We are living in a modern and busy world where everything has a price tag. So you can’t deny the need and requirements of financial management, whether it is a healthcare business or any other work. Medical billing deals with managing finances and paying attention to the process so physicians can get the payments on time.
 In simple terms, medical billing involves paying the medical bills for health care services to get the claims accepted on time. To submit a claim, medical billing experts put all the required information, including demographics, clinical services, and insurance details, write medical bills, and send them for payment approvals.
We have shortlisted the essential process, requirement, or crux for revenue cycle management. These steps are easy to follow and help to understand how the medical billing process works. However, you can hire reliable medical billing services if you want a professional medical billing team.
How does the medical billing process work?
Following are the medical billing steps:
- Patient Registration
- Verification of eligibility insurance
- Patient check-in
- Coding process
- Putting charge entry
- Claims submission
- Collection process and medical billing
- Payment posting
Let’s discuss all these steps one by one, which are part and parcel of the collections procedures in healthcare organizations
Patient registrations
The whole process starts with patient registrations. When the patient arrives at the hospital, meet the receptionist. The receptionist checks the patient’s record to see whether he is registered with the insurance company or not. If you do not find any information about the patient, you need to enter the correct and relevant information, including name, address, SSN, date of birth, and insurance information. Then, when writing the patient information at the front desk, you need to register the accurate information; there is no chance of misinformation. Otherwise, you will face lots of complications later on.
Checking insurance eligibility
When the patient enters the hospital and registers, the next segment will be to check the information provided by the patient. You need to verify what sort of insurance the patient covers because there are more variations in the insurance plans. For instance, at this stage, doctors or the administrator staff dealing with the process must verify whether the patient is registered with the specific program or not. If physicians see ambiguous information, they need to inform the patient.
Co-payment collection
When the patient visits the doctor after an appointment, the billing officer will confirm the information after checking the details related to the insurance plans via insurance card or by personal ID. The doctors will receive the co-payment or full payment at the segment if the insurance company does not cover the insurance plans.
Coding process
Two types of medical codes are used to define any medical condition. ICD-10(International Classification of Diseases) and CPT codes. ICD codes are a way to elaborate on the patient health conditions s, and the CPT codes are used to tell the clinical procedure through which the patient underwent. Therefore, proper use of CPT and ICD codes necessary part when dealing with payments. However, only professional coders can put the correct codes to avoid medical errors. Most of the time, coding errors are the reasons for the delayed payments.
Charge entry
After the codes have been written, it is time for charge entry. Charge entry is the process of defining the total cost of writing medical codes and making submissions electronically. In this segment, it is a requirement to put the accurate entire overcharged. Misappropriation may result in the denials of the payments.
Claim submission
After the medical billing professional has confirmed the details before final submission, most claims are submitted electronically via insurance companies or a different schedule. Therefore, professionals must double-check the information on this site before final submission.
Collection of payments
Once the claims are accepted, payments are received in the physician’s accounts, and they make sure that claims do not have any issues. If there are denials in the claims, they are sent back for approval after doing the correction. It is not the responsibility of the medical billing service providers to check the issue and fix it before resubmission.
Payment posting
Medical billers make sure that physicians are paid justly. Then, if the payments are according to the claim, they are sent to the patient.
Final thoughts
The whole process of medical billing requires the proper submission, care, and attention. All the procedures are required, and everything will be incomplete without others. The billing process is the backbone for the success of any medical billing company. If you want to increase your revenue and have peace of mind, then avail reliable medical billing services.
