every stage.
As soon as a patient encounter ends, the visit is auto-coded and queued for billing. Bulk claim submission happens on a daily basis rather than weekly or monthly. This gets your claims in the payor’s system more quickly.
Electronic remittance advice is then imported directly into the EMR and reconciled against submitted claims. This automation removes latency from the reimbursement cycle. Payments get posted to patient accounts faster.
Healthcare faces stringent regulatory demands. HIPAA sets privacy and security rules governing protected health information (PHI). Billing operations must safeguard patient data and demonstrate compliance. Specialized EMRs allow your gynecology practice to meet these challenges.
The right EMR platform is HIPAA compliant right out of the box with technical, physical, and administrative safeguards in place. That means role-based access controls, encrypted data storage and transmission, and data backup protocols to prevent unauthorized PHI access.
Detailed audit logs track EMR access, and you can run reports to detect anomalies indicating improper use. Patient portals let your gynecology patients securely access their health records and communicate with your office. These capabilities help demonstrate you have HIPAA’s required safeguards implemented.
Specialized EMR platforms like Calysta EMR also include payer-specific billing tools to ensure compliance with applicable regulations. For instance, forms and workflows assist with prior authorization requirements mandated by payors for tests, imaging, and procedures. This prevents care delays or rejected claims.
In some cases, even with an EMR optimizing your billing operations, the volume of administrative work can still overwhelm your staff.
Outsourced medical billing services integrated with your gynecology EMR provide extra support. Your billing tasks get handled by dedicated specialists.
A billing services partner manages key aspects of your revenue cycle including:
This alleviates the burden on your staff, freeing them up for more patient-centered tasks. Your EMR still gives you visibility into billing workflows managed offsite. Seamless integration means clean hand-offs between outsourced functions and in-house operations like patient scheduling.
The benefit? Reduced administrative workload lets your staff focus on delivering excellent gynecology care. Outsourced services also provide billing expertise to maximize reimbursement and prevent issues like coding errors that lead to denied claims. It’s a win-win for improving practice efficiency.
While EMR software provides the core framework for optimized billing operations, certain functionality may require interfacing with separate systems. EMR platforms like Calysta EMR that offer (or integrate with) ancillary solutions under one umbrella deliver the most robust billing environment.
For example, bidirectional integration with practice management (PM) software enhances scheduling, registration, eligibility verification, and patient billing. Interfaces with analytics tools offer deeper revenue cycle insights. Patient engagement apps improve communication and aid revenue collection. Interface engines can connect your EMR with hospital and lab systems to pull documentation into patient charts.
Evaluate your existing tech stack and consider supplemental solutions that fill functional gaps in your EMR system. With the right integrations in place, you gain end-to-end automation that maximizes the impact of your EMR investment.