EHRs and Billing: Advantages of Keeping Them Apart at Your Healthcare Facility

When it comes to providing quality patient care, healthcare facilities these days heavily rely on electronic health records or EHRs. This technology has somewhat revolutionized the way hospitals and clinics manage patient information and enhanced their overall workflow and efficiency.

Insights shared by Grand View Research reveal that the global EHR market has a value of around $28.1 billion as of 2022. With the addition of client billing, this EHR market has seen a decent growth in popularity. What’s happening now is that EHR systems are becoming a one-stop solution for managing patient data and billing across clinics and hospitals.

However, within the healthcare industry, there is currently an interesting debate – should there be a separation between EHRs and billing systems? Some people within the industry argue that integrating these two systems can be very advantageous to them. However, many others argue that keeping the two apart can offer even more benefits.

In most cases, it’s been found that keeping billing and EHRs separate is the way forward, but why so? To answer that, let’s explore a few key advantages of keeping these two systems separate at your healthcare facility.

Compliance and Privacy

In healthcare, strict regulations and privacy laws govern the handling of patient data. By keeping EHRs and billing systems separate, healthcare facilities can better adhere to these regulations and maintain patient privacy and data security.

Integrating EHR and billing functions can increase the risk of data breaches or unauthorized access. Billing information often includes sensitive financial details, such as insurance data and payment records, which should be kept separate from clinical data. This separation minimizes the potential for unauthorized personnel to access or misuse sensitive patient information, ensuring compliance with privacy regulations.

Thomson Reuters recently reported that healthcare data breaches are on the rise in the US. Thus, it’s important to incorporate the best data privacy practices in the healthcare sector. If that means keeping a separate billing system to limit access vulnerabilities, so be it.

Improved Workflow Efficiency

Maintaining separate EHR and billing systems can lead to improved workflow efficiency at your healthcare facility. Each system can be optimized to perform its specific functions without interference from the other. Besides, a dedicated billing staff can concentrate on accurately coding and processing claims in the billing system.

This type of specialization results in faster claim submissions, quicker reimbursement, and a reduction in billing errors. All this ultimately streamlines the entire process, from patient registration to billing, and leads to enhanced operational efficiency.

A good working model centered around the idea of separate billing and EHR systems can be found within the US Medicaid services. Take the Texas Medicaid Healthcare Partnership (TMHP) billing module as an example. Payments here are made in a traditional, fee-for-service system, meaning healthcare service providers get paid for each service they provide. There’s no bundled or bulk payment made in these cases.

Thus, Texas Medicaid providers work with a TMHP billing company to handle the billing side of things. It helps them verify Medicaid coverage, understand the Medicaid fee schedule, and stick to local Medicaid guidelines for payment collection. There’s also a separate EHR system handling all the administrative and data management tasks.

According to Millin Associates, keeping EHR and billing separate also allows for a higher collection rate. It also helps with better reporting and better cash flow. This, in turn, usually results in increased revenue.

Scalability

Healthcare facilities can choose EHR and billing solutions that best suit their specific needs. These systems can be customized to accommodate changes in practice workflows and requirements.

When EHR and billing functions are integrated, making changes or upgrades can be challenging and costly. Customizing integrated systems to meet the unique needs of your facility can lead to complications and a lack of scalability.

When you keep these systems apart, you can more easily adapt to evolving industry standards and regulatory changes. This, in turn, ensures that your facility remains agile and responsive.

Reduced Training and Onboarding Complexity

As noted by Healthcare Dive, there are a lot of wasteful administrative costs in the US health spending. To combat such administrative lapses, healthcare facilities need to train their employees.

Healthcare staff, both clinical and administrative, undergo extensive training to become proficient in their respective roles. When EHR and billing systems are kept separate, the training process becomes more straightforward and less overwhelming for new employees.

Integrated systems often require training on both clinical and financial aspects, which can be time-consuming and overwhelming. Separate systems allow staff to focus on mastering their specific roles, resulting in faster onboarding and reduced training costs.

Conclusion

Arguments for integrating medical records and billing systems in healthcare facilities have always been there. They will also continue to be a part of discussion within this industry.

However, as you can tell from our discussion above, there are compelling advantages to keeping EHRs and billing systems apart. The decision to whether or not to take this step ultimately comes down to the specific needs and objectives of your healthcare facility.