What Is Medical Billing?

Medical billing involves processing the reimbursement claims for health care services. There are many types of services and resources that must be translated into a code for the proper reimbursement. For example, X-ray film is a straightforward expense, but radiologist fees and electricity for the X-ray machine must be calculated separately. Similarly, facilities use a variety of codes to describe the use of their facilities. You can find the top medical billing company on this page.

 

In this stage, medical billers work with medical coders to ensure that the patient receives the correct payment for a medical service. When claims are denied, medical billers have to prepare appeal letters to resubmit the claims. In this phase, they also follow up with delinquent patients to minimize the amount of bad debt. Once the collections process is completed, they submit the revenue to accounts receivable management, who tracks payments.

 

The administrative part of medical billing is governed by the Health Insurance Portability and Accountability Act (HIPAA). HIPAA helps improve the efficiency of healthcare financial transactions and protect patient privacy. The act also imposes financial penalties for violations. The medical office may choose to perform the billing process in-house or hire a third-party company to perform the work for them.

 

The process begins with the registration of the patient. A staff member will collect demographic information and insurance information from the patient and enter these information into a practice management system. A patient then fills out a registration form when they arrive at the place of service. The billing staff should maintain standard operating procedures (SOPs) to avoid data capture errors. Accurate data is vital for determining patient eligibility and obtaining prior authorization.

 

Medical billing requires meticulous documentation and verification. The claims must be processed correctly or they will be denied by the insurance company. A provider must review their patients' insurance policies to make sure they are not billing for services they did not perform. They should also make sure they do not overcharge for non-existent services. When these practices are exposed, they may be subject to audits by Medicare.

 

Medical billing specialists also need to be excellent communicators. They must be able to communicate well with patients and insurance representatives and explain procedures to them. It is also important to listen well. This skill goes hand in hand with the ability to problem-solve. This service is responsible for making sure that the medical practice gets paid in a timely manner.

 

Many practices are exploring additional revenue options to offset the declining patient census. Telemedicine and adding service lines are two such options. If done correctly, medical billing can help healthcare providers better manage the revenue cycle. It also helps reduce costs by streamlining procedures. Traditionally, medical billing processes were typewritten and paper-based. However, multiple technologies have made the process more efficient and error-free.

 

In addition to understanding the medical terminology, medical billers and coders must ensure privacy of patient information. As such, they must have knowledge of each insurance company's policies and procedures. It is also necessary to learn how to use the software used in the medical practice. This helps minimize errors and save time.  You can get more enlightened on this topic by reading here: https://en.wikipedia.org/wiki/Medical_classification.