Medical Billing Process Flow Chart

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Medical Billing Process - A Flow Chart

• Presented by - Bikham Healthcare

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Medical Billing Process Flow Chart

• The medical billing process is a progression of
  steps finished by billing experts to guarantee
  that medical experts are repaid for their
  services. Contingent on the conditions, it can
  take only days to finish, or may extend more than
  a little while or months. While the procedure may
  contrast marginally between medical workplaces,
  here is a general blueprint of a medical billing
  work process.

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Patient Registration

• Patient registration is the initial step on any
  medical billing Flow chart. This is the gathering
  of fundamental statistic data on a patient,
  including name, birth date, and the explanation
  behind a visit. Insurance data is gathered,
  including the name of the Insurance supplier and
  the patient's policy number, and confirmed by
  medical billers. This data is utilized to set up
  a patient document that will be alluded to amid
  the medical billing process.

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Financial Responsibility

• The second step in the process is to decide
  financial related duty regarding the visit. This
  implies investigating the patient's insurance
  details to discover which procedures and services
  to be rendered amid the visit are secured. On the
  off chance that there are Services that won't be
  secured, the patient is made mindful that they
  will be monetarily in charge of those expenses.

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Superbill Creation

• Amid registration, the patient will be approached
  to finish forms for their file, or in the event
  that it is an return visit, affirm or update data
  as of now on document. Distinguishing proof will
  be mentioned, just as a legitimate insurance
  card, and co-installments will be collected. When
  the patient looks at, medical reports from the
  visit are converted into determination and
  technique codes by a medical coder. At that
  point, a report called a "superbill" might be
  ordered from all the data accumulated up to this
  point. It will incorporate supplier and clinician
  data, the patient's demographic data and medical
  history, data on the procedures and services
  performed, and the relevant diagnosis and
  methodology codes.

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Claims Generation Charge Entry Process Flowchart

• The medicinal biller will at that point utilize
  the superbill to set up a medical claim to be
  submitted to the patient's insurance agency. When
  the case is made, the biller must go over it
  cautiously to affirm that it meets payer and
  HIPPA consistence benchmarks, including measures
  for medical coding and format.

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Claims Submission

• When the case has been checked for accuracy and
  consistence, submission is the subsequent stage.
  Much of the time, the case will be electronically
  transmitted to a clearinghouse, which is an
  outsider organization that goes about as a
  contact between healthcare insurance suppliers
  and health insurers. The exemption to this
  standard are high-volume payers, for example,
  Medicaid, who will acknowledge guarantees
  straightforwardly from healthcare providers.

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Monitor Claim Adjudication

• Settling is the procedure by which payers assess
  medical claims and decide if they are substantial
  and agreeable, and assuming this is the case, the
  measure of reimbursement the provider will get.
  Amid this procedure, the case might be
  acknowledged, dismissed or denied. An
  acknowledged case will be paid by the insurers
  providers concurrences with the supplier. A
  rejected case is one that has blunders that must
  be remedied and the case resubmitted. A denied
  case is one that the payer will not repay.

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Patient Statement Preparation

• When the case has been prepared, the patient is
  charged for any outstanding charges. The
  statement generally includes a detailed list of
  the procedures and services provided, their
  costs, the sum paid by insurance and the sum due
  from the patient.

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Statement Follow-Up

• The last step in the medical billing process is
  to make sure bills are paid. Medical billers must
  follow up with patients whose bills are
  delinquent, and, when necessary, send accounts to
  collection agencies.

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