The Art in the Process of Medical Billing
Medical billing is similarly like medical coding that seems to be a complicated process.
For most medical professionals, medical billing is as complicated as medical coding. However, digging down the whole aspect of medical billing, it may seem that it is just a fundamental process. This process is generally consists of simple steps to follow through. Yet, in terms of medical billing, it is really crucial to remember that the duties in the ‘front-of-the-house’ and ‘back-of-the-house’ are completely different. This may applies true even those processes at the ePsychBilling.
Process of Medical Billing
Generally, the state-of-the-art process of medical billing has eight basic steps to follow. These steps are stated below.
1. Patients registration
A preregistration process is basically the start of the process wherein a patient usually sets an appointment with the medical provider. Patients who previously had a previous appointment will only need to tell the reason for their succeeding visit. This is because their information is already on file of the medical provider. For new patients, information regarding personal and insurance matters must be provided.
2. Confirmation of financial responsibility
The description of the one who has the obligation for a specific visit to a physician is known as the ‘financial responsibility’. In case, necessary information from the patient have been gathered by the biller, then the covered services for the insurance plan of the patient may be identified.
3. Check-in and out
Basically, the procedure of the check-in and check-out of patient is done at the front-of-house area. Several forms are required to be completed by the patient. In addition, through this process, copayments are collected. A superbill is also given as well.
4. Preparation of claims
Once the superbill is taken by the biller, it can be incorporated to either a paper claim form or proper practice billing software. The cost of the medical procedures will be stated by the biller in the claim.
5. Transit claims
Transit claims are electronic claims that must be submitted by the biller. Although, billers may still utilize the manual claims. However, through technology and art this method comes with some disadvantages.
6. Monitoring of adjudication
Adjudication is the process where the claim reaches the payer. This is the process where the claims have been evaluated by the payer and verified if it is valid.
7. Generation of patient statement
The bill of the medical procedure given by the provider is usually the patient statement.
8. Payments follow up and collection
The last stage is typically the assurance of getting the bills paid. Billers are the one responsible for the medical bills and follow up payments.