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Medical Billing

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Medical Billing Process
Nathia Herod
HCR/220
2/26/2012
Melinda Sousa

Medical Billing Process
There comes the time in everyone’s life that just about almost everyone who is adults has gone through some part of the medical billing process. It is a process in what keeps most workers in the field their job and some patients their health. In the end, in order for everyone to be satisfied, everyone must play their role and work together. In order for the patient to understand what they are paying for; the biller must know who to bill and what they are paying for as well.
There are ten steps of the medical billing process and the first step of this process would be to always pre-register the patients. When you break this step down a little further all it means is that you are setting appointments for the patient but first thing’s first, you must get their insurance in order to know what the patient is going to pay and what they are not going to pay.
When the patient is done being preregistered; you are now available to state their financial responsibility for the visit. Most of the time when patients are preregistered, they kind of already have a prejudgment as to what they are going to pay because of their insurance which also establishes a financial responsibility. You must clarify clearly in the beginning as to why they are paying for this and not paying for something else. You must always try your best to get the patient to understand or else there will be a lot of confusion.
In the third step, the patient must be checked in of course when they come in the front. If patient has already established their relationship with the facility and is regular, then the less work you have to do unless they switched insurance companies. This is kind of like security measure for the safety of you and other patients and also the facility.
The third step leads us to our fourth step in which the patient gets checked out. In order for a patient to leave they must always be checked out and it must be Okayed by the caregiver, or doctor. Whatever the patient was seen for is turned into a code in which makes it easier to add up and bill to them. This is kind of like a receipt just as when you shop at the mall at a certain store and you have barcodes for your items that were purchased and the same with medical billing codes.
The next step would be compliance. In other words your coding has to follow certain guidelines and rules in order for the code to be finalized and processed. In accordance to comply with the rules of coding are also briefing or going over the codes to ensure that there are no mistakes so that the patient gets billed right and you do not get in trouble.
Step five of course brings us to step six in which you must check the billing compliance. Each visit happens to be filed under a different code due to the different specifications. This also means that they might have a different code as well. Not all billing codes are paid for but are shown on the bill due to insurance covering those fees. That is why one must make sure that the billing codes are correct ones.
Step seven involves preparing and transmitting claims. This just means that the bills are being sent to the patient and sometimes the insurance company of the patient so that they are able to pay some of the fees as well as reimburse you or the facility.
After one has received their bill and paid it or they are making payments, a facility must collect that money as soon as possible in order to keep the facility running and flowing smoothly without disruptions. These are some of the many downfalls of smaller facilities because some bills are never paid on time and always sent to claims which could cause the facility to go out of business.
When it comes to step nine, a patient is kind of receiving the last of the bill since the bill has went to everyone that it has needed to and even if you have paid yourself in the beginning, there most likely is always the things left over. This is called generating the patient statements. Basically the last of the bill gets sent out to the patient.
Last but not least, is sort of like a review of everything starting from step one. Follow up patient payments and handle collections. Patient and biller must keep up with bills especially in order to comply with the rest of the procedure. This is to ensure patients preventive health is not disrupted as well as the facility being disrupted.

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