Web-based medical billing software is the smarter, faster,
and proven choice of physicians and practive administrators. EMD Systems Billing applications are developed
by industry experts who understand medical billing and the challenges of running a profitable practice in todays economy.
The recent changes in health care reimbursement means your medical practice cannot rely on antiquated billing methods and obsolete technology.
The Medical Group Management Association reported that the rejection rate of billing claims is 30%. Out of that only 50% are resubmitted. That leaves a lot of potential revenue left unclaimed.
The medical billing solutions developed by EMD Systems are designed to help you overcome high billing claim rejections. We focus on developing web-based
medical billing software that includes
special tools such as Claim Revenue so that you are assured only compleate, up-to-date claims are submitted. The claims reveue process alerts you of potential errors prior to submission, resulting in a higher
first-pass acceptance rate.
ELECTRONIC AND PAPER FORMAT 5010
EMD provides a single integrated healthcare and payments platform, our applications are
ready to support the transition from ASC X12 Version 4010 to ASC X12 5010. Our objective is to minimize the impact during this transition period.
The Current Procedural Terminology (CPT)
code set is maintained by the American
Medical Association through the CPT
Editorial Panel. The CPT code set
describes medical, surgical, and
diagnostic services and is designed to
communicate uniform information about
medical services and procedures among
physicians, coders, patients,
accreditation organizations, and payers
for administrative, financial, and
New editions are released each October.
The current version is the CPT 2013. It
is available in both a standard edition
and a professional edition.
CPT is currently identified by the
Centers for Medicare and Medicaid
Services (CMS) as Level 1 of the Health
Care Procedure Coding System.
Electronic Insurance Verification helps to solve
the problem of missing or invalid insurance information that can cost a practice time and money.
By utilizing state of the art technology the application can automatically retrieve insurance and
benefit information in just seconds. This process can also be manually triggered at any time.
The results the inquiry are automatically stored – no typing required. This provides an imediately
recognizable productivity booster, EMD makes checking insurance eligibility so fast, there’s no
reason not to do it for every patient. This inoformation is posted in the application dashboard
for all appropriate staff to see with a glance.
This feature can be support via connections to Insurance clearing houses such as Emdeon or
Availity. If clearing house are not feasable connections to individual insurance carriers can be established.
Accurate determination of patient co-pay and deductible
Minimizes claim denials, reducing accounts receivable problems, and improving cash
Easy to use, no additional learning curve, improvement in productivity
Facilitates the patient enrollment process
Real-time processing with immediate response within the application
Saves administrative time and reduces labor costs
Meets all HIPAA/CMS criteria for identification, authentication, and encryption
Rules-based for client flexibility and customization
270 Transaction Eligibility/Benefit Inquiry
271 Transaction Eligibility or Benefit Information (response to 270)
276 Transaction Claim Status Request
277 Transaction Claim Status Notification (response to 276)
The insurance benefits information returned will be stored as
part of the patient record and an automatic notice that the eligibility checking has been done will be
made on the patient's appointment record. Additionally, a print-out of the benefits information
for the patient can be produced.
This feature is an intergrated into the EMD products and is also available as an SKD.
EMD knows that a practice has multiple fee schedules that
are used on a daily basis. Our applications are built with this fact in mind. To facilitate that
fact we include the following features in our applications:
The ability to designate the default Technical, Professional, and Global fee for a charge item.
The ability to designate a "Contract" fee schedule based on the ordering physician.
The ability to designate a "Contract" fee based on the ordering physician group.
The ability to designate a "Contract" fee based on the insurance carrier.
Contracts can be copied to new contracts to facilitate the rapid deployment of new contracts.
Contracts can have an expiration date assigned.
Contracts can be flagged as active or inactive.
ICD9 AND ICD10 CODE SUPPORT
EMD products fully supports the use of ICD9 and ICD10 codes.
There are two related classifications of diseases with similar titles, and a third classification on
functioning and disability.
The International Classification of Diseases, Clinical Modification is used to code and classify morbidity
data from the inpatient and outpatient records, physician offices, and the National
Center for Health Statistics (NCHS) surveys.
EMD goes a step further by allowing the ICD codes to be mapped to CPT codes to help ensure that
non-appropriate exams are scheduled. This helps to ensure proper patient care and medical reimbursement.
Processing insurance pre-authorizations can be tricky
business without a sophisticated management system. Our applications records all the staff member
who obtained the authorization, authorization number, referral number, effective date, expiration
date, issue date, and notes. Authorizations are tied directly to the patient and the exam. The
authorization status is updated to the application dashboard to inform front desk staff of a patient's
The requirement for pre-authorization can be configured based on the CPT code ordered and the insurance
carrier entered for the patient.