Why Medical Billing Still Being Done on Papers?

why medical billing still depends on papers

A shocking number of healthcare providers largely depend on paper medical billing!

In the present era where everything has become digital, why do hospitals continue to take resort on antiquated paper processes when it comes to billing?

According to PWC Health Research Institute, only 15 percent of health care providers pay electronically. Also, it has been reported by Bloomberg Business that, while most of the industries have switched to electronic payment mode for their medical billing procedures, still the medical industry is largely dependent on the paper billing systems.

The biggest challenge due to which clearinghouses are not moving towards a cashless billing is the cost factor. They are not able to realize that in contrast to saving the costs, they are pushing the cost of their medical billing procedures in the form of postage charges, additional phone calls with all the paperwork. This necessitates why most healthcare providers need to streamline their medical billing systems.

The major question that arises is that what is holding back the medical industry to completely rely on electronic medical billing procedures. Below are mentioned a few reasons due to which a switch to the electronic billing system has been resisted by the healthcare providers-

  • A fragmented and unorganized healthcare system
  • Major resistance to the financial investment and commitment of funds in the electronic billing advanced technology
  • Lack of incentives given to the payers, providers, and other stakeholders to coordinate
  • A mindset of some small and individual healthcare providers that the switch to the electronic mode of billing is not worthwhile

Electronic medical billing is an easier and faster way to deal with the system of medical billing. Computerized billing records and medical bills are full of benefits that affect the patients and healthcare providers in a positive manner. Below are mentioned some of the reasons why medical billing should be done electronically:

  1. Effectively eliminates hassles– Doing medical billing manually creates a lot of hassles for the medical providers. If medical billing is done manually and even a single page is lost, it will drastically affect the payment or bill of the patient. With electronic billing systems, there is no risk of losing the bill or the bill getting damaged or lost. 
  2. Automatic processes are created– When the data is entered into electronic medical systems, it automatically gets linked up with the patient’s billing systems. There is no need to worry about the physical copies of the bill and healthcare providers need not maintain any hard copy of the bill.
  3. A real-time check can be performed- The medical practitioners are able to check the insurance of the patient immediately. There is no need to wait for a long period of time for the approval of the documents. 
  4. Cost-effective- Maintaining the records electronically helps healthcare providers to keep their costs in control. It is a less expensive method of medical billing. They need not hire any separate employees for manual billing or pay extra salaries and allowances.

Of course, the advantages of electronic medical processes are more.  However, paper billing medical claims still exist. There is no doubt about it that the electronic medical billing processes are much faster and simpler as compared to the process of manual paper billing. Paper billing is not the first choice for medical claims. It is not much preferred by high-end clinics or hospitals. But sometimes it becomes a necessary chore. 

Below are mentioned some of the tips on how to make the process of manual paper-based billing more smooth:

  1. Use the correct form for medical claims: UB-04 or CMS-1500- Proper standard medical claim form should be used by the healthcare providers. 
  2. Healthcare providers should make sure that the format in which the claim is submitted should be correct. Stamps, staples, paper clip, sticky notes should not be attached along with the claim forms.
  3. The data should be entered correctly on the forms. The healthcare providers should ensure that they are using correct procedure codes and diagnosis codes whenever required. In addition, they should make sure that all the data is entered accurately and correctly in the relevant fields.
  4. Proper documentation should be included- Most of the time paper billing demands that proper documentation should be mailed along with the claim form.
    – Any proof of the incident, injury or accident should be submitted
    – Primary payer explanation of benefits
    – Itemized statement should be included
    – Any medical records or medical history should be attached with claims
  5. A clean claim should be submitted- Submitted a clean claim to the payer will ensure that the correct payment is received for the first time. This will save a lot of time, cost and effort both on the part of the healthcare provider, as well as, the insurance company.