MEDICAL SERVICES SETTINGS
Handles medical services settings related operations and functionality.
Application Suite
Maximize Revenue with Intelligent Medical Billing
From OPD to IPD, from cash to credit—complete billing and revenue cycle management for your hospital with 99.7% accuracy.
Insurance ReadyTPA IntegratedAudit Ready
Suite Overview
11Modules included
20%Increase in Monthly Charges
50%Reduction in Claim Denials
Modules in this Suite
What's Included
MEDICAL BILLING MASTERS
Handles medical billing masters related operations and functionality.
MEDICAL SERVICES
Handles medical services related operations and functionality.
BILLING OFFICE
Handles billing office related operations and functionality.
IPD BILLING
Handles ipd billing related operations and functionality.
CREDIT BILLING
Handles credit billing related operations and functionality.
DOCTORS ACCOUNTING
Handles doctors accounting related operations and functionality.
COST ACCOUNTING
Handles cost accounting related operations and functionality.
DOCTOR SHARE
Handles doctor share related operations and functionality.
OPD BILLING
Handles opd billing related operations and functionality.
PACKAGE BILLING
Handles package billing related operations and functionality.
Challenge & Solution
How We Solve It
The Challenge
Problem 1: Revenue Leakage from Unbilled Services
The Solution
The Medical Billing suite provides complete revenue cycle management. Clinical services trigger billing automatically. Charges flow through validation, coding, and billing. Claims are submitted to payers. Payments are reconciled and posted. Automated charge capture with reconciliation between clinical notes and billing. Multi-payer billing with automated rule application for each payer type. Pre-bill validation with claims scrubbing reduces denials significantly. Automated doctor accounting with configurable share calculations. Automated package billing with utilization tracking and profitability analysis.
ROI Metrics
Measurable Impact
20%
Increase in Monthly Charges
Automated charge capture eliminates revenue leakage from unbilled services—increasing monthly charges by 20%.
50%
Reduction in Claim Denials
Pre-bill validation and claims scrubbing reduce claim denials by 50%.
55%
Faster Charge Entry
Automated workflows reduce charge entry lag by 55%—faster billing, faster payments.
21%
Increase in Collections
Faster, more accurate billing accelerates payments and improves collections by 21%.
40%
Improvement in DSO
Faster billing and automated follow-ups reduce days sales outstanding by 40%.
100%
Transparent Doctor Accounting
Automated doctor share calculations with real-time visibility into consultations, procedures, and earnings.
Architecture Overview
How It Works
The Medical Billing suite provides complete revenue cycle management. Clinical services trigger billing automatically. Charges flow through validation, coding, and billing. Claims are submitted to payers. Payments are reconciled and posted.
Stakeholders
Who Benefits
Billing Manager
Complete Revenue Visibility
Real-time dashboard showing charges, collections, denials, and revenue cycle metrics.
Billing Staff
Efficient Operations
Automated workflows with validation, claims scrubbing, and automated follow-ups.
Doctors
Transparent Accounting
Real-time visibility into consultations, procedures, share calculations, and earnings.
Finance
Revenue Assurance
Complete revenue cycle visibility with analytics, reporting, and reconciliation.
Patients
Clear Billing
Itemized bills with clear explanations, payment options, and online payment capability.
Administration
Revenue Analytics
Complete revenue cycle analytics for strategic decision-making.
Compliance & Security
Built for Compliance
Pre-Bill Validation
Automated claims scrubbing with NCCI edits, medical necessity checks, and coding verification.
Audit Trails
Complete billing audit trails with every transaction logged and timestamped.
Revenue Integrity
Automated checks ensure revenue integrity with reconciliation and validation.
"The Medical Billing suite transformed our revenue cycle. Charge capture leakage dropped from 5% to under 1%. Claim denials reduced by 50% with pre-bill validation. DSO improved by 40%. Doctor accounting is now transparent and automated. Our revenue increased by 20% within the first 6 months."
Mr. Amit Kumar, Revenue Cycle Director, 450-Bed Tertiary Care Hospital
FAQ
Frequently Asked Questions
How does charge capture work?
Clinical documentation triggers automatic charge generation. Reconciliation ensures every service is billed. Missing charges are flagged for review.
Can it handle multiple payer types?
Yes, configurable billing rules for insurance, TPA, corporate, cash, and charitable patients with automated rule application.
How does doctor share work?
Configurable share calculations for consultations, procedures, and referrals with automated tracking and real-time visibility.
How does package billing work?
Automated package billing with bundled services, utilization tracking, profitability analysis, and pricing optimization.
Can we track claim denials?
Yes, complete claim denial tracking with root cause analysis, resolution workflows, and prevention strategies.
How does patient billing work?
Itemized bills with clear explanations, multiple payment options, online payment capability, and automated follow-ups.
Ready to get started with Medical Billing?
Talk to our team and configure your modules