What Is Medical Billing Software?

Medical billing software is a computer program that must be able to either print out a claim form or be able to send the information electronically to the insurance company, Medicare or Medicaid. The claim forms contain detailed information about the patient and their medical visit, medical surgical procedures or a medical supply that is rented or purchased.

Variations of Software

• There are many companies that create variations of medical billing software (see links in References). Each company makes its product a bit different, either in cost, complexity, specialty or ease of use.

Identification

• Billing software must include the ability to add patient information like name, address, date of birth and insurance identification information.

Diagnoses Codes

• Billing software must also include at least the option to have 4 diagnoses codes if needed.

Necessary Requirements

• The software must also have the ability to add Current Procedural Terminology (CPT) procedure codes, CPT modifiers, units of service and dollar amount charged. These are required items necessary for the insurance to process the claim.

Place of Service

• A critical area in the billing is that the software must be able to add not only the physician who provided the services, it must be able to have the address where the service took place and the payment address, which may be different than the physical address where the service took place.