Our Customized Billing Workflow:

We do not use a Practice Management System. Most of the systems are too expensive, too confusing, and not very versatile.

Elation EHR feeds superbill as JSON to Google Script. A few scrubbing can be done using Google Script such as using POS 2 for the virtual visit modification 95 for a few payers. Then each claim was be prepaired as xml and uploaded to claim.md through its API.

The system is not perfect. I noticed duplicate superbills. Also, the superbill status in Elation is not always updated with the claim submission number. But I saw the same problem with Kareo.