Medical billing is a payment practice within the United States health system. The process involves a healthcare provider obtaining insurance information from a patient, filing a claim, following up on, and appealing claims with health insurance companies in order to receive payment for services rendered; such as testing, treatments, and procedures. The same process is used for most insurance companies, whether they are private companies or government sponsored programs: Medical coding reports what the diagnosis and treatment were, and prices are applied accordingly. Medical billers are encouraged, but not required by law, to become certified by taking an exam such as the CMRS Exam, RHIA Exam, CPB Exam and others. Certification schools are intended to provide a theoretical grounding for students entering the medical billing field. Some community colleges in the United States offer certificates, or even associate degrees, in the field. Those seeking advancement may be cross-trained in medical coding or transcription or auditing, and may earn a bachelor's or graduate degree in medical information science and technology.
An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.
Medical practice management software (PMS) is a category of healthcare software that deals with the day-to-day operations of a medical practice including veterinarians. Such software frequently allows users to capture patient demographics, schedule appointments, maintain lists of insurance payors, perform billing tasks, and generate reports.
The Certification Commission for Health Information Technology (CCHIT) was an independent, 501(c)3 nonprofit organization with the public mission of accelerating adoption of robust, interoperable health information technology in the United States. The Commission certified electronic health record technology (EHR) from 2006 until 2014. It was approved by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS) as an Authorized Testing and Certification Body (ONC-ATCB). The CCHIT Certified program is an independently developed certification that includes a rigorous inspection of an EHR's integrated functionality, interoperability and security using criteria developed by CCHIT's broadly representative, expert work groups. These products may also be certified in the ONC-ATCB certification program.
Purkinje Incorporated pioneered pen computing for comprehensive clinical management of patients by physicians in 1991 with the "PureMD" ontology-anchored medical record was later rename Dossier that allowed physician order entry, knowledge-based clinical decision support, and billing from clinical note taking recorded on a tablet computer. in 1994 and 2007, "Dossier" was respectively awarded the "OCTAS of excellence" and the "TEPR award for standalone eprescribing systems". Dossier's impact of on clinical redaction was evaluated in two peer-reviewed studies. "Purkinje software and services" currently serve over 13,000 physicians in clinics, community health centers, and hospitals throughout North America. The company provides health software and related services in the areas of practice management, electronic health records, personal health records, and electronic prescribing. In addition Purkinje provides a series of professional services to physician practices including billing services, transcription, and medication dispensing.
Health information technology (HIT) is health technology, particularly information technology, applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors. Based on an often-cited 2008 report on a small series of studies conducted at four sites that provide ambulatory care – three U.S. medical centers and one in the Netherlands – the use of electronic health records (EHRs) was viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system.
The Veterans Health Information Systems and Technology Architecture (VISTA) is a health information system deployed across all veteran care sites in the United States. VISTA provides clinical, administrative, and financial functions for all of the 1700+ hospitals and clinics of the Veterans Health Administration VISTA consists of 180 clinical, financial, and administrative applications integrated within a single transactional database.
DrChrono is an American digital health technology company providing a software and billing service platform consisting of Web- and cloud-based apps for doctors and patients. It makes electronic health records (EHR), practice management software and medical billing software available digitally and provides medical revenue cycle management (RCM) services. The company is based in Sunnyvale, California
Practice Fusion is a web-based electronic health record (EHR) company based in San Francisco, CA. The company was founded in 2005 by Ryan Howard and acquired by Allscripts in 2018.
LSS Data Systems (LSS), was a Minnesota-based medical software and service company that develops products for the physician practice community. LSS was founded in 1982, and since then was a partner of Medical Information Technology (MEDITECH), developing physician practice management and ambulatory electronic health record software. In 2000 and 2001 MEDITECH invested in LSS and in February 2011, acquired complete ownership. LSS became a wholly owned subsidiary of the Massachusetts based company, and announced completion of the merger on January 1, 2014.
NextGen Healthcare, Inc. is an American software and services company headquartered in Atlanta, Georgia. The company develops and sells electronic health record (EHR) software and practice management systems to the healthcare industry. NextGen Healthcare also provides population health, financial management, and clinical solutions for medical and dental practices. On September 7, 2018, Quality Systems, Inc. changed its name to NextGen Healthcare, Inc. and on September 10, their stock ticker symbol changed to NASDAQ: NXGN.
CareCloud, Inc. is a publicly traded American healthcare information technology company that provides services, to healthcare providers and hospitals throughout the United States. The Company maintains its headquarters in Somerset, New Jersey and employs approximately 4,000 workers worldwide.
Intelligent Medical Objects (IMO) is a privately held company specializing in developing, managing and licensing medical vocabularies. IMO partners with various health care organizations, medical content providers and EHR developers.
Nightingale Informatix Corporation, commonly abbreviated as Nightingale, is a public company headquartered in Markham, Ontario, Canada with offices in Rancho Cordova, California, Cambridge, Ontario, Kansas City, Missouri, Pembroke, Massachusetts, and Wexford, Pennsylvania. Nightingale provides products and services that support physicians, allied healthcare practitioners, hospitals and other healthcare organizations with their clinical and operational requirements. Nightingale provides EHR and Practice Management services, as well as a Patient Portal, Revenue Cycle Management and Medical transcription services to solo physicians, group practices and large clinics across the United States and Canada. The EMR/ EHR by Nightingale is a web-based program and is hosted in a secure ASP environment.
Zynx Health Incorporated is an American corporation formed in 1996 that specializes in providing evidence-based clinical decision support system products made available at the point of patient care through electronic health record (EHR) systems. Based in Los Angeles, the company serves over 1,900 hospitals and outpatient practices globally, though most are located in the US. As of 2012, Zynx Health products and services impact over 50% of hospital discharges in the US.
Kareo is a company based in Irvine, California that provides software as a service for independent medical practices. The company offers cloud computing products and services for electronic health record (EHR) management, medical practice management software, managed billing services and software to help practices engage with their patients. In 2019, the company reported over 55,000 providers using its technology.
GroupOne Health Source, Inc. is a private company based in Jefferson City, Missouri with operational sites in St. Louis, Missouri and Indianapolis, Indiana. The company offers electronic health record medical billing, implementation, transcription, and consulting services. GroupOne primarily provides services to private medical practices and hospital owned medical groups. As of January 31, 2007 GroupOne Health Source, Inc. operates as a subsidiary of Pradot Technologies Private Limited.
Greenway Health, LLC is a privately-owned vendor of health information technology (HIT) including integrated electronic health record (EHR), practice management, and revenue cycle management solutions. Intergy, Greenway’s cloud-based EHR and practice management solution, serves ambulatory healthcare practices. The company has offices in Tampa, Florida; Carrollton, Georgia; and Bangalore, India.
CollaborateMD is a private company that provides cloud-based medical billing and practice management software services for independent medical practices and hospitals. The company's software uses real-time claim submission and built-in edits and integrates with various electronic health records (EHRs).
Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives and penalties for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.
