5 Medical Billing Software Features You Can’t do Without

5 Medical Billing Software Features You Can’t do Without

5 Medical Billing Software Features You Can’t do Without

With dozens of competitors in the thriving medical billing software industry, it comes as no surprise that medical software solution developers are falling all over themselves to provide you with increasingly appealing features and options. All of this can lead to a cluttered, confusing decision-making process when it comes time to choose the right software solution for your office.

Medical billing software is undoubtedly one of the most important investments your practice can make to further its success. Electronic patient records, prescription management, claims filing, and billing are the norm, not the exception—and regulations requiring updated, secure technology are only growing stricter. Medical billing software developers provide practices with the ability to ensure that they’re in line with regulatory provisions and provide their patients with the best appointment setting, claim filing, and billing experiences automatically.

One way to streamline that process is to look closely at the most important features offered, and compare their ease of use, efficiency, and suitability for your practice between different software brands. Below, we’ll discuss five features that are must-haves. When researching a software solution that fits your needs, you’ll want to examine exactly what each option offers.

1. Billing automation

Billing automation allows you to enter codes for diagnoses and fees with the tap of a button. It can also help you avoid pesky mistakes when using medical billing software and alert you to notify of any errors. New doctors or staff in your practice can benefit a lot from this feature and avoid making mistakes. Smart billing automation allows you to streamline the billing process, even more, to ensure that you can spend more time attending to your patients instead of struggling with the billing system. 

2. Collaboration and Electronic Transmission

Healthcare software can be used to avoid duplicating patients or claims when multiple physicians within a practice may tend to the same patient. The visibility of the course of action by other doctors can help physicians make collaborative decisions regarding their patients and allow for everyone to share claims. Collaboration tools can create transparency within your team and insurance providers since all claims will be handled electronically when using a medical software program.

Again, this one is a no-brainer in terms of inclusion, since practices are required to transmit the vast majority of claims electronically, under current HIPAA regulations. There are rare occasions, however, that require a manual claim. Research whether or not both options are available as medical billing software features, and how streamlined the process is.

3. Clearinghouses

While nearly all software options will offer some form of claim generation—after all, that’s central to medical billing! —research how claims are generated. Why? Well, claims are generated based upon rules and algorithms that assess the claim for insurance eligibility. Great medical billing services will have a knowledge base that updates with each and every claim they process, resulting in a medical billing software solution that automatically checks the claim against millions of insurance and regulatory rules.

Clearinghouses collect insurance claims prior to their being sent to the insurance company or other responsible agency and double-check the claims for accuracy. Any changes or corrections are made, and the claim is then forwarded. While some billing services do not use clearinghouses and advertise a shorter turnaround period, the risk of claims being rejected en masse and repeatedly is very real. And managing rejections can be a costly and time-consuming task by itself so it is important to make sure there’s no possibility of your claim getting rejected. Whether you opt for a service that uses a clearinghouse or not, research and read reviews to find out if their system is accurate and efficient. 

4. Following Up

Claim follow-ups, in the event of a denied or delayed claim, can be initiated by the medical billing software user or may be automated. Any service you use should have a number of simple, automated follow-up processes that allow identifiable errors to be corrected and claims to be submitted without human intervention. Another nice feature is for medical billing software to automatically generate a query if the claim has gone unanswered for a significant period of time.

Don’t underestimate the importance of being able to access and manually follow up on claims as well, however. Is the interface intuitive? Can you reach the information you need quickly and efficiently, without undue confusion?

5. Reporting Features

A diverse set of features, options, and presentations fall under this category—which makes it all the more important for you to carefully examine the reporting features of any medical billing software solution in which you’re interested. There are several important considerations. The first is whether or not the software can generate the types of reports that you find necessary, or helpful, for your practice. Accounts receivable reports are necessary for nearly all offices. Statistics like the number of patients during a specific time period may be less important, depending upon your particular priorities. Detailed reports of all active claims can help a practice understand their earnings and also see what claims are still pending or rejected. Thus, your medical billing software can help you stay on top of your practice’s accounts. 

In addition to making sure the software offers the type of reports you want and generates them with ease, check on how these reports can be shared and exported. What formats are available? How easy or difficult is it to email or otherwise share these reports with the necessary parties?


One of the best ways to check out the availability of these and other key medical billing software features is to use our top Medical Billing Software Guide. It will give you an overview of important considerations when choosing software while providing you with profiles of the top solutions in the industry so that you can easily compare them side by side. Choosing the right medical billing software can be a game-changer in helping manage your patients and the finances of the practice. 

Share Article:
The right software for your business

Get your personalized recommendations now.