Medical Billing Process and Procedures
Medical billing and coding can be a complex process, but our experienced professionals handle every step perfectly. Here’s a sneak peek at the eight essential procedures:
Registering Patients
Effective pre-registration of patients for a doctor’s visit is the first and essential step. If the patient is new, they must provide personal data and insurance information to ensure they are eligible to receive care services from the provider.
Ensure Financial Responsibility
Financial eligibility indicates who has to pay what for the provider’s visit. Our medical biller obtains solid information from the patient to determine which services are covered under the patient’s insurance plan.
Patient Check-in and Check-out
The medical report from the patient’s meeting is forwarded to our medical coder, who translates the data into perfect and relevant medical codes. This report includes analytical information and patient’s medical history, often called the ‘super bill’ or ‘face sheet’.
Check Claims Compliance
Before submission, claims are thoroughly checked for compliance with payer rules and regulations. This critical step minimizes errors, reduces rejections, and ensures that claims meet all necessary criteria for successful processing.
Transmit Claims
All health institutions under HIPAA are required to submit claims electronically, except in certain situations. We prioritize electronic billing to save time, energy, and money, ensuring swift and secure transmission of claims.
Track Adjudication
In this process, the payer studies the medical claim and decides if the request is compliant and checks the refund. This is the stage where a claim may be acquired, refused, or rejected. We meticulously track this process.
Generate Patient Statements
The patient statement is the bill for the services the patient received. Once the payer has agreed to pay the service provider for the claimed services, any remaining balance is then communicated to the patient through clear statements.
Follow up and Collection of Payments
The final stage of the coding and billing procedure is to ensure all bills are paid efficiently. Once the bill has been paid, the information is securely stored with the patient’s file, completing the revenue cycle.