How to Develop a Medical Billing Software?

Right from the stage of appointment booking, the healthcare process goes through multiple people representing various departments. With many people involved, it is natural for manual errors to occur. Mistakes on medical bills cost hospitals a whopping $68 billion annually. Not only this, billing errors result in overcharges of 26% on average.

No wonder healthcare organizations are switching to medical billing software development to automate and streamline their process. While implementing off-the-shelf medical billing solutions seem a good choice, often this software fails to be compatible with other healthcare solutions, thereby not serving the purpose well. Custom medical billing software offers a solution here. But simply choosing a healthcare software development company is not enough. There’s more to it. Let’s discover various aspects of how to develop medical billing software in the following few minutes.

What is Medical Billing Software?

  1. These systems are fully integrated with EHRs, which reduces the chances of manual error and presents data in a better way in a few clicks.
  2. Claim scrubbing functionality helps boost the first-pass acceptance rate by inspecting claims for edits before final submissions.
  3. Automated claim worklists help billers to stay focused on serving patients
  4. When integrated with the clearinghouse, billers submit claims to several payers using the interface and faster reimbursement.

Some of the challenges that you can solve with medical billing software include:

  1. Fragmented workflow slows down the overall process with billing errors and claims denials.
  2. Paper-based billing systems can slow down revenue cycle management.
  3. Lack of interoperability makes it complex to integrate with other healthcare systems and share data within them.
  4. Avoids bundled payments by providing episode-based payments for risk-based delivery.
  5. Inability to manage patient claims data securely and under HIPAA compliant billing system.

Get Started on Medical Billing Software Development with Custom Software Development Company

  • Industry experience
  • Technical expertise
  • Skills of the development team
  • Development process
  • Project management tools
  • Client testimonials
  • Post-deployment maintenance services

How to Develop Custom Medical Billing Software- The Process Matellio Follows as Custom Healthcare Development Company

We start medical billing software development while helping you uncover the hidden aspects required for building medical billing software. In the discovery phase, our business analysts perform the following actions to get into the details of how a medical billing software should work.

Step 1: Understand the Working of Medical Billing Software for Architecture Creation

Step 1: Patient Insurance Validation

Step 2: Charge Capture Records

Step 3: Medical Coding

Step 4: Claims Submission

Step 5: A/R Follow Up

Step 6: Denial Management

Step 7: Remittance Processing

Step 8: Third-party Follow-Up

Step 9: Patient Collections

Step 10: Reporting and Data Analytics

Step 2: Finalize the Required Features for your Medical Billing Software with You

1. Patient Preregistration

  • Patient medical history
  • Insurance eligibility
  • Medicare provider enrollment
  • Patient’s details

If the preliminary information is available at the time of registration, it is easier to address gaps in the future, and also, the information is displayed to the doctors in concern in a timely and accurate manner.

2.Claims Management

  • Claim processing
  • Invoice creation
  • Claim submission
  • Claim updates

And more.

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3. Automated Accounting

  • E-Invoices
  • Payment Reminders
  • Coding
  • Claims management

4. Data Exchange and Collaboration

5. Patient Data

  • Medical records
  • Insurance eligibility
  • Medicare coverage
  • Prescription history

6. Appointment Scheduling

  • Patient inflow
  • Treatment details
  • Appointment type
  • Revisits

An easy-to-use UI/UX that can be a common platform for scheduling and billing is ideal for medical billing software.

7. Compliance

8. Reporting and Analysis

Step 3: Technology Stack that Would Best Suit Your Project Requirements

Front End Development

Libraries Vue.js, React

Languages CSS 3, JS, HTML 5

Back End Development

Server Nginx

App Frameworks Laravel

Databases My SQL, Redis

Hosting AWS, VULTR

Step 4: Finalize the Team Structure

  • Project manager
  • Front-end developer
  • Back-end developer
  • UI/UX experts
  • QA and testing engineers

Step 5: Custom Medical Billing Software Development and QA/ Testing

  • SRS Creation: A software requirement specification (SRS) document captures the complete project description, including how a system shall operate and other technicalities. In this stage, a detailed view of the system is designed on paper, with each aspect explained. Once you approve the SRS document, the following phases of the document shall begin. Developers will consider the requirements mentioned here as benchmarks, so the client must ensure that all the requirements are specified.
  • Software Development: Based on the SRS, the development work will start. It is mainly carried out in UI/UX development, front-end development, and back-end development. The project manager oversees the entire process to ensure cutting-edge delivery and shall stay connected to you to share regular updates.
  • QA/ Testing: QA and testing experts design and run the system based on various use cases to ensure that the system works like it is intended to. This is a crucial stage to deliver software that not just meets your requirements but is also bug-free.

Are You Ready to Begin with Custom Medical Billing Software Development?

Matellio has been serving many healthcare organizations (among other verticals) for 20+ years in the industry. To begin, book a free 30-minute consultation with our team and explore.

Founder & Board Member at Matellio — Technology enthusiast with enterprise solution design & development expertise