Medical Billing – Electronic Billing Pros and Cons

Everything in our world is becoming more and more automated. The days of paper are becoming things of the past. Who uses typewriters any more? True, they’ve been replaced by computers and printers, but with the advent of email and modems, information doesn’t have to be printed at all any more. This is also true of medical billing to insurance carriers. With electronic billing, no longer do we have to send them a paper HICFA, but is it all good? We’re going to take a devils advocate approach to electronic billing and examine both the pros and cons of sending your bills electronically.

The pros are easy to see. With electronic billing, you obviously save a lot of paper. No longer do you have to print out each bill. With electronic billing, by using a modem, you can send that bill directly to the carrier. Not only does this save paper, but it also saves postage. The cost of that phone call, which in most cases is an 800 number, is a lot less than the cost of sending these bills snail mail.

Another pro of electronic billing is accuracy. The programs that are created to send these claims electronically have built in checks for errors, since a human still has to enter the information. After the information for the bill is entered, you can run another program that checks to make sure that everything and we do mean everything, is filled out completely. Anything missing or in error is displayed on an error report which can either be printed or viewed directly on the computer.

Another pro of electronic billing is speed, not only of how quickly the claim gets to the carrier, since they don’t have to wait for the mail, but of how fast claims are paid. The reason claims are paid quicker in this manner is that the receiving carrier also has a program that checks for errors, so the claim itself doesn’t have to be manually reviewed. This speeds up the process.

It would seem from all of this that there can’t be anything bad about electronic medical billing. Oh, if only that were the truth. Unfortunately, there are things that can go wrong and all too often, do go wrong.

For starters, computers act up. Programs have bugs, especially when they are new. Because the medical industry is constantly changing, these programs have to be constantly updated. When this happens, bugs do pop up. When that happens, claims can’t be submitted until the bugs are fixed. This can effectively shut down billers for days. Not a pretty sight.

Another problem is with the actual transmission of the data itself. Modems can act up and often do. Sometimes there’s just a problem with the phone line. There may be noise on it. Unlike talking on the phone, the transmitting of data requires a perfect connection or the data doesn’t transmit properly. When this happens, the claims are rejected even though they may be valid. The data just becomes corrupted.

For the most part, electronic medical billing is a wonderful thing, but problems do occur and it is important to be prepared for those problems.