The medical billing process is a complex system that requires various steps to ensure accuracy and efficiency. Medical billing services work hard to make sure that medical bills are processed quickly and accurately, allowing for timely payments from insurance companies.
The medical billing process begins with patient registration, where the patient’s demographic information like name, age, address, contact information, and medical insurance information is collected. This helps medical billing services to have quick access to patient records and simplify the medical billing process.
Patient Insurance Verification
The next step in medical billing is patient insurance verification, where medical billing services contact the insurance provider to check the patient’s coverage details and pre-authorization or referral requirements if any. This ensures that medical billing companies can process medical billings accurately, with lesser chances of denials or rejections.
Medical coding is done to assign codes to each of the medical procedures and services carried out. This helps medical practitioners in effectively tracking medical bills and also allows insurance companies to accurately assess medical bills.
Once medical coding is complete, medical billing services enter medical charges into the medical billing software or system. This information is then reviewed to check for the accuracy and completeness of the data. If any discrepancies are found, they are corrected immediately by medical billers before it gets sent to insurance companies for payment processing.
After medical charges are entered and checked for accuracy, the medical billing services process a medical audit to ensure that all medical procedures billed were actually provided and were medically necessary. This helps in avoiding any unnecessary medical billing errors or inaccuracies.
Once charge entry and medical audit are complete, insurance companies will be contacted to determine the eligibility of the patient to confirm the medical billing and coding accuracy. This is known as the insurance verification process. During this process, medical billers ensure that all medical services are allowed by the particular insurance plan and verify if any pre-authorization requirements or referrals were done.
After successful insurance eligibility verification, medical billers submit claims to the respective payers. Medical billers then monitor the status of medical claims to ensure timely payment from insurance companies. This is done through Accounts Receivable (AR) calling, which involves regular follow-up with payers for medical claim status.
In case of any medical billing denials received, medical billers conduct a denial management process by obtaining detailed information on the medical claim denials and analyzing the same for appeal submission.
Once medical claims are processed by insurance companies, medical billers post all payments received in the medical billing software. This process is referred to as payment posting and helps medical professionals track the financial performance of the medical practice.
To ensure quality medical billing services, medical billers conduct medical billing audits on the medical billings periodically. This medical billing audit helps medical professionals identify any discrepancies in medical claim payments, medical coding errors, and insurance policies or contract rules.
Benefits of Hiring a Medical Billing Company
Medical billing services are important for medical practices to receive timely payment of medical claims. Knowing the step-by-step medical billing process ensures medical practices run smoothly and efficiently.
Medical billing steps are critical for medical practices as medical bills are submitted for reimbursement purposes. An experienced medical billing team is necessary to ensure an accurate medical billing process. Qualified medical billers should be familiar with medical terminology, medical coding, medical laws and regulations, and insurance policies. Hiring a medical billing service can save time and money for the medical office as they are experienced in managing medical claims with accuracy.