Advanced Reimbursement Solutions

Advanced Reimbursement Solutions

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6 Essential Steps in the Medical Billing Process

medical billing process

Being a medical billing specialist comes with a lot of accountability. Medical billing in a medical practice deals with gaining information from every patient about their insurance coverage and keeping track of any procedures and diagnoses so that the insurance company can be billed accurately. This is perhaps the main reason why it is vital to work hand-in-hand with medical billing experts. Some medical practices may assume that they are in control of their medical billing process, but, in reality, they are not. Here is how a medical claim generally goes through in an office where medical billing is conducted:

1. Patient check-in

The very first step is a medical biller keying in the patient’s information, such as the demographic information, as well as insurance information.

2. Verification of insurance information

Verification of insurance eligibility and information is vital at each appointment, even with regular patients. The reason for this is that information changes over time. Insurance information changes may impact benefits, as well as authorization information.

3. Record the services received by the patients

A healthcare provider, such as a nurse or a doctor, examines the patient, then gives a diagnosis or provides any other services that are necessary. The healthcare professional then goes ahead to record the data obtained in the Patient’s Electronic Record.

4. Charge entry

This means charging patients for the services they have received. Charge entry includes suitable linkage of medical codes to procedures and functions given during the patient’s visit.

5. Submission of a claim

Right after the patient’s payments and codes have been submitted, the medical coder can generate an insurance claim, which is then tendered to the insurance company with which the patient is insured.

6. Receive and post-payment

This is the last step, and it involves a deposit, as well as posting functions. If the claim is submitted as it should be, the insurance company will send the payment to the medical practice, and the medical coder then posts the payments to the practice’s account. Medical coders are in charge of fixing claims submitted with errors and following up on late payments.

If you read through the list and noticed that your medical practice is not as prepared as you imagined, get in touch with us at Advanced Reimbursement Solutions so that we can help make your medical billing process better. Contact us in Wilmington or Phoenix today to get started.

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