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Health Care Billing Systems

HealthCare Billing Systems

Technologychanges are inevitable and have been embraced in all the aspects ofhumanity. The health care industry has not been left behind inenjoying the benefits brought about by technology, while alsoaddressing the challenges that come along with implementation oftechnological changes. According to Herrick, Gorman &amp Goodman(2010), there are many benefits linked with proper implementation ofhealth information technology, however, a poorly implemented systemresults to many challenges in the health care setting. Nonetheless,the essence of using technology in the health care industry is forincreasing efficiency and improving the quality of the servicesrendered. The health information system is employed in differentareas of the health care industry, among them includes the billingsystem, the storage of medical services, for tracking of inventory,profits and losses, and in disease data bases among others. Thisresearch paper focuses on the use of technology in the billingsystem, the implementation process, and the role of leaders inimplementation of the technology and effect on the community.

Technologyin the Billing System

Medicalbilling system billing system entails a process by which healthcareproviders put forward payments from the health insuranceorganizations for the medical services offered to insured clients.Most insurance firms have a similar criterion of billing systemirrespective of whether it is sponsored by the government or by aprivate organization.

Themost significant billing system that is applicable in the health careindustry is the electronic billing system. Electronic billing systemis controlled by the Health Insurance Portability and AccountabilityAct (HIPAA), that seta rules and regulation (Carter&amp AmericanCollege of Physicians–American Society of Internal Medicine,2001). The electronic billing system has numerous advantages over thetraditional billing system.

TheMedicaid, insurance companies, and Medicare spend about $360 billionannually in billing, however, the amount can increased to that amountdue to the high administrative costs. The billing system employs lowtechnology system that happens to be wasteful of the meagerresources. An overhaul of the billing system and adoption of theelectronic billing system can reduce the cost per annum to be about$32 billion. The software used in the electronic billing system hasthe potential to save these costs and improve the quality of servicesoffered because there will be reduced cases of errors of omissionsand commissions. The electronic billing system is part of theHealthcare Information and Management Systems Society (HIMSS) that isaimed at increasing the efficiency and quality of services withinthe health care industry (Wager,Lee &amp Glaser, 2013).

Otheradvantages of electronic billing system is that checking is done inreal time, hence saving time required to go through paper work, thereis high degree of accuracy, it can be customized depending on theneeds of the health care provider, and it is an automated system thatreduces redundancy, while ensuring that information is shared fast tothe required agents. The days spent by accountants doing theaccounting and billing process are reduced, and the number ofpersonnel required to manage the billing department is reduced, hencereducing cots while increasing efficiency. More so, it does not taketime to abide to the changes within the health care system in respectto medical laws and regulations surrounding the patient insurance(Agrawal,2002).

Implementationof the Electronic Billing System

Theimplementation process of the electronic billing system needs to dedone with great professionalism because an error can result to lossof billions through legal suits. Privacy and security of the systemshould be enhanced to prevent hackers, corruption of the system andunauthorized access from occurring. The implementation processinvolves four main processes, these include:

  • Evaluating the needed resources

  • Evaluating when the healthy care facility is ready for implementation

  • Assessment of work flow analysis

  • Assigning responsibilities for the implementing team

Uponrealizing the healthcare needs to implement the electronic billingsystem, it needs to evaluate the resources that are needed. Theseresources include the hardware, software, and resources. This is asimple task, but the financial needs are critical because electronicbilling system is an expensive investment, although the returns arehigh in the long run. Evaluating when the healthy care facility isready for implementation is a very important step and the healthcarefacility needs to evaluate both the internal and externalenvironment. In this stage of implementation, some deficiencies arerealized and must be addressed. Among factors worth being consideredis the financial status, availability of a strategic plan which iscrucial for establishing priorities, needs for staffing changes, andavailability of staff for the required physical resources like theserver (Bhattacherjee, et, al, 2007).

Thework flow analysis involves establishment of how the implementationprocess with take place. The schedule for respective activity,carrying out diagnostic tests and reviewing them is important forensuring that all goes as planned. This process requires researchfrom other health care facilities that have implemented the change,and some recommendations from HIPAA must be considered. Assigningresponsibilities is the last implementation stage that requires theteams and established.


TheBenchmark Systems Software is an innovation work being considered inthe electronic billing system. The software can execute variousfunctions in the health care industry, among them includes storage ofmedical records, appointment scheduling, and practice managementamong others such as revenue management. Among the greatestadvantages of Benchmark Systems Software is ease to use in the healthcare industry, high quality compared to other software, and offersclient support (Gupta, 2008, p.149).

Thisinnovation through the Benchmark Systems Software enables health careindustry to execute their functions with great accuracy, efficiency,and effectiveness. The software will thus increase the quality of theservice offered to community, while the user will enjoy jobsatisfaction. An example of a health care facility that has employsBenchmark Systems Software and earned great results include TazewellFamily Physicians, Desert Valley Orthopaedics and East River Medical,PLLC.


Theleadership role in implementation of the technological approach is toconvince the community about the importance of adopting the newtechnology. This is because in most cases, there is resistance tochange. Thus, the senior health care leadership has to useinterpersonal communication skills to ensure that all the members ofthe community understand the benefits of the intended change. Thesenior health care leadership has also to oversee properimplementation of the technology. The community will greatly improvefrom the technological change because they will enjoy better servicescharacterized accuracy of billing process, being served fast, and thesystem offering client support.


Atechnological change of introducing the electronic billing system isa noble idea that needs to be adopted in the health care industry. Through the guidance offered by HIPAA, there are many advantagesthat come with this technology such as reduced cost and increasedefficiency. The implementation process needs to carry out with highdegree of precision to ensure the system is a success. The BenchmarkSystems Software is an innovation that benefits both the organizationand the society because it can perform multiple tasks simultaneously.The leaders in the health care industry have a key role to convincethe stakeholders about the benefits of the technology are implementedand guarantee that the implementation process is a success.


AgrawalA. (2002. Return on investment analysis for a computer-based patientrecord in the outpatient clinic setting. JAssoc Acad Minor Phys.,13(3),61–65.

Bhattacherjee,A, et al. (2007). The differential performance effects of healthcareinformation technology adoption. InformationSystems Management,24 (1),5–14.

Carter,J. H., &amp American College of Physicians–American Society ofInternal Medicine. (2001).&nbspElectronicmedical records: A guide for clinicians and administrators.Philadelphia: American College of Physicians-American Society ofInternal Medicine

Gupta,P. (2008).System Analysis and Design.Boston: Firewall Media.

Herrick,D. M., Gorman, L. &amp Goodman, J. C. (April 2010).HealthInformation Technology: Benefits and Problems. NationalCenter for Policy Analysis.Policy Report No. 327. Retrieved fromhttp://www.ncpa.org/pdfs/st327.pdf

Wager,K. A., Lee, F. W., &amp Glaser, J. P. (2013).&nbspHealthcare information systems: A practical approach for health caremanagement.San Francisco: Jossey-Bass.