Steps in Medical Billing Process Essay Example for Free

Steps in Medical Billing Process Essay There are several steps to the medical billing process step one to ten are as follows: Preregister patients, Establish financial responsibility for visits, Check in the patients, Check out the patients, Review coding compliance, Check billing compliance, Prepare and transmit claims, Monitor payer adjudication, Generate patient statements and finally Follow up patients payments and handle collections. Preregister patients is when you schedule and update appointments and collect insurance information for the patients. When you are scheduling appointments for new patient you need to get basic information and insurance information and reason for appointment. Establishing Financial Responsibility is an important step where you must determine what services are covered under the patients insurance and what service they are responsible for this also help if a preauthorization is need and ensures that are information is done and billed correctly. Check in Patients This is when you collect all necessary information from the patient such as copies for insurance cards. This is also, where you can collect copays and make sure the patient’s information is correct and updated if need be. Check out Patients This is where you record the proper medical codes for the visit. This is also where you provide information if the patient has made a payment or how much they owe and to make sure it is coded properly so the patient will be charged correctly. If payment or copays have been made then a receipt is given. Review Coding Compliance This is where guidelines must be follow when coding the visit. This must be checked for errors and the visit and the code should be connected so the payer understands the charges. Check Billing Compliance Each charge, or fee, for a visit is related to a specific procedure code. The provider’s fees for services are listed on the medical practice’s fee schedule. Most medical practices have standard fee schedules listing their usual fees. Even through there is separate codes for each fee not all are necessarily billable Prepare and Transmit Claims This is where the claims are prepared and submit in a timely manner listing the diagnosis, procedures, and charges for the payer. Most are sent electronically and each practice, as a policy as to when claims are filed be it daily, every other day etc. Monitor Payer Adjudication is where the where the health plans decide rather to pay the whole bill, part of the bill or deny the bill altogether. It is important for them to get their money as soon as possible, this is also where any discrepancies are address, and an appeal is then file if there are any discrepancies found. Generate Patients Statements This is where payments are listed from the payer, and what is still owed and what the patient is being billed it is them mailed to the patient. The date of service and any balances , and services provided are all listed on the statement. Follow up patients payments and collections this is where patients payments are monitored and checked and if they are behind they are sent a notice and if still no response collection procedures maybe started.