Biggest Medical Billing Issues

Modern economic trends in the world show an increase in the number of enterprises engaged in services. The provision of any services on a commercial basis, including medical, involves the use of billing systems. Significant growth of this sector of the economy determines a significant increase in the role of billing in the management of enterprises, in one way or another related to this area of activity. The introduction and use of a billing system require modern approaches and technologies. Under conditions of severe competition and crisis phenomena in the economy the issues of efficiency and degree of integration of various information systems, as well as the use of advanced information technologies are especially urgent.

Problems with Medical Billing

Real-time work involves the development, support, and provision of intermediaries who have licenses for the collection of payments (banks and payment systems), and access to web services of the billing system – to identify customers and deposit funds on their personal accounts. The client is usually identified by one or two alphanumeric requisites entered by the client when making a payment, for example: by the cell phone number or a combination of the client’s personal account and his landline phone. How does the patient services billing of a medical institution work? In case of successful identification, funds are accepted by the payment system and credited to the billing account of the newly identified client. The advantage of using web-services technology is the speed, and the main disadvantage is the potential threat to the security of the clinic’s internal network and the need to verify the accuracy of the information. Since the web service opens a gateway between the Internet and the company database, the web service can be used not only by payment systems but also by criminals to make bogus payments. Solving the problem of information security and reliability requires investments such as purchasing special security devices, paying qualified programmers, and using software that has been licensed and certified for the corresponding security levels.

Fierce competition

Current market conditions are characterized by fierce competition. Medical institutions engaged in treating their patients are forced to fight for each client. To attract new and retain existing customers, they are constantly introducing new rate plans, discounts, marketing promotions, and bundling separate service packages. For billing, it means a constant complication of business logic, regular changes in business rules for billing services, and thus constant changes in the billing system.

The basis of quality work is a modern and flexible billing

As a result, there is a tendency for centralized implementation of business logic and data processing in billing systems. The reasons for this trend are as follows: it is much easier to control and change business logic if it is implemented and stored in a single centralized database, rather than on the jobs of specialists responsible for certain business processes; much faster, and most importantly – more reliable to make changes in a single procedure that defines a particular business rule, and make this procedure available to all users interested in it. This technology guarantees that since the replacement of the version of the corresponding procedure with a new one no one will be able to use the old version, consequently, the centrally established business rules will not be broken; it is much easier to ensure the safety and security of the centralized rather than distributed enterprise database: it is cheaper to maintain a centralized group of programmers supporting a complex billing system than to distribute these specialists among affiliates. So, in today’s conditions of global economic development (fierce competition and lack of funds due to crisis phenomena) managers are faced with the need to improve the efficiency of medical institutions. For them, the basis for effective functioning will be modern and flexible billing.