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Medical Billing

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Submitted By arobbins
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From the research that I have done, there appears to be ten steps in medical billing. The steps are as follows: * Preregister patients * Establish financial responsibilities for visits * Check in patients * Check out Patients * Review coding compliance * Check billing compliance * Prepare and transmit claims * Monitor payer adjudication * Generate patient statements * Follow up patient payments and handle collections
For step one, preregistering patients gives you all the information that you will need as in contact information and insurance information. This way when billing comes up you know who you need to contact whether it be insurance or patient. Step two is knowing WHO is going to pay for any medical procedures that need to be preformed. Verifying insurance eligibility and figuring out how much to collect up front from the patient is a must. Step three is having the patient sign in, collect whatever necessary money from them, copy or scan their current insurance information. Step four is checking out the patient, and verify one last time that you have all of the correct information from the. Step five is to obtain CPT and ICD-9 codes from the doctor(s) and verify that all information is correct before entering it into the computer system. Codes can be tricky and you need to make sure that you have all of you bases covered when entering them in. Step six is making you know how to submit billing for different insurance claims. I know that every insurance company is different and they like their billing done a certain way. Step six and seven kind of tie into each other, step seven is transmitting the claim with this done mostly electronically now, it makes it easier. Step eight is maintain an aging report which shows all outstanding claims in columns based on how many days old they are. You may have to call, or resubmit if a claim hasn’t been paid. This is where paying close attention to codes; following submit billing procedures for different insurance companies comes in handy. Step nine is to print statements every month and send out to patients. This keeps them informed on what payments have been received, by whom, and how much is left to be paid. Sometimes insurance can be tricky and the patient may have to contact the insurance company if they aren’t paying for things that they should be. Having a statement every month helps to keep the patient informed. Last but not least, step ten, payments and collections. Monitor if a statement has been billed more than once and if it’s been sent more than three times, let the patient know he/she is in danger of their account being sent to a collection agency if payments are not made.

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