What Are 3 Different Types Of Medical Billing Systems In Healthcare?

A system is a set of procedures or protocols that work together as an interconnecting network. There are three basic types of systems: closed, open, and isolated. Medical billing is one large system part of the overarching healthcare network. The healthcare network includes everything from medical billing to best practices for patient care, health institutions, and private practices. Medical billing systems are multifaceted and can be divided into 3 of the basic types of systems.

1. Closed

A closed system is a system that doesn’t allow transfers. In terms of medical billing systems, it means that this system focuses on one singular practice. The biggest example of a closed system is using EMRs, or electronic medical records in your practice. EMRs are basically the digital versions of old-school paper charts. While this is still used in modern practices today, it is combined with other types of records. EMRs, are as the system implies, closed. They don’t allow for collaboration with other doctors and healthcare facilities (i.e. labs, urgent cares, etc.).

2. Open

An open system is a system that allows for transfers across healthcare professionals, practices, facilities, etc. An example of using an open medical billing system is using EHRs, or electronic health record. Sometimes people in the medical interchange EMR and EHR, but in reality, EHRs are a highly collaborative record-keeping style, which enables everyone to be privy to the patient’s healthcare.

Having an open system means the medical billing software (AdvacedMD, AllMeds, GE Centricity, McKesson, etc.) needs to be able to communicate and collaborate efficiently. Not all software allows for an open system because they want to keep it closed and have sole access to patient records. Also, some practitioners and healthcare facilities argue that because of HIPAA it’s important to be careful with open systems to protect the patient’s privacy.

3. Isolated

An isolated system is one that is completely removed from healthcare facilities, physicians, and practices. PHRs, or personal health records, are used in isolated medical billings systems. The patients hold all their healthcare records and they’re designed and managed by them. These records are separate and shouldn’t replace EMRs or EHRs; it is simply to help the patient manage their health information.

Since PHRs can’t legally replace official healthcare records, isolated medical billing systems aren’t commonly used. Sometimes, if the patient uses appropriate software, their PHR can be used to fill out the medical practices’ official records. Again, this requires open communication between the software to ensure that everything gets transferred correctly.

Each system has its pros and cons in terms of medical billing systems. While the records aren’t the only aspect in the types of medical billing systems, it does play a major role in determining the type of system you want in your practice. Once you’ve determined the system and the record-keeping you want, then you can move forward on either choosing software or keeping the one you currently have. Medical billing systems will help you determine the extent of outsourcing medical billing and coding.