Insurance claim software helps medical offices process insurance claim forms. Some products interact with their scheduling software, accounting software and other office programs to provide a complete business solution. Some software packages leave you responsible for insurance claims submission. Other services submit medical claims through clearinghouses (for a fee), but offer free electronic submission.
Claims software can be purchased as a stand alone product with a variety of functionality from claim printing only to complete claim processing with electronic submission capabilities. This software is also included as part of a medical software suite including patient scheduling, accounting, electronic medical records, contact management, and time management applications.
Features of claims processing software packages include:
- Electronic transmission ANSI 837 HIPAA-compliant format
- Standard insurance claim forms with different formats
- Automatic payment posting
- Tracks billings, accounts receivable and payments
- Commercial claims sent via Web MD or clearinghouse of your choice
- Line item accounting
- Invoice printing for private billings
Major Vendors:
- 2K Medical Billing
- Max Systems
- QQ Online
- Avolent
When evaluating and selecting an insurance billing application, several factors should be considered:
- What level of service are you looking for (claim printing only, claims submission and payment posting, or complete medical software package)
- Ease of use and training requirements
- Cost to upgrade
- Integration issues with accounting and other office software
- Special billing needs of your sub-industry
- System resources: Not usually an issue, but sometimes small medical offices are on over-taxed hardware already.