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Healthcare is often reactive, rather than proactive, when it comes to opportunities for improvement. It is often a race to fix what went wrong, not institute infrastructure to prevent it.
Tied to the above is the fact that EMR/EHR is a significant outlay of cash for providers for something that is not directly a medical product. EMR/EHR is not treating patients, but rather it is often something more easily interpreted as administrative as many physician offices are only focusing on capturing incentive dollars.
EMR/EHR companies are using any and every angle they can to make their product stand out above the others. Some EHR/EMR vendors are including billing software and telling providers that their EMR “software” does the billing too. They also push the fact that the EMR and the billing are “linked” to each other. They tell their prospects that they can save money by not hiring a billing service to take care of the billing and collections (Revenue Cycle Management), but anyone who is an expert in RCM knows this is just not true.
Personally, I see EMR as a totally separate entity from the billing. Having billing software does not mean it is smarter for a provider to keep the billing in-house. Actually, most providers who outsource their medical billing already have software capable of billing. The issue for most providers who choose to outsource is that they realize they must maximize their reimbursement at every turn and they do not have experienced staff who expertly and consistently handle the billing, the claims tracking, the phone calls, the denials and appeals process, keeping up with the continuous healthcare mandate changes, the clearinghouse and electronic submissions, credentialing and they recognize that the experience that they get from outsourcing their billing and collections to a billing company is crucial to keeping the doors open. Many providers realize they save money by outsourcing. Some have difficulty hiring, training and keeping a knowledgeable person in that position in their office.
Bottom line, no matter how good your billing software is, it is only as good as the person using it. A provider’s income relies on the billing. If they don’t they will lose money, no matter how good their software is and whether or not it’s tied to their EMR/EHR.
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