What are the 3 different types of medical billing systems in healthcare?

There is a popular belief that medical health facilities only use a single billing system for all kinds of transactions. There are typically three types of medical billing systems in use in the world, and not using the most appropriate one can result in a considerable loss of revenue.

Each of the three billing systems has its own use, and they also cater to different professionals and patients. This blog will explain the types of billing systems, how they are used, and who uses them.

What are the 3 different types of medical billing systems in healthcare?

The three main types of medical billing systems are:

Closed medical billing system

As suggested by the name, a closed medical billing system contains the health records within the domain of a particular clinician. The Electronic Medical Record (EMR) is the most common digital tool that is used to digitally store the records of a patient's data. EMRs can be connected with other EMRs within a practice; they cannot be used outside a clinic's boundaries. It is only used by billing teams and physicians.

EMRs perform several functions in facilities, such as:

  • EMRs are used to keep track of patients due dates for screenings and checkups.
  • Service providers can track and monitor a patient’s vital parameters.
  • EMRs can be connected by physicians for a comprehensive view of the treatment plan.
  • EMRs can also be used to track vaccination programs.

Open medical billing system

Patient records, when they are moved beyond a single practice, are said to have been moved into an open medical billing system. All the stakeholders, such as patients, physicians, healthcare organizations, billing teams, and third-party vendors, have access to this information.

Electronic health records (EHR) are systems that are used to transmit and share patient data across varying systems. EHR, compared to EMR, provides a more wide-scale chart. Moreover, it is not only confined to the boundaries of a particular practice, as it can be edited and monitored by patients and several healthcare professionals.

EHR has a number of uses, apart from maintaining a digital version of paper-based treatment plans.

  • EHRs are critical for maintaining patient history. EHRs can be used to record healthcare details such as past test results, demographic factors, previous diagnoses, allergic reactions, and any past or present medications.
  • Specialists in a single practice can have easy access to a patient’s history, thus providing them with a more holistic view of the patient's health.
  • Imaging centers and laboratories can also access the EHR if a patient is referred to them.

Isolated medical billing system

Generally, isolated systems don’t participate in medical billing structures but can benefit health providers. Unlike a closed or open system, isolated systems are maintained through personal health records (PHR). Patients can add their health information to these records, maintain them, and refer to them at their convenience.

PHRs, however, aren’t legally accepted, but they can have a lot of benefits for professionals and medical billing teams.

  • PHRs can help patients fill in their medical history when registering with a healthcare organization.
  • PHRs offer a holistic view of prior and existing medical treatments and conditions to professionals.

Who can use these billing systems?

Close billing systems are beneficial for small practices with fewer physicians. However, larger organizations with multiple departments can use an open system.

Moreover, organizations that want to outsource their medical billing systems should choose an open billing system, as it will allow seamless transmission of information.

Isolated medical billing systems are only for patients; thus, EMRs and EHRs are the only legally acceptable options.

How can FRT help you develop a billing system?

If you are a small medical practice, a large organization, or just a patient looking for a top-notch system, then FiveRivers Technologies can build it for you.

FiveRivers Technologies is an award-winning software and IT outsourcing company with over 20 years of experience in the industry. With over 500+ customized solutions, including medical billing software, under our belt, we know what goes into developing the medical billing system that you need.

Reach out to us, tell us what your requirements are, and leave everything to us!