Key Takeaways on EHR and Billing Integration
- Connected information: An integrated EHR and practice management system keeps information connected from registration through payment, reducing duplicate entry and manual transfers.
- Integration vs automation: Integration connects information across workflows; automation handles specific tasks and may vary by system or feature.
- Vendor evaluation: Ask vendors to demo one workflow and show where staff members have to re-enter information or complete manual steps.
- Azalea’s approach: Azalea connects clinical and financial information to the same encounter across ambulatory EHR and billing.
Integrated EHR and billing doesn’t mean the same thing across vendors. Some systems share data, but staff members still have to reconcile records or enter the same information more than once.
What matters is how well the systems work together. Strong integration keeps clinical and financial workflows connected without duplicate work or extra handoffs. Here’s what to expect from an integrated system and what to look for when comparing vendors.
What Effective EHR and Billing Integration Looks Like
An integrated system should support the flow of information from the front office through the clinical encounter and healthcare billing and payment. Staff members shouldn’t have to re-enter information or track down details, such as CPT codes, to process a claim.
Here’s how effective integration should flow between each stage of the patient journey:
- Registration: Patient information remains readily available for clinical and billing workflows.
- Eligibility: Staff can access eligibility results within the workflow without switching systems or manually transferring details.
- Charge capture: Clinical documentation feeds information needed for billing without duplicate or routine manual data entry.
- Claims: Claim activity stays connected to the original encounter.
- Payment: Payments, adjustments, and outstanding balances stay connected to the claim and original encounter.
Integration doesn’t mean every step happens automatically. Some EHRs automate parts of workflows, while others offer automation as an additional feature. Integration serves a different purpose: ideally it keeps clinical and billing information connected from registration through payment.
How Integrated Workflows Benefit Your Practice
When clinical and billing information stays connected, staff spend less time re-entering data, tracking down documentation, and resolving inconsistencies between records. Fewer handoffs also mean fewer opportunities for information to get lost or delayed as an encounter moves to billing.
For providers, that can mean fewer interruptions to answer billing questions or locate information already documented in the chart, which equals more time to focus on patient care. Billing staff can spend more time resolving claim issues and submitting claims promptly.
Reducing this administrative work helps your practice make better use of the team you already have. As patient volume grows, connected workflows can help you streamline practice operations and manage your team’s workload without adding staff.
How to Evaluate EHR and Billing Integration
When you evaluate an integrated EHR software and billing system, follow a patient through each workflow. Look at where staff enter information, how the clinical encounter connects to billing, and what information is available without switching between systems. And check how easily users can complete common tasks.
For each area below, here’s what to look for and what to ask the vendor.
One Patient Record
Patient information should flow from clinical to financial workflows without unnecessary re-entry or manual handoffs. If front-office staff update a patient’s insurance before an appointment, the billing team shouldn’t have to enter it again or update a separate record.
Ask the Vendor
- Does information entered during registration carry through clinical and billing workflows?
- What information does staff have to enter more than once?
Clinical-to-Billing Workflow
Information from the clinical encounter should flow directly into billing without requiring your staff to export codes or enter the same information in another area.
Ask the Vendor
- How does information get from the clinical encounter to billing?
- What information has to be entered or transferred manually?
Revenue Cycle Visibility
Your billing team should be able to see what’s happening with a claim without looking in another product.
For example, when a claim is denied, the biller should be able to find the original encounter and the information needed to investigate the denial. Staff members shouldn’t have to search for the matching clinical record first.
Ask the Vendor
- Where can staff see claim status, payer responses, and other revenue cycle management (RCM) data?
- Where do staff go when a claim needs follow-up?
Automation
An integrated system can create opportunities to automate repetitive work across clinical and financial workflows, including eligibility checks, claim reviews, payment posting, and patient statements.
Ask the Vendor
- Which tasks can the system automate?
- Which functions are included, which cost extra, and which require staff intervention?
For instance, some systems can use stored insurance information to automate parts of eligibility verification via clearinghouse integration.
Workflow Usability
Staff should be able to complete related work without repeatedly switching between systems or applications.
Ask the Vendor
- How many systems, applications, or logins does it take to complete common workflows?
Pay attention to how many steps it takes to find information already captured in the system. This gives you a concrete way to see how the technology supports medical practice operations.
Use the Demo to Verify Integration
A product demo shows how integration works in practice instead of relying on the vendor’s description.
Ask the vendor to follow one patient from registration through payment. During the demo, watch for places where your staff need to:
- Enter information that already exists in other workflows or products.
- Switch systems or applications to complete related work.
- Reconcile conflicting information.
- Search for information that should already be connected to the encounter.
Ask the vendor to demonstrate claim denials because of a coding issue. Can the biller readily access the documentation, diagnoses, and codes tied to that claim, make the correction, and resubmit it? Watch for areas where billers have to track down information or transfer it from another location.
Ask the vendor to update a patient’s insurance, then show how that change carries through the encounter and claim. Look for information that stays connected without staff copying it, matching records, or updating another system. When a manual step is needed, ask whether it supports a review or decision, or simply moves information from one place to another.
Your practice type also affects what you need from an integrated system. Make sure the vendor supports your medical specialty and the workflows and your practice’s clinical workflows and billing requirements.
How Azalea Health Integrates EHR and Billing Workflows
Azalea Health connects ambulatory EHR and practice management (billing) workflows in one cloud-based EHR platform. Clinical and billing teams work from the same product, keeping information connected as the visit progresses from intake to care delivery to payment.
Here’s how Azalea addresses some of the integration criteria covered above:
| What to Look For | How Azalea Health Handles It |
| One Patient Record | Patient information stays connected to the same encounter as the visit moves from registration through clinical care and billing. |
| Eligibility Verification | Real-time eligibility checks through a clearinghouse use the patient’s recorded insurance policy — the same policy connected to the claim. |
| Clinical-to-Billing Workflow | Clinical documentation, codes, and modifiers attach to the encounter and flow directly to billing. And encounters are checked for required billing data before moving to billing. Incomplete encounters are held until needed information is complete. |
| Revenue Cycle Visibility | Claim status, payer responses, and remittance details are linked to the encounter, giving the billing team access to the information needed for claim submission. Claims that need attention are flagged and routed, so staff know which claims need follow-up and who owns each one. |
| Workflow Usability | Clinical and billing teams work from the same system and a single encounter instead of manually matching or transferring information across separate products. |
The Azalea Ambulatory EHR keeps clinical and financial information in one product tied to the same encounter, eliminating duplicate entry and manual transfers needed to keep clinical and billing information consistent and accurate.
There’s no charge export, no superbill handoff, no clinical ID to be matched to a separate billing ID. The encounter number a provider sees in the chart is the same encounter number the biller works a denial on six weeks later.
To experience first-hand how the Azalea Ambulatory EHR integrates clinical and billing workflows, request a demo.
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