Medical billing and coding is one of the parts of the administrative side of the health care system that deals with and manages the medical care revenue cycle. It is the method that makes sure health insurance claims for services rendered to insured patients are reimbursed by the insurance companies.
Medical billing and coding is an essential part of the health care industry because of the popularity of using health cards to obtain and pay for medical care services. Without the people taking care of the revenue cycle at the administrative offices of hospitals and clinics, the physicians will find it difficult asking for reimbursements or payments from insurance companies and it will have a negative impact on health care services. The detailed explanation of the tasks performed by the medical billers and coders, is given as a overview below
Insurance verification - this part of the procedure performed by medical billers and coders need verification of the authenticity of insurance credentials provided by patients. The insurance coverage will also be resolute here.
Patient information recording - this part of the process consists of recording the patient's personal information as required in filling claims.
CPT and ICD-9-CM coding - this is all about applying the standard medical codes to services given to patients. Charge entry - this is all about booking the quantity equivalent to services rendered.
Claims submission - is the actual process of preparing the claim form and submission of the claim to the insurance company. This can be performed using the traditional mail process or electronically via the facilities in the insurance company website.
Payment posting - this is the method where settlements or payments from insurance companies are monitored and booked.
Follow-up - this process is all about inspection up on the status of the claim.
Denial management - is about the process of handling refusal of claims by the insurance companies. If corrections are needed then the medical biller and coder will do it here.
Reporting - this process gives the management actual feedback on the status of the revenue cycle.
The above processes are the ones medical billers and coders execute.
Medical billing and coding is an essential part of the health care industry because of the popularity of using health cards to obtain and pay for medical care services. Without the people taking care of the revenue cycle at the administrative offices of hospitals and clinics, the physicians will find it difficult asking for reimbursements or payments from insurance companies and it will have a negative impact on health care services. The detailed explanation of the tasks performed by the medical billers and coders, is given as a overview below
Insurance verification - this part of the procedure performed by medical billers and coders need verification of the authenticity of insurance credentials provided by patients. The insurance coverage will also be resolute here.
Patient information recording - this part of the process consists of recording the patient's personal information as required in filling claims.
CPT and ICD-9-CM coding - this is all about applying the standard medical codes to services given to patients. Charge entry - this is all about booking the quantity equivalent to services rendered.
Claims submission - is the actual process of preparing the claim form and submission of the claim to the insurance company. This can be performed using the traditional mail process or electronically via the facilities in the insurance company website.
Payment posting - this is the method where settlements or payments from insurance companies are monitored and booked.
Follow-up - this process is all about inspection up on the status of the claim.
Denial management - is about the process of handling refusal of claims by the insurance companies. If corrections are needed then the medical biller and coder will do it here.
Reporting - this process gives the management actual feedback on the status of the revenue cycle.
The above processes are the ones medical billers and coders execute.
3 comments:
Thanks for your post. I would like to say Outsourcing medical coding to offshore service providers is a trend to endows accuracy and ensure proper claim and promote reimbursement. Professional medical coders work in a prompting environment and support billing activity and also submit medical claims to insurance companies in order to receive payments.Check out below link to learn more about medical coding outsourcing.
Quite informative blog.Thanks for sharing it.The revenue of a healthcare practice can be improved by medical billing Service Company. Hence because they are managing the process of accounts receivables follow–up, patient’s eligibility verification and insurance coverage verification are all covered under billing services.
for info
Thanks for your valuable information...
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