Business

Medical Billing Process and Need for Efficient Billing Companies

It is important to have an optimized billing process if you are a healthcare service provider or a related group such as a patient group or medical billing company. Since this process encapsulates a series of steps leading to a fulfillment of obligations, it is important to see things as they are from the start itself.

Start with Insurance Verification

You begin the medical billing with the insurance verification. This is the eligibility verification stage where they check for a necessity for pre-authorization or referral along with the eligibility of the insurance. They check if they need to collect any copayment, if the deductible has been met, and the amount of share of the co-insurance the patient has. Here they also check if the insurance covers the service they seek.

Use of CPD Coding

Next is the demographic entry of the patient and the CPD coding. Medical documents need to be verified, so they check the patient information and superbills. These medical documents go to the medical coding department to undergo CPD and ICD 10 coding. The coding manager will cross-check them and proofread them. If you need the service, you must check the list of medical billing companies and find one that suits you. They will take care of your needs.

Making the Charge Entry

We come to the Charge Entry next. Here the charges are entered to the patient account. If the patient does not have any previous account, then the patient demographics are entered and a new account is created. We can get the details from the patient registration form. Before they transmit the claims, the Quality Assurance team will audit the charges and issue a clean chit. Claims are filed after charges are entered and audited. A few service providers can process paper claims.

Entering the Payments

Upon the receipt of checks, the payments are entered into the system. The appropriate patient account is charged. Initiation of denied claims is started in case the claims are much below the actual or expected one. The insurance follow-up comes next. Claims are given to the payer for processing. A BPO follow-up team goes after unpaid insurance claims more than 30 days old. This reduces the accounts receivable days of the claim. Contact any of the largest medical billing companies because you will get the best service from them.

Generating a Report

All Denied Claims are allocated a priority basis. Billers and coders find the missing puzzle pieces fast. The patient statement is recorded and filed on a monthly or weekly basis. We use phone calls to follow up. If there is no response, those are moved to collections. The report is generated and sent. This reporting package consists of customized reports Key Performance Indicator Reports, and insurance aging reports.

It is important to start off on the right foot. People check for coding companies that have an easy method of access and use. When they understand what they need on the frontend, it is easy to streamline things at the backend. Companies with simplified workflows and schedules are easy to work with and so people will choose those over those that have tedious and rigorous mechanisms.

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