Easy Steps To Follow In Medical Billing Process - PowerPoint PPT Presentation

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Easy Steps To Follow In Medical Billing Process

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A well-organized practice require proper financial resources to make sure not only the delivery of medical services to the patients but payment to the providers and support staff, and also payment of overheads. – PowerPoint PPT presentation

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Title: Easy Steps To Follow In Medical Billing Process


1
Easy Steps To Follow In Medical Billing
Process
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Easy Steps To Follow In Medical Billing Process
A well-organized practice require proper
financial resources to make sure not only the
delivery of medical services to the patients but
payment to the providers and support staff, and
also payment of overheads. Importance of Revenue
Cycle Management in Medical Practice Any practice
can streamline their tasks and allow practice to
run smoothly with the help of revenue cycle
management. Medical practice management software
required to automate key functions in RCM such as
scheduling, medical billing and coding, claims
submission to insurance companies and report of
collected payments. Medical practices such as
solo providers, group providers and hospitals
etc. reply on proper reimbursement for the
healthcare services that are provided to
patients. Documentation is the key in the revenue
cycle as the medical practice will only be paid
from the insurance companies if the medical
details and bills are properly processed. Steps
to Follow in Medical Billing Patient
Scheduling Very first and foremost step is to
list the patient details, such as his/her age,
gender, address details, and contact number.
Insurance related information is also important
while listing details.
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Easy Steps To Follow In Medical Billing Process
The demographic and insurance details must be
noted and should be revised/added if the patient
regularly visits the medical practice. Nowadays
most practices use advanced medical practice
management software where patient details are
entered only once, and patients do not have to go
through the trouble of giving information every
time they visit the hospital or
clinic. Eligibility and Verification Every
patients insurance information and eligibility
information needs to verify before date of
service. Insurance information may change at
given time, which may require patient interaction
to provide insurance details before his/her visit
to provider. The status of insurance is also
asked, and only active insurance plans would be
processed, and if the mentioned medical services
are covered or not otherwise, the patient has to
make a payment out of pocket. Any changes in the
insurance plan or policy impact the patients
authorization information and benefit. Medical
Coding Accurate coding of claims is very
important for providing information to insurance
payer of what exactly the patient is being
treated for as well as the method of treatment
the patient is undergoing. Every practice should
use correct CPT codes to describe the patients
symptoms or illnesses. This practice will help to
reduce denials and boost practice collection.
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Easy Steps To Follow In Medical Billing Process
Charge Entry The expenses incurred to render the
service is added to the amount that is calculated
by the medical coder. This is the first step in
preparing the claim form that is submitted to the
insurance company, and without a definite and
accurate amount, the payment cannot be collected.
The claim form is thoroughly checked to ensure
the right amount is quoted as it resulted in
either reduced payment or claim rejection
altogether. Claims Submission Once the claim
completed, it must be send to insurance for the
further process to receive reimbursement. Medical
billers need to have access to the information
they need about the insurance payer since there
are so many variables for each insurance payer in
determining how and when to submit a
claim. Claim Denial Management and Account
Receivable The insurance company only processes
the claims that are received within a specified
time limit. Insurance companies deny claims with
errors. The claims denied even after corrections
are followed rigorously with the insurance
company, and further information is gathered that
caused a denial of payment. The Insurance Coding,
Medical Coding, and Charge Posting are shared to
see for any errors. Account receivables team has
to take care of claim denied reasons and the list
of trend or rejection issues to prevent future
claim denials.
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Easy Steps To Follow In Medical Billing Process
Payment Collection Once insurance company verify
the claim and decided to pay the claim, then
either insurance company pay through a physical
check or electronic fund transfer. Providers also
receive explanation of benefits (EOB) for the
payment made by insurance company. The
professional team at a medical practice should
all the details about the payment into the
practice management system to prepare a
collection report. Our team is trained and
certified, knows how to straightened out medical
billing process for any medical practice and
solutions according to requirement of particular
medical practice and then connecting it with
specific insurance company.
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