Anyone enrolled in a medical coding and billing course online should learn how medical billing functions. It allows communication between health care providers, their patients and insurance companies.
Following is a detailed explanation of how medical billing functions.
1. Patient Registration
The whole process begins when a patient schedules an appointment. Records are made of personal, insurance and medical information.
2. Insurance Verification
Before any work is done, the healthcare provider confirms that the patient meets the insurance requirements for services.
3. Medical Documentation
While the consultation takes place, the doctor notes down the patient’s medical problem and how they plan to treat it.
4. Medical Coding
Medical coders assign standard codes such as ICD and CPT, to every diagnosis and procedure entered into billing systems.
5. Charge Entry
Charges are entered by the medical biller using the given codes.
6. Claim Submission
Next, a claim is submitted so the insurance company can check and provide reimbursement.
7. Insurance Processing
Depending on the facts, the insurer accepts the claim and arranges payment or may reject it with proper reasons.
8. Patient Billing
After your insurance pays its portion, the patient is sent a bill for the extraordinary balance.
9. Payment Collection
Afterward, the clinician collects the patient’s payment and wraps up the account.
Those aiming for a role in healthcare administration can get important skills and understanding by enrolling in medical coding and billing courses online.
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