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What Are 3 Different Types Of Billing Systems in Healthcare?

by | Nov 8, 2021

Things You Need to Know About Closed

A billing system in healthcare is a set of protocols and procedures that make sure that every task involved in revenue collections management is going great. That ultimately results in a streamlined administrative workflow as well as improved billing collections.

Here’s a question that arises: what are the different types of lab billing system in healthcare? & which one should you choose for healthcare practice? Before making any decision, it’s very important for the lab technicians to first analyze their practice needs. Because without having a complete understanding of the needs, they cannot adopt the right billing model for laboratory practice.

What are 3 different types of billing systems in healthcare?

The majority of healthcare providers might not know about the 3 types of billing systems. And usually, they don’t even try to find out the best one that best fits their needs. Due to the lack of this understanding, they end up with inefficient claims management and eventually revenue loss.

If you want to make the right decision about your billing and coding services, then read this article carefully. In this article, I have mentioned the complete features of the 3 billing systems namely open, closed and isolated.

1. Closed:

A closed medical billing system doesn’t let health records and billing charts from any of its end. It simply means the entire data will remain within the boundaries of particular lab practice. In closed lab billing systems, the preferred tool to keep the records of patients’ diagnoses, treatments and information about medical equipment and health services provided to the patients is Electronic Medical Record (EMR).

EMRs contain detailed information on the medical history of the paints. and can be connected with different EMRs within the practice. However, they cannot be used, accessed or connected outside your laboratory premises. Only assigned lab technicians and billing teams can handle them. As per lab billing and coding experts, EMR is simply an electronic version of the good old medical paper charts.

Implementation of Closed Systems

If you’re running a small-sized healthcare practice, with a lesser number of lab technicians. Then this type of system can meet your needs. However, if you decide to outsource your laboratory billing and coding services to a third party like Laboratory Billings. Then you need to change your billing system to an open one.

Use of EMRs?

Many of the lab technicians may get confused with Electronic Medical Records (EMR) and Electronic Health Records (EHR). However, let it be clear that EMRs are digital versions of the paper charts in healthcare facilities. They help laboratory technicians in the following ways:

  • Enable healthcare providers to keep medical history, diagnoses, medications, immunization dates and lab results in a digital form.
  • To take the view of a patient’s treatment plan, lab practitioners can connect multiple EMRs within their practice. This integration will help the healthcare providers to check the preventive screenings and track the due dates for a patient’s check-up.
  • This also enables you to track over a period of time a patient’s vital parameters. In this way, you become able to determine any requirement for a change of treatment plans remarkably.

2. Open:

The open laboratory billing system is considered as the more collaborative structure as compared to the closed ones. This kind of system allows healthcare records to travel beyond the boundary of the healthcare practice.

It enables all major stakeholders including: billing teams, healthcare providers, patients and other medical organizations to access the healthcare records for better and coordinated care services.

In this kind of setup, the patients’ health data can be easily transmitted to different sectors through Electronic Health Records (EHR). Third-party billing service providers can easily get involved in the billing process through completely secured and authorized access to the EHRs.

Implementation of Closed Systems

Laboratory practices having multiple departments can benefit from such types of billing systems. Because they offer complete flexibility when it comes to accessing the patients’ healthcare records. It helps lab technicians to transmit information to the outsourced billing companies as well as other healthcare professionals easily.

Use of EHRs?

Do you know the fact that the use of EHRs isn’t just bound with maintaining the patient’s records in digital form? It can also help you in the following ways:

  • EHRs help healthcare providers to store vital information of the patients. Such as: demographic information, diagnoses, past test results, as well as the entire medical history of the patients.
  • It provides complete, accurate and real-time access to the healthcare records at the point of care. Which ultimately leads to better and coordinated care.
  • Patient portals improve the communication and interaction between healthcare providers and patients.
  • Helps front desk staff of the lab practices to gather and keep the record of accurate patient information such as: name, date of birth, gender, age, contact number, address, social security number, and basic insurance information.
  • Increase the level of specificity and accuracy of the information. That ultimately results in inaccurate medical codes and clean medical claims
  • Protects your highly confidential information from mismanagement, theft and cyberattacks.
  • Reduces costs and saves time associated with managing the patient records on papers and also diminish the chances of duplication in the documents.
  • One of the major benefits of the implementation of an EHR system is the better coordination between the front desk and back end staff of a healthcare organization.
  • If the patient is referred to another provider, the new healthcare professional laboratory or imaging center can get a comprehensive picture of the patient and treat them accordingly.
  • Unlike traditional methods of keeping a record of healthcare data, patients aren’t kept blindfolded regarding their health data. They have the option to access their health records for a better understanding.
  • EHR systems have the flexibility to get easily integrated with the existing systems.
  • Can also help practice & lab owners stay on top of they medical billing & coding key performance indicators.

3. Isolated:

These systems are only designed for patients. Lab technicians and patients can access them completely with the help of PHRs (personal healthcare records). While medical facilities do not have access to these systems. In this way, patients can access their health care records when they have a complete hold over them. They are responsible to put and maintain their medical data in these records.

Implementation of the Isolated Systems

As we have made it clear that isolated systems are only handled by the patients. Therefore, they cannot be replaced with EMRs and EHRs at any cost. It’s pertinent to mention here that only EMRs and EHRs are legally accepted.

Final Thought!

All three billing systems have different and unique requirements, which depends on the needs and of course the size of lab practice. However, in order to make your laboratory practice financially successful, you should pay close attention to the needs of your healthcare practice.

Once you determine the needs, you will become better able to decide which type of lab billing system can play a crucial role in the overall success of your lab practice. After deciding any system i.e. open, closed or isolated for your healthcare practice. Then the next step is the implementation of the right billing and coding strategies to get maximum return on investment on your submitted medical claims.

You have two options, either outsource your revenue cycle management to a professional billing collection agency or keep it in your lab premises. It all depends on your needs and requirements. If you find it challenging to invest time and money in maintaining an in-house billing department, then collaboration with a third party can bring enormous benefits to your healthcare facility. Following is the listicle by DesignRush that can you help you find helpful resources.

However, if you are looking for a competent partner for outsourcing your healthcare RCM services. Then stop looking further than Laboratory Billings. Our billing and coding services are fully tailored, designed after analyzing your needs.

Looking for Revenue Impact? Speak to us!!!

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