Medical Billing Process

The Steps in the Medical Billing Process
HCR/220
Instructor Kerby

The Steps in the Medical Billing Process
In the medical billing process, there are significant and mandatory steps that healthcare workers need to do. Preregister patients are the first step, and this contains two major duties. The first duty is to schedule appointments because the patients need to have a time and date to see the physician, plus to update appointments. Gather preregistration demographic and a patient’s insurance information. A new patient that calls for an appointment needs to provide information (Valerius, J., Bayes, N., Newby, C., & Blochowiak, A., 2014).
With the second step is to establish the financial responsibility
There is a separate fee related to each code, and each code might not be billable, so it all depends on the client’s rules. Certain payers merge some physician work with payment for a different code (Valerius, J., Bayes, N., Newby, C., & Blochowiak, A., 2014). The sixth step is the checkout process, which the medical codes were given, checked, and the bill amounts have been established. The charges are added and then explained to the patient, and this is when the payment for the charge is collected (deductibles, copayments). If any payments were made then a receipt is prepared and any additional work will be scheduled (Valerius, J., Bayes, N., Newby, C., & Blochowiak, A., 2014).
The seventh step is an important step because this is when the claims are accurately prepared and in a timely manner. Many facilities use the PMP when preparing claims for a patient and then they will send them electronically. A claim has all the information about all the procedures, diagnosis, and charges to the payer (Valerius, J., Bayes, N., Newby, C., & Blochowiak, A., 2014). There is a schedule for communicating claims, for example, daily or every other
When money is due from the plans or from the patients it adds up to the facilities accounts receivable, and this money is needed for the practice can run. The payers review every claim by using the process adjudication, and they can determine if the claim should be paid or not (Valerius, J., Bayes, N., Newby, C., & Blochowiak, A., 2014).
The ninth step is when the payers’ payments will be applied to the correct patients account. In many cases, the patient will be billed for the rest because the plan does not cover the entire bill. Any bills mailed to the patients provide the dates and services, the payments either they or the payer has paid, and then the balances are now due (Valerius, J., Bayes, N., Newby, C., & Blochowiak, A., 2014).
The tenth step is when a patient doesn’t pay their medical bills and then a collection process starts. Then the patients’ medical and financial records will be stored and kept because of the medical practice policy. There are federal and state regulations that control which documents needs to keep and exactly how long (Valerius, J., Bayes, N., Newby, C., & Blochowiak, A.,