Ever look at a medical bill and wonder what in the world you are reading? The process of creating and submitting medical bills for reimbursement can be incredibly complicated and challenging to understand. Here are the basics:
- Patient Registration – The first step in creating a medical bill is registering a patient. This process determines how expenses interred will be billed and who will receive the bill. Registration is generally done by the patient before he or she visits for the first time.
- Determine Financial Responsibility – This process sets the amount the patient must pay and the amount that will be billed to the insurer. Some procedures are not covered by insurance and must either be paid in full by the patient or not performed. It’s important to get those facts squared away before the visit takes place.
- Patient Check In – this is where the patient reports for his or her visit and pays any co-pays that may be necessary.
- Patient Check Out – After a patient checks out, professionals in charge of creating medicals bills will code the information from the visit into information that will be submitted to the patient’s insurer.
- Superbill Created – All the information from the patient’s visit, along with demographic and medical history information is included in a document called the superbill. This bill also contains complete information about the medical provider and procedures performed and the codes for diagnosis and procedures.
- Medical Bill Submitted – A medical biller will receive a superbill from the medical coder and submit that claim to an insurer electronically or through an actual paper document. The biller is responsible for ensuring that the information provided meets the standards established for diagnosis, treatment and payment.
Medical billing and coding is a vital part of any medical office operation. While the process seems complicated, there is very little ambiguity in charges, standards or outcomes. Interested in exploring a career in medical billing and coding? Check out the New Career Certification Subscription at 360training.com. Not only can you learn a new career for a low monthly payment, you can earn college credit from the University of Phoenix as well!