Integrating EHR and medical billing: three challenges

Practices face challenges when integrating EHR and medical billing systems, particularly if the two systems are separate from the beginning. Although technical challenges should concern practices, internal challenges pose a similar threat to success. Consider these three hurdles that practices must successfully navigate to ensure integration between EHR and medical billing systems.

1. Billing-friendly EHRs

Even if a practice did its homework on EHR systems, it may not have considered what the system meant for its medical billing processes. Although some systems offer an integrated medical billing system, too, the strength of the medical billing system may be limited. Practice managers need to consider the billing capabilities needed to perform everyday tasks.

If a practice has, for instance, a billing-friendly EHR, it means that it has a system that allows providers the ability to build charts. Charts, essentially, build any medical claim. A chart often includes visit dates, office notes/dictations, provider names, upcoming appointments, lab details, diagnosis, and so on. A billing-friendly EHR provides a practice a starting point to integrate a medical billing system.

Find the billing features your practice needs with this guide to 50 features to look for in your next EHR

However, without a billing-friendly EHR system, practices face a new battle: customization. Integration software is an option, but it requires additional time, money, and outside help-finding a software consultant with access to computer programmers that specialize in healthcare systems is paramount. Without a billing-friendly EHR system, the technical challenges are twofold: creating a charting ability and creating integration between the EHR and medical billing system. Make it easier on your practice, and shop for an EHR system that includes a robust medical billing module or system.

2. Data migration

A serious technical challenge presents itself during the necessary task of data migration. Whether a practice has an older electronic billing system or a paper system, moving information from the old to the new is daunting. Consider how frustrating it can become for both medical provider and patient when access to a patient’s medical history is restricted. Meaningful use requires interoperability, including the ability to share patient medical history with other systems as needed.

If new visit information isn’t entered into a billing-friendly EHR system, a medical billing system cannot pull information to bill. Similarly, if old visit information isn’t entered into a billing-friendly system, a medical billing system won’t include access to medical history. Some surgeries and hospital stays require medical history review by insurances in order to process new claims. If the billing staff cannot access the old information from the billing system, it can’t begin the medical review process with the insurance carrier.

Focusing on data migration may be just as important as ensuring you have the right type of system. Prioritizing the patients or information that need to be entered as well as considering an internal data entry process becomes the best chance practices have at seamless integration.

3. Training

Although not necessarily a technical consideration, training is just as important to a successful integration between EHR and medical billing systems. Everyone involved-including front end staff, providers, billing staff, and data entry-need to understand the process of integration and the flow of information. Any new process or technology can intimidate employees. Supporting employees through training geared toward integration preparation may seem obvious, but getting training right is difficult.

Communication between departments makes an integration process easier. Consider the following: if everyone understands their role in information entry, they may take their job more seriously. The front end staff should be aware that entering accurate appointment information and insurance information makes it easier for scheduling adequate staff and, ultimately, billing. Providers need to be aware about how their data entry affects billing-a wrong diagnosis code or bare-bones description of services can result in denial from the insurance companies, and, in some cases, inadequate future care based on invalid information.

Integration is only as good as the training. If people aren’t willing to understand and utilize a system, the integration between one system and another is meaningless.

Challenges will arise when integrating EHR and medical billing systems, there really is no avoiding it, but by selecting the best EHR for your billing needs and being wary of these challenges; the integration may just go that little bit smoother.