Billing Process

Specialists in medical insurance address all jobs that administrative staff members complete in the medical billing process. Medical insurance specialists make sure that all duties are completed by following a ten-step medical billing process.
The process’s first step is the preregistration of patients. This is done by scheduling and updating appointments, as well as collecting demographic and insurance information prior to a patient’s registration. When a patient calls and requests an appointment, that patient has to provide information about his or her insurance as well as some basic information, including the reason he or she is requesting an appointment.
The process’s second step is the establishment of financial responsibility for the patient’s visit. For patients that have health insurance, the medical insurance specialist must determine the services that the plan covers, the plan’s billing rules, and how much the patient is left with the responsibility to pay. Knowing this information helps the office send the correct bill to the health insurance for the services that it will cover, as well as making sure that patients pay for their portion when services are not covered.
Checking in patients is the third step in the process. Patients who are new to a doctor or practice must complete medical and demographic information. Returning patients must be sure that their information is up-to-date. Copies of identification cards and insurance cards are taken and placed in patients’ charts. If a copayment is required, it is collected when the service is rendered, either prior to or after the patient sees the physician.
Checking out patients is the process’s fourth step. The first part of it is to record the visit’s medical codes. If the patient sees the doctor, the diagnosis/diagnoses are documented in the patient’s file. For payment to be made for these procedures, medical codes must be assigned. The primary illness of the patient is given a diagnosis code, and...