The medical billing process starts when a healthcare provider makes a physical examination and provides medical care to a patient. The diagnosis and medical services that are rendered by the healthcare provider to the patient are then translated into numerical codes drawn from the International Statistical Classification of Diseases (ICD-9) and the Current Procedural Terminology (CPT) code databases. Medical billing software enables a medical biller to transmit a medical claim to an insurance company using an electronic claim (using the ANSI 837 electronic format) or a paper claim (using the CMS-1500 paper form). The insurance company processes the claim and delivers reports to a healthcare provider’s medical billing software. Approved claims are reimbursed at a percentage of the billed services based on pre-negotiated rates between the healthcare provider and the insurance company. Failed claims are rejected and a notice is sent to the provider in the form of an Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA) report. Any copayment, deductible, or coinsurance amounts on approved claims or non-covered services on failed claims are then billed by medical billing software to the patient on a patient statement (also known as a “medical bill”). The frequency of rejections, denials, and over payments by insurance companies is high (often reaching 50%) and many healthcare providers also carry large accounts receivable (for an average of 75 days).
Effective medical billing software helps healthcare providers avoid the potholes of the medical billing process that can lead to serious cash flow problems within their medical practice. Healthcare providers can manage their medical billing process with ease while getting paid faster from insurance companies and patients. That’s because Power of Appeals denial management software is the most user-friendly, easy-to-buy, and fast-to-deploy denial management software on the market offering immediate benefits with reduced risk and cost.
Medical Billing Solutions by User, Specialty, and Payer
Denial management solutions from Appeal Solutions are available for many types of users, medical specialties, and insurance companies. With thousands of healthcare providers in 50 states and 36 medical specialties, Appeal Solutions provides medical denial management solutions that are right for your business.
Power of Appeals denial management software works for many types of users:
- Medical Billing Solutions for Physicians – Healthcare providers, also known as “doctors” or “physicians”, make more money and keep their staff happy and productive with our denial management software.
- Medical Billing Solutions for Office Managers – Office managers, also known as “practice managers”, “practice staff” or “practice administrators”, run their offices smoothly with our medical billing software.
- Medical Billing Solutions for Medical Billers – Medical billers, also known as “billers” and “medical billing specialists” use Power of Appeals denial management software to save time and get more done with automation of routine tasks.
- Medical Billing Solutions for Medical Billing Services – Medical billing services, also known as “medical billing companies”, work with clients more efficiently on Power of Appeals denial management software.
Denial management software provided by Appeal Solutions is used for denial management in a variety of medical specialties:
- Ambulance Billing Software – Denial management software for vehicles that transport sick or injured people between places of treatment, typically from illness to injury.
- Anesthesiology Billing Software – Denial management software for healthcare providers that are trained to administer anesthesia drugs and manage the medical care of patients before, during, and after surgery.
- Cardiology Billing Software – Denial management software for doctors that specialize in dealing with disorders of the heart and blood vessels.
- Chiropractor Billing Software – Healthcare providers that emphasize diagnosis, treatment, and prevention of mechanical disorders of the spine can use Power of Appeals denial management software.
- Dermatology Billing Software – Denial management software for the branch of medicine dealing with diseases of the skin.
- DME Billing Software – Denial management software for billing of durable medical equipment (DME), which is a term used to describe any medical equipment used in the home to aid in a better quality of living.
- Family Practice Billing Software – Denial management software for the medical specialty devoted to comprehensive health care to people of all ages.
- Hospitalists Billing Software – Medical billing software for the discipline of hospital medicine concerned with the general medical care of hospitalized patients.
- Internal Medicine Billing Software – Doctors concerned with the diagnosis, management and nonsurgical treatment of unusual or serious diseases can use Denial management software.
- Mental Health Billing Software – Denial management software for mental health conditions characterized by a level of cognitive or emotional well-being in the absence of a mental disorder.
- Neurology Billing Software – Denial management software for neurologists, a term used to describe the medical specialty dealing with disorders of the central nervous system.
- Obstetrics and Gynecology Billing Software – Denial management software for healthcare providers in the surgical specialty dealing with the care of women and their children during pregnancy and childbirth.
- Optometry Billing Software – Optometrist, which are health care professionals concerned with eyes and related structures, as well as vision, can use Power of Appeals for their Denial management software needs.
- Ophthalmology Billing Software – Medical software for ophthalmology, a branch of medicine dealing with the diseases and surgery of the visual pathways.
- Pain Management Billing Software – billing software for pain management, a discipline focused on non-surgical solutions for the treatment and relief of pain.
- Pediatrics Billing Software – Medical billing software for healthcare providers that render medical care to infants, children, and adolescents.
- Physical Medicine Billing Software – Medical billing software for physical medicine and rehabilitation, which aims to enhance and restore functional ability for those dealing with physical impairments of disabilities.
- Physical Therapy Billing Software – Medical billing software for physical therapy and occupational therapy, which strives to develop, maintain and restore maximum movement and functional ability throughout the lifespan.
- Radiology Billing Software – On-demand medical billing software for healthcare providers that study and apply imaging technology like x-ray and radiation to diagnosis and treat ailments and diseases.
- Surgery Billing Software – Medical software for doctors that use operative manual and instrumental techniques to investigate and treat a pathological disease or injury.
Denial management software by Appeal Solutions is used for medical billing in a variety of billing and payment situations:
- Patient Billing Software – billing software can be used to bill patients for so-called “self-pay” visits, otherwise known as situations that are not covered by their insurance companies.
- Medicare Billing Software – Denial management software by Appeal Solutions can be used to electronically bill the Medicare federal government program that insures patients over the age of 65.
- Medicaid Billing Software – Medical billing software for billing electronic medical claims to the Medicaid state government programs that insure low income and indigent persons.
- Blue Cross Billing Software – Denial management software can be used to send electronic medical claims to insurance companies that do business under the Blue Cross brand.
- Blue Shield Billing Software – Denial management software can be used to bill payers that insure patients under the Blue Shield emblem.
- Commercial Insurance Billing Software – We also offer Denial management software for billing all major commercial insurance companies, such as Aetna, Cigna, United Healthcare, WellPoint, and many others.
Power of Appeals Denial Management Software
To wrap it all up, denial management software is used to manage the medical claims appeals process between healthcare providers and payers. Effective Denial management software should simplify your healthcare business and help your doctors get paid faster by insurance companies and patients. Appeal Solutions’ Denial management software provides all of the features and functionality that you need for your practice. You can sign up online, pay a low monthly subscription fee, and cancel at any time if you don’t see the immediate benefits of our Denial management software.