The Medical Billing Process

The medical billing process like medical coding is a lengthy procedure, complicated too. The steps include the following steps:

• Registration

If a patient sets an appointment with the health care providers they usually preregister for the visit with the doctor. But they need to register their names with the health service providers stating the reasons for their visit. They must provide personal insurance information to prove that they are eligible to get the service for the reimbursement.

• Confirmation of financial responsibility

The medical biller determines the services that cover the insurance plan which differ with the variety of medical billing company settings. The plan accepted by the one may be rejected by the other company.

• Patient check in and checkout

The time when the patient checks in, particularly for the first time, they need to complete some formalities, one of them of course is the filling of some forms or verify the information the doctor has in their files. The patients are also required to add more information if required. The patient may also be required to give some kind of official identification, like a driver’s license or passport, in addition to a valid insurance card.

The bills once completed, the superbill is then transferred, typically through a software program, to the medical biller.

• Prepare claims/check compliance

The medical biller after taking the bill from the medical coder, and puts it either into a paper claim form or into the proper practice management or billing software. The Billers includes the cost of the processing in the claim. They won’t send the full cost to the payer, but rather the amount they expect the payer to pay, as laid out in the payer’s contract with the patient and the provider.

• Transmit Claims

Since the Health Insurance Portability and Accountability Act of 1996 (HIPAA), all health entities are covered by HIPAA have been required to submit their claims electronically, except for certain circumstances.

The final phase of the medical billing process is to ensure those getting, well paid. Billers are then responsible for sending out timely, accurate medical bills and then following up with patients whose bills are erroneous. The paid bills are, then stored with the patient’s file for further reference.