Medical Billing - Software Registration
In the world of medical billing, there is a lot of red tape. The government itself has so many regulations that they're enough to strangle a billing company to the point where they can just about do business. And just when you thought that this problem would at least end with the software that you buy to do your billing with, you get hit with more red tape and regulations. In this installment, we're going to discuss the issue of software registration, both on the end of the manufacturer and the biller.
A company can't just decide it wants to make a piece of medical billing software. Well, it can, but selling it is going to be another issue altogether, at least in the United States. See, the good old USA has very strict guidelines that have to be followed when doing your medical billing. That's why, if you're sending claims electronically, there are a zillion record specifications that need to be transmitted. Forget to dot one "I" or cross one "T" and you're looking for trouble. Because of this, insurance carriers, especially the government-controlled ones, require that software be registered. If you look at your records' specifications you will find that one of the records requires the biller to send over the software version that they are using. If this version isn't on the carrier's list of approved vendors, your claim will not be processed. So, how does a software vendor get their software approved?
Well, it's one heck of a tedious process. After the software is made, they have to send a copy of it to every insurance carrier that they want to bill. This usually includes every Medicare and Medicaid agency in all the 50 states. So we're talking about at least 100 carriers. The good news is that if you send to just one to start and you're rejected for whatever reason, you probably won't be accepted by any of the others and therefore can save yourself the trouble of sending your software out to those other carriers. Once you're approved by one, most likely you'll be approved by them all.
To get your software registered is actually simple. You make a sample claim file of fictitious names and transmit the claim file to the agency. If the file passes, you're registered with that carrier. If it doesn't, you're not. It's pretty much the same thing with the medical billing company as well. They also have to send a test claim in order to get approved to submit claims to that particular carrier, even if the software itself was already approved. I told you there was tons of red tape.
In the world of medical billing, there is a lot of red tape. The government itself has so many regulations that they're enough to strangle a billing company to the point where they can just about do business. And just when you thought that this problem would at least end with the software that you buy to do your billing with, you get hit with more red tape and regulations. In this installment, we're going to discuss the issue of software registration, both on the end of the manufacturer and the biller.
A company can't just decide it wants to make a piece of medical billing software. Well, it can, but selling it is going to be another issue altogether, at least in the United States. See, the good old USA has very strict guidelines that have to be followed when doing your medical billing. That's why, if you're sending claims electronically, there are a zillion record specifications that need to be transmitted. Forget to dot one "I" or cross one "T" and you're looking for trouble. Because of this, insurance carriers, especially the government-controlled ones, require that software be registered. If you look at your records' specifications you will find that one of the records requires the biller to send over the software version that they are using. If this version isn't on the carrier's list of approved vendors, your claim will not be processed. So, how does a software vendor get their software approved?
Well, it's one heck of a tedious process. After the software is made, they have to send a copy of it to every insurance carrier that they want to bill. This usually includes every Medicare and Medicaid agency in all the 50 states. So we're talking about at least 100 carriers. The good news is that if you send to just one to start and you're rejected for whatever reason, you probably won't be accepted by any of the others and therefore can save yourself the trouble of sending your software out to those other carriers. Once you're approved by one, most likely you'll be approved by them all.
To get your software registered is actually simple. You make a sample claim file of fictitious names and transmit the claim file to the agency. If the file passes, you're registered with that carrier. If it doesn't, you're not. It's pretty much the same thing with the medical billing company as well. They also have to send a test claim in order to get approved to submit claims to that particular carrier, even if the software itself was already approved. I told you there was tons of red tape.
posted by zzzzzzzzzzz at
4:43 AM
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