Medical Billing Process
Medical billing is the process of generating healthcare claims to submit to insurance for the purpose of obtaining payment for medical services rendered by providers.
Medical Billing and Coding Blog which provides more information about Medical Billing information from across the world inlcuding US Healthcare, UK, UAE and India.
The medical billing is a process that involves a third party payer, which can be an insurance company or the patient. Medical billing results in claims, which are billing invoices for medical services rendered to patients.
Revenue cycle management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.
Check out more about RCM Process…
Charge capture |
Rendering medical services into billable charges.
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Claim submission |
Submitting claims of billable fees to insurance companies.
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Coding |
Properly coding diagnoses and procedures.
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Patient collections |
Determining patient balances and collecting payments.
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Preregistration |
Collecting preregistration information, such as insurance coverage, before a patient arrives for inpatient or outpatient procedures.
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Registration |
Collecting subsequent patient information during registration to establish a medical record number and meet various regulatory, financial and clinical requirements.
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Remittance processing |
Applying or rejecting payments through remittance processing.
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Third-party follow up |
Collecting payments from third-party insurers.
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Utilization review |
Examining the necessity of medical services.
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Medical billing is the process of generating healthcare claims to submit to insurance for the purpose of obtaining payment for medical services rendered by providers.
Clinical Laboratory Improvement Amendments (CLIA). What is CLIA? How to obtain CLIA Certification? Types, details, and purpose explained here.
ABN in Medical Billing: The first role of ABN is to get reimbursement for the services provided to the beneficiary of the Original Medicare Plan.