A health plan operator It is a company that, like any other organization, needs efficient administration to prosper. It is important to keep your finances up to date, comply with certain tax obligations, organize customer data and comply with everything required by law.

The software is of enormous assistance to health plan operators. However, you may want to do your research before purchasing one. Ideally, the product should be intended exclusively for the healthcare sector, that is, personalized for your business.

In this article, we will show you 9 qualities that efficient medical billing software should have. Read and understand better!

The software and its qualities

The use of a software It greatly optimizes the management of any health plan operator. It replaces the secretary, spreadsheets and all paperwork with a system that integrates all company data.

Security is the result of good software that routinely performs automatic backups and also carries out information validation and encryption processes.

As they work online (in the cloud), they are more practical and accessible, eliminating the need to purchase usage licenses and install them on the operator's own providers. This way, they become much more productive than Excel spreadsheets.

Check out 9 qualities that modern medical billing software should have.

1. Sending payment slips automatically

Through electronic capture, the network of medical service providers sends payment forms simply and automatically.

There are many options, ranging from typing to complete system integration.

2. Automatic, individual and mobile auditing

A electronic audit it is also a feature of good medical billing software. It is customizable and allows the analysis of all tabs before the system accepts them. This gives more speed and more precision to the process.

However, advanced software also allows manual auditing. All medical bill guides are available for individual checking. Auditors have automatic alerts of possible irregularities at their disposal. This contributes to business compliance.

To ensure transparency, there is also a counter-audit tool, with functions that give medical service providers participation in the process.

Another form of auditing that good software offers is mobile, which allows external auditors to record information on medications, fees and procedures directly from the medical network.

3. The gloss feature

To simplify and speed up the audit, the software allows medical service providers to send disallowance resources directly through the system in accordance with the ANS/TISS standard (National Health Agency/Supplemental Health Information Exchange).

4. Support different types of TISS guides

Good quality medical billing software must be able to support all types of ANS-defined TISS guides and many versions at the same time.

5. Electronic document management

Electronic document management, or GED, consists of managing all documents using only the computer keyboard. Just make a few clicks and the entire process will be faster and safer for the team of auditors. All of this is done completely online.

6. Request analysis

The operator can, with agility and simplicity, individually evaluate the Request for Hospitalization Authorization, Extension and SADT (Diagnostic and Therapeutic Support Service) guides with several functions to provide support.

7. The Web Authorizer

This feature offers a lot of ease to the medical service providers. They can forward their Request for Authorization for Consultations, Exams, Hospitalization and Extension guides directly via the Web.

8. Pre-authorization

The system allows pre-analysis of requests for authorization of procedures, medicines and materials.

9. Customization

If the operator needs a module and it is not present in the software, there is the possibility of customizing it, that is, it is possible to develop and integrate it so that the software completely meets the management and control needs of the business.

The differences between SAUDI medical billing software

When choosing your medical billing software, in addition to evaluating the qualities above, pay attention to the differences. In other words, how does it differ significantly from other products in the same segment?

The SAUDI software presents all 9 qualities listed in the post and also offers the following differences.

Cost reduction

A thorough audit eliminates undue payments to the medical provider network. SAUDI also improves the entire process, until payment is made, which contributes to a relevant decrease in operating expenses.

The level of automation and intelligence

As this is software dedicated primarily to auditing assistance accounts, which corresponds to the highest cost for health plan companies, it provides a level of contribution and process improvement like no other product on the market.

The return on investment

Due to the low cost of the software and the benefits it has on accounts and processes, SAUDI users can make the product pay for itself in the first month of use.

Transparency with the medical field

SAUDI performs automatic analyzes and has powerful auditing tools that make the relationship between the company and medical service providers more transparent. Bills are very clear during the payment process.

Solid references on the market

SAUDI runs on different operators, including Unimed networks, reaching a total of approximately 60 companies in different states in Brazil.

Medical billing software is also the basis of SCAM (Acol Account Management and Medical Audit System), which has been operating at Bradesco Saúde for over 10 years.

Other medical auditing service companies also use SAUDI tools.

Respect for each operator’s processes

Developed intelligently, SAUDI ensures complete adherence to the different processes of each operator.

The system is adjustable, allowing the company to continue running its processes or make any changes according to its needs.

The other differences

We can also mention other differences:

• simplicity and speed of use;
• increased productivity;
• the possibility of total customization;
• quick and easy integration, including with any ERP system that the operator already has;
• the high number of medical service providers already registered with SAUDI.

The forward-looking manager should carefully consider the acquisition of good quality medical billing software, well-reputed in the market and with unique features.

Did you like SAUDI? Do you think it is actually the software you need? Enjoy and contact with the company right now.