Medical Billing Process
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- Date Submitted: 02/06/2011 10:18 AM
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Medical Billing Process
There are many steps that go into the medical billing process. You have to follow them so that everything gets taken care of. If you make one error it could really mess things up. So I am going to talk about the different steps.
The first step is to pre register the patients. In this step you would get their name and phone number and important contact information. You would also get there insurance information and make copies of it. Always make sure there contact information and insurance is correct. This is always something to take care of because it the wrong information is entered it could lead to problems. The second step would be to establish financial responsibilities. This would be verifying insurance eligibility and figuring out how much money to collect up front from the patient. You would verify eligibility then check the services covered under plan and see how it pays.
The third step would be check in the patient. They would sign in and collect copayments if needed. Also copy and scan their current insurance documents and also update any information if needed. The fourth step would be check out the patient. You would give them referral paperwork or lab information that is needed to set up appointments. Also give them there prescriptions if any. The fifth step is review coding compliance. You are to obtain CPT an ICD 9 codes from the doctor. This has to be checked for any errors before entering into the computer. The sixth step is to check billing compliance. Each fee or visit has its on procedure code so you when enter this code. Whether it is billed depends on the payer’s rule.
The seventh step is prepare and transmits claims. Usually this is done electronically and it is acknowledgment of the receipt by the insurance company. A claim may be reimbursed for services rendered or to report an encounter to an HMO. The eighth step is monitor payment adjudication. This is where you maintain an aging report which shows all...
There are many steps that go into the medical billing process. You have to follow them so that everything gets taken care of. If you make one error it could really mess things up. So I am going to talk about the different steps.
The first step is to pre register the patients. In this step you would get their name and phone number and important contact information. You would also get there insurance information and make copies of it. Always make sure there contact information and insurance is correct. This is always something to take care of because it the wrong information is entered it could lead to problems. The second step would be to establish financial responsibilities. This would be verifying insurance eligibility and figuring out how much money to collect up front from the patient. You would verify eligibility then check the services covered under plan and see how it pays.
The third step would be check in the patient. They would sign in and collect copayments if needed. Also copy and scan their current insurance documents and also update any information if needed. The fourth step would be check out the patient. You would give them referral paperwork or lab information that is needed to set up appointments. Also give them there prescriptions if any. The fifth step is review coding compliance. You are to obtain CPT an ICD 9 codes from the doctor. This has to be checked for any errors before entering into the computer. The sixth step is to check billing compliance. Each fee or visit has its on procedure code so you when enter this code. Whether it is billed depends on the payer’s rule.
The seventh step is prepare and transmits claims. Usually this is done electronically and it is acknowledgment of the receipt by the insurance company. A claim may be reimbursed for services rendered or to report an encounter to an HMO. The eighth step is monitor payment adjudication. This is where you maintain an aging report which shows all...