Billing Process

The Medical Billing Process is composed of ten different steps, each as equally important as the next. These ten steps are pre-register patients, establish financial responsibility, check in patients, review coding compliance, review billing compliance, check out patients, prepare and transmit claims, monitor payer adjudication, generate patient statements, and follow up payments and collections. When you bill a patient you want to be sure that you are not only doing it correctly but that you are charging or sending the bill to the right person whether it be the patient or the patients’ insurance company. With the ten steps to the medical billing process you want to make sure that you are doing it in the correct order. First you want to make sure that you are pre-registering the correct patient and that you are inputting their information as well as their insurance information in the system correctly. After this has been completed you are now able to schedule appointments for this patient. The next step in the process is to establish financial responsibility (who is paying for the medical bills), whether it be the patient or the insurance company. If the insurance company is assuming financial responsibility you want clarify what insurance plan the patient is falling under as well as what procedures are not covered and what financial responsibilities the patient may have (copayment). After all of this is complete, then comes checking in the patient. When checking in new patients, they need to fill out a detailed medical information sheet that will be kept on file and if they are not a new patient all they will do is review this sheet to see if anything has changed or needs to be updated. You also what to obtain a copy of their insurance card, both front and back and keep this on record as well. All medical diagnosis and procedures are given a medical code, these codes are extremely important when it comes to step four of the process, review coding compliance.