Medical Billing Software in Pakistan

1. Dashboard

• Shows you: Main billing overview screen
• What you can do here:
  • See monthly revenue totals
  • Check how many claims submitted
  • View pending claims count
  • See denied claims needing attention
  • Check recent invoices
  • View claims requiring immediate action
  • Get alerts for deadlines and denials

2. Patient Billing

• Shows you: Patient invoice creation and management
• What you can do here:
  • Create new patient bills
  • Add services/procedures with CPT codes
  • Add diagnosis codes (ICD-10)
  • Calculate insurance adjustments
  • Determine patient responsibility
  • Generate invoices
  • View recent patient bills
  • Edit or reprint invoices

3. Insurance Claims

• Shows you: Insurance claim submission and tracking
• What you can do here:
  • Submit new insurance claims
  • Track claim submission status
  • Check expected payments from insurance
  • View Explanation of Benefits (EOB)
  • Follow up on pending claims
  • See claims status summary
  • Track days outstanding
  • Manage claim appeals

4. CPT/ICD Codes

• Shows you: Medical coding database
• What you can do here:
  • Look up CPT procedure codes
  • Search ICD-10 diagnosis codes
  • See code descriptions
  • Check average reimbursement amounts
  • Add codes to bills quickly
  • View commonly used codes
  • Update code databases
  • Check code compatibility

5. Payments

• Shows you: Payment processing and reconciliation
• What you can do here:
  • Record patient payments
  • Process insurance payments
  • Match payments to claims/invoices
  • Print receipts for patients
  • Handle refunds
  • View payment reconciliation
  • Track payment methods (cash, card, EFT)
  • Manage payment posting

6. Claim Denials

• Shows you: Denied claims management
• What you can do here:
  • View all denied claims
  • Check denial reasons
  • See appeal deadlines
  • Start appeal process
  • Add supporting documentation
  • Track appeal status
  • Identify denial patterns
  • Reduce future denials

7. Reports

• Shows you: Billing analytics and reports
• What you can do here:
  • Generate revenue reports
  • View aging reports (30/60/90 days)
  • Check denial rate reports
  • See insurance performance reports
  • Generate patient statements
  • Create collection reports
  • Export data for accounting
  • Track key performance indicators

8. Insurance Companies

• Shows you: Insurance provider database
• What you can do here:
  • View all insurance companies
  • Check claims addresses
  • See payer IDs
  • Track processing times
  • View fee schedules
  • Add new insurance companies
  • Edit insurance information
  • Check network participation

9. Settings

• Shows you: System configuration
• What you can do here:
  • Set practice information (NPI, Tax ID)
  • Configure billing preferences
  • Set up auto-submission
  • Configure clearinghouse settings
  • Set up denial alerts
  • Manage user accounts
  • Configure payment posting
  • Backup billing data

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Real-Life Example – How Medical Billers Use the System:

When Patient Visits Doctor:

1. Medical coder → Go to “Patient Billing” → Create new bill
2. Add services → Select CPT codes for procedures done
3. Add diagnoses → Enter ICD-10 codes from doctor’s notes
4. Check insurance → See expected payment vs patient responsibility
5. Generate claim → System creates electronic claim form (837)

Insurance Claim Submission:

1. Biller → Go to “Insurance Claims” → Submit clean claim
2. Choose clearinghouse → System sends to insurance electronically
3. Track submission → Get confirmation number
4. Monitor status → Check if claim received and processed

Payment Processing:

1. Insurance payment arrives → Go to “Payments” → Record EFT payment
2. Match to claim → Link payment to original claim
3. Post adjustments → Record insurance adjustments
4. Patient payment → Record patient co-pay or balance

Denial Management:

1. Denied claim alert → Go to “Claim Denials” → Check reason
2. Fix errors → Correct coding or documentation
3. Submit appeal → Add supporting documents
4. Track appeal → Follow through to resolution

Patient Communication:

1. Generate statements → Create patient bills for balances
2. Send reminders → System automatically sends payment reminders
3. Answer queries → Check claim status for patients

Financial Management:

1. Daily reconciliation → Match payments to bank deposits
2. Aging reports → Check which claims are overdue
3. Revenue analysis → See which services generate most revenue
4. Insurance performance → Track which insurers pay fastest

Code Management:

1. Code updates → Regularly update CPT/ICD codes
2. Fee schedules → Update allowed amounts from insurers
3. Code validation → Ensure codes are current and valid