Medical Billing is one of the fastest developing and most dynamic sectors of the medicinal services industry. Medical Billing is a complex procedure of invoice and gathering money for the health care administration provided to the patient. To run a profitable medical business, healthcare facilities and hospitals should follow a compelling method for collecting reimbursement. Electronic medical billing is imperative to run a successful practice.
Medical Billing requires efficiency and accuracy which is vital. Medicinal billing is the procedure in which there is follow ups and submissions of clams to insurance agencies in order to get the payment of administrations provided by a health care supplier. Claim procedure is also used for many insurance agencies, whether they are privately owned or government owned companies.
The procedure followed by medical billing claim process is as follows:
- Claims Transmission: The medical claim is being forwarded to medical billing companies by the hospital.
- Retrieval and Checking of Medical Claims: All the documents are checked by the companies.
- Medical Coding: Diagnosis codes are fixed for the patients.
- Charge Creation: Claim is created based on the billing rules.
- Medical Claims Audit: Audit for verifying the complete information and procedure.
- Medical Claims Transmission: Creating claims before sending electronically to the claim transmission department.
- Claims Submission to Insurance Agencies: Claims are ready to be dispatched to the concerned government department or insurance agency.
- Follow up and Settlement: Billing organizations follow up reliably with payment agencies and insurers until the last settlement is made.
Insurance verification – where the insurance is verified, patient’s demographic entry, ICD-10 and CPT coding, Charge entry, Claim Submission, Payment posting, A/R follow up, denial management and reporting.
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