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Developing a Medicaid Billing System for NEMT: What You Should Know

Creating a Medicaid billing software

Non-emergency transportation companies are a crucial part of today’s healthcare sphere. The number of seniors and disabled people is continuously growing in the U.S. NEMT providers ensure that these population categories and other low-income citizens have the opportunity to get to and from their doctor’s appointments, rehab, urgent care, pharmacies, etc. 

To tell the truth, NEMT is an honorable, profitable but hugely complex business. Like any other transportation industry, it faces various NEMT issues. The most serious of them include: 

  • Human errors – they frequently happen if employees perform all operations manually. While doing so, employees usually overwork and have piles of documentation on their desks. It leads to muddle, therefore, mistakes. As a result, the company loses money.    
  • NEMT companies usually work with multiple payers and have to consider all their special aspects. This leads to confusion.  
  • Finally, billing operations are last but not least here. They require so much time, labor, knowledge, and skills from providers and billing specialists! 

Billing is the first field in the NEMT business which has to be updated and automated to do billing and reimbursements since the overall company’s profitability depends on it. Besides, the right technology should reduce human errors and “know” regulations for NEMT companies in the state where you are performing. 

So, how do you develop a Medicaid billing system? What features should it have to save providers’ time, labor, and money? The answers are below!

Required Features

We bet that all NEMT providers have at least once dreamt about developing a Medicaid billing system which would be just perfect for satisfying their daily needs. Such a system would boast certain features to be helpful and cope with various operations so that NEMT providers can entirely rely on it and run the business without any hassles. 

Data Imports

The document flow is endless in your work! Data import processes are time- and labor-consuming. Obviously, you don’t want to waste your time on double-entering or reentering all the information like dates, clients, quantities, procedure codes, etc. 

That’s why a system that is capable of batch data entry and sending in just seconds is a must for you. Also, such a system has to be HIPAA-compliant to generate multiple certified and approved electronic claims with a single click. It would definitely speed up data imports and other documentation processes.

Error Check

As we’ve touched on above, errors are the main holdup for fast reimbursements. Claims must be “clean” (free of errors), otherwise, payers will reject or deny them, hence, providers won’t get paid as soon as they expect. 

For this reason, the Medicaid billing system must have an error check feature that will eliminate such vital mistakes as incorrect codes, leaving out codes for procedures and/or diagnoses, mismatched medical codes, incorrect patient, provider, and/or insurance provider information, duplicate billings and more. 

If billing specialists and providers reduce these inaccuracies, they’ll have a much higher number of “clean” claims. And this, in turn, will make billing operations much quicker.

Payment Tracking

It’s difficult to track accounts receivable and always stay aware of which claims are reimbursed and which ones need to follow up, especially if all operations are done manually. However, the system with cash flow management could solve this problem. It should give you full control over payment tracking and the clients’ data. It would be great if the system instantly updates all client account ledgers and balances.  

Besides, when you’re thinking over how to make a Medicaid billing system, note that it must validate everything before sending it to Medicaid. This way, you’ll avoid rejections, denials, or incorrectly paid claims making the whole process straightforward and fast.

Cross-platform Availability

It’s so convenient when you have access to the database and can send reports and claims from any internet-enabled device such as computers, tablets, or smartphones. Actually, such a feature allows you to work from wherever you like, as long as you have an Internet connection. Due to this, it’ll become straightforward to update records, outwatch patients’ billing balances along with other documentation, confirm services, and perform dozens of various actions. 

So, when you consider developing a Medicaid billing system, don’t forget about cross-platform availability, it’ll make running your business more efficient.

Useful Capabilities 

What other useful features and capabilities would you like to see in your new billing system? Here are several ideas for you:

  • User-friendly interface – such a system will reduce the learning curve, no need for special billing guidelines for users. It should be easily integrated with your existing platform, simplifying the transfer of data, and reducing lots of hassle involved. A new system must make your workflow effortless, accurate, precise, and fast. 
  • Fast billing process – a new system must provide you with the easiest and quickest way to manage billing operations, client info, submit HIPAA-compliant claims, receive priority payment, and control accounts receivable. 
  • Multiple claim sending – every day you get orders from MAS (non-emergency Medicaid transportation management company), then you have to create dozens of reports and send them to Medicaid. That’s why the multiple claim sending feature is a must for NEMT providers. 

Final Thoughts 

How to create a Medicaid billing system? What features to develop? Now you know the answers to these questions! 

However, you can find an even better solution for your NEMT business, it’s BillPro software. While designing this software, creators have considered all so-much-needed features and capabilities that we mentioned above and even more! 

Below there are some extra reasons to choose BillPro software.

  • Medicaid pays electronic claims before paper ones. That’s why electronic billing is a must for fast reimbursements. 
  • Errors are caught long before the rejection stage so that claims can be submitted accurately and fast. You’ll get more revenue with less effort.
  • Our software is HIPAA-compliant and makes the most of your time, labor, and money.
  • BillPro software helps you create accurate reporting and ensures fast payment due to reliable controls and built-in logic. 

Subscribe for BillPro software now and rev up your success!

One Reply to “Developing a Medicaid Billing System for NEMT: What You Should Know”

turo iz says:

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