Medical Billing Portal Best Practices

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Functionalities of a Medical Billing Portal

A medical billing portal is a very capable system for delivering value to medical facilities, enabling them to easily collect on payments that are due for patients, without being a hindrance or an inconvenience to them. Medical billing portals typically require some form of HIPAA data storage. Therefore, they usually need to be configured in a way that safeguards security and information availability that the user can access after certain validation or authentication.

The main underlying thought process behind a medical billing portal is the functional usability for the end user, such as a patient who has received care. In a hypothetical scenario, maybe the insurance didn't fully cover an appointment or the administered medical care. The patient in question, for whatever reason, hasn't paid the corresponding amount yet.

Normally, the patient will then receive an email, a text, or -most commonly- a letter in the mail and a due date for the payment. Ultimately, the letter in the mail is a bill or a notification that they need to complete their payment. Most of the time, the medical billing portal integrates to a back office system and informs it, from a data perspective, as to which patients have received those mailings.

Whenever someone receives the mailing, they can go to the portal itself and enter in identifying information that's unique to that particular patient. Usually that includes either a confirmation number, a specific case number or a patient identifier and then possibly their first and last name, date of birth, or some other similar form of identification.

That information is then processed in order to authenticate with the back office system that the data itself (and quite often the information used to authenticate against) is HIPAA compliant. In other words, making sure the HIPAA security requirements and privacy rules are strictly followed.

Encryption & Validation Protection

Information Security Throughout the Process

Ultimately, the concept is that any information the user is putting into the medical billing portal gets encrypted and is sent securely to the HIPAA compliant endpoints and database. Upon information validation, the associated patient key comes back, which is random and hard to guess. This key is not PHI (Protected Health Information) but rather a generic identifier.

Then, some form of unique identifier is stored with that user session but it can also be stored with their username and password if they need to create an account. At a bare minimum, it's stored with their session so that patients can use that key value to make payments, view invoices, view details of invoices and possibly dispute a payment. The medical billing portal is predominantly used for one-time payments or schedule payments in installments over a period of time. Finally, the application itself needs the ability to process the payments on time and then send the information back to the HIPAA compliant data storage.

Most likely, an API (Application Programming Interface) will allow the medical billing portal to see that the payment was processed. In the case of recurring payments, the relevant information would be included (e.g. a 3-month plan, 6-month plan, yearly plan, 18-month plan, etc.). In this instance, the medical billing portal may be required to set up the recurring payment portion of the actual payments.

After a payment is successfully processed, the end user would need to receive a notification that the payment occurred. In case of installments, the user would continue to receive appropriate notifications for the duration of their selected payment schedule.

Most users that visit a medical billing portal are often looking to complete one of the following actions:

  • Verify their information
  • Verify the details of any billings or charges
  • Process a payment in full or in some form of spread out payment option
  • Interact with the billing company about the charges
Evolving as Your Business Grows

Medical Billing Portal Scaling Options

In addition to having a medical billing portal in general, it's possible that the portal might need to be able to service multiple different medical facilities. There might be 100, 1,000 or 10,000 different medical facilities that are all using the same medical billing portal. Each facility may have a separate subdomain, subdirectory or some other identifier within the portal itself. This allows the medical billing portal to associate the identifier with each medical facility and display their logo, styling, branding or specific content. Each subdomain can essentially be white labeled or branded to match the needs of that particular medical facility.

Moreover, each facility can have distinct verbiage or policies and terms that are specific to that location, group or organization. Other portal abilities include modification of payment and API information, pulling data appropriately and processing payments to the right account per medical facility.

The general idea is that a medical billing portal constitutes an exceptionally powerful tool for individual healthcare organizations. It's also extremely powerful for medical or electronic billing companies, because it can enable them to offer a medical billing portal to different medical facilities from a single application. An individual system that can provide branded and customized medical billing portals for each one of dozens, hundreds or even thousands of healthcare facilities or organizations.

How Can Clarity Help

Utilizing Other Technologies Alongside the Portal

Finally, it's also crucial to be able to leverage the latest technology, such as mobile apps, text messaging, advanced emails, and other forms of interacting with a billing system. Another example might be a tablet app in the medical facility where someone can go ahead and set up recurring payments while they're having an appointment. Or possibly, in order to see the doctor or the medical expert they may have to complete some form submission through the medical billing portal so that their information is available. The applications span a wide range of scenarios and cover different needs for each healthcare or electronic billing organization. But most importantly, a medical billing portal embraces the concept of making it easy for people to pay.

Clarity offers a very robust medical billing portal system that can be brought to bear, as well as patient-doctor portals for healthcare providers of any size. We certainly encourage you to reach out to our team of experts if you have any questions or you'd like to review. You're also welcome to look at the details in this section of our site to find out more. Our specialists will be glad to collaborate and discuss the potential next steps for your patient portal development.

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