High-tech billing solution that meets CMS, NUCC, and HIPAA regulatory standards

As EMR gains traction, post the Stimulus Act; The accounting application cannot be ignored. For any small, medium or large medical information business, medical billing of healthcare services is the most indispensable and simple for healthcare industry.

Binary Spectrum’s billing application is a robust platform that automates electronic claims, remittances, member registration, eligibility and opt-out processes for a large HMO. The application provides customization to customer software and billing process with rapid medical billing services, saving customer human and operational expenses. It helps scale claims processing capabilities and is able to do so in a timely manner while also being able to deal with a wide range of providers.

The billing solution provides seamless integration capabilities for billing based on the data provided in the clinical charting capabilities to eliminate duplicate and error-prone data entry. Submission of applications can be done either electronically, ie ECT, or paper based pre-printed forms.

Below is a list of supported EDI messages:

For batch transactions-

• 837 P/I (Professional / Institutional) – Electronic Claim Files

• 835 – Healthcare Referral Confirmation Electronic Application Form

• 834 – Enrollment and opt-out for Medicaid eligibility

• 820 – Electronic response files for premium payments to the insurer

For real-time transactions-

• 271 / 272 – Request/response for membership authorization

• 276 / 277 – Claim status request/response

• 278 – Authorization and transfers

The main differentiator of the Medical Billing application is that there are multiple ways to create a final bill for a patient.

• At the time of booking an appointment, an encounter can be started, treatment plan details entered, and the encounter ended, which takes the user to the costing screen and creating the cost of the encounter.

• Another flow is from the Book Appointment page. There is the option of Super Invoice which will start the fee creation process, import all the services recorded in the Super Invoice into the fee creation screen and create the fee, associating the appropriate prices for the services.

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Benefits for the billing companies:

Billing companies can benefit from:

• Reduce the effort involved in entering data

• Automated workflow and rule management

• Compliance checks and generation of confirmations

• Support for multiple integration mechanisms for vendor interactions

• Analysis and validation mechanisms

• Integrated processes related to the family doctor, the HMO and the state payers (CMS / ACHA)

Benefits for doctors:

The billing solution helps doctors:

• Take the hassle out of medical billing

• Support for real-time news

• Support for both government and private multiple health insurance plans and in a variety of ways including sponsor, co-pay, primary/secondary/tertiary

• Timely and accurate charge capture and claim preparation

• Implementation of and compliance with applicable standards, including HIPAA, Standard Operating Procedures CPT and Disease Nomenclature ICD.

• Faster payment to doctors accurately

Binary Spectrum delivers significant system and human developed software with outstanding 24/5 customer service. Our solution-oriented approach helps us provide our technical expertise for cost-effective, robust solutions for our customers.

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