Medical billing is the process of generating health claims to submit to insurance companies for the purposes of obtaining payment for medical services rendered by providers and provider organizations. The medical billing process can be also be frustrating. Processing claims is no easy feat either. It can take months and several communications before you reach the collection stage. In another words medical billing is the process of submitting claims on behalf of patients to receive payments for the services rendered by health care providers.
The medical billing process consists of various other administrative and legal tasks like eligibility and verification, medical coding, charge entry, and claims submission. The focus of medical billing is to ensure that the hospitals, as well as the doctor, get paid for the medical services offered by them. These services may include diagnosis, treatment, Lab test, and outpatient facilities, etc. Medical billing is an integral administrative aspect of the medical profession, and it is such a comprehensive task that it requires a whole new department of professions who are proficient in billing practices in order to deliver results in a swift and efficient manner.
The medical billing includes a cycle and can take in upwards of days to months to complete, and at times take several communications before resolution is reached. As all of us know that the process of medical billing begins with a patient visiting their medical provider and then the patient’s medical record is then updated summarizing the diagnosis, treatment and any pertinent information. Hence this information is then recorded electrically for future account updates.
As all of us we know that the goal of medical billing process is to prepare claims and submit them to insurance providers. As a result of this process, the healthcare organization is reimbursed for the services they provided to their patients. Without this concept [medical billing] hospital or medical office may not be able to function or continue serving their communities.
Key Steps to follow for a successful medical billing process
To know more about the medical billing process first of all we want to know the steps mentioned below to speed up the billing activities.
STEP 1: Register Patients
To make data collection processes a breeze.
STEP 2: INSURANCE VERIFICATION
STEP 3: SUPERBILL CREATIONS
STEP 4: CLAIMS GENERATION
STEP 5: CLAIMS SUBMISSION
STEP 6: MONITOR CLAIM ADJUDICATION
…Scenario 2-If payers reject the claim…
…Scenario 3-If Payer Deny the Claim…
STEP 7: PATIENT STATEMENT PREPARATION
STEP 8: HANDLE COLLECTIONS
THE IMPACT OF COVID-19 PANDEMIC ON MEDICAL BILLING PROCESS
By studying the above information, we concluded that the medical billing process is the part of the healthcare system because it enables care providers to accurately bill insurance providers as well as gather useful data about the treatments, procedures and patient experience.
Max Freedman, Select Hub, Cap line healthcare management, Med Converge, Bryant Stratton College.
How useful was this post?
Tasks handled by our staff, updated in real-time.