Preview

Medical Billing Process Essay

Good Essays
Open Document
Open Document
545 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Medical Billing Process Essay
SAVE YOUR RESOURCES BY OUTSOURCING TO OFFSHORE BILLING COMPANIES

Medical Billing process is crucial to the healthcare industry to follow up on medical claims and submit the same to the insurance agencies. This can also be referred to as the billing cycle. This process may take a few days to several months before the medical provider gets payment for the services rendered. This process starts with the patients’ visit to the hospital. The full details of the patient, the purpose of his visit, previous ailments if any etc. are gathered and recorded. The medical record of the patient is updated briefing about the diagnosis, medical treatment done and other relevant information. The recorded information is then transcribed into alphanumeric procedural codes for the purpose of submitting claims to the insurance firms. Overall, medical billing helps in building up a strong relationship between the medical providers and the insurance companies by managing the healthcare industry’s billing cycle.

In a healthcare organization, the
…show more content…
Outsourcing is the process of handing over a company’s business practice to an external vender in order to reduce the labour cost along with 100% quality assurance. Outsourcing saves resources, saves cost and also saves time. When outsourcing is done by companies located in other countries other than the medical provider it is termed as Offshore Outsourcing. Though most businesses have heard about offshore companies, only a few of them are totally aware of their nature of work. Most of the Offshore Billing companies are HIPAA compliant and provide all aspects of medical billing services for all types of medical specialities at affordable rates. With their dedicated team of specialized medical billers, they help to increase the amount of reimbursement and reduce the operational cost of the healthcare

You May Also Find These Documents Helpful

  • Satisfactory Essays

    Working in the medical billing industry can be daunting at times. My last position as a follow up representative, proved to be the most challenging job that I have ever had. I have an extensive background in the medical insurance industry. I was aware of the way that claims were to be handled and submitted to insurance companies. The company that I had worked for had just won a contract for taking over the medical billing for twelve physicians in Portland, Oregon. Right off the bat, there were a variety of issues concerning how to bill the medical claims correctly. Claims have to be submitted on time, with the correct codes and information on them, before they can be processed by the insurance company.…

    • 370 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    In my own words how, HIPPA, ICD, CPT, and HCPCS influence each of the ten steps of the medical billing process is that when it comes to medical billing and the coding process, there is a special task that must be completed by the billing staff members of any medical facility, whether it is a small doctor’s office or a large hospital. They must provide quality care in the mean while protecting the patients’ privacy and expediting the payment of services rendered. There are ten steps to this process: pre-registration, establish the financial responsibility, the checking in and checking out of patients’, reviewing the coding compliance, checking the billing compliance, preparing and transmitting the claims, monitor payer adjudication, creating patient statements and the handling of collections. HIPPA policies are carefully reviewed by the patient’s informing them of the process necessary in transmitting their claims and the facilities devotion to their confidentiality.…

    • 264 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    There are ten steps included in the billing process and are used to help process the patient’s information from preregistration to the follow up payments. Each patient has the responsibility to pay for their services once they have received care from a facility by themselves or an insurance company. Many different health insurance companies that may help an individual cover their medical expenses or even pay the entire bill. This billing process is usually done in the back office whereas the registration and collection of information is done in the front office.…

    • 749 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Hcr/220 Week 9

    • 288 Words
    • 2 Pages

    The submittal of claims to insurance companies requesting payment for medical services provided by a doctor to a patient is called the medical billing process. Ten steps make up the process: preregistration of patients; establishment of financial responsibility for the visit; checking patients in; checking patients out; the review of coding compliance; verifying billing compliance; the preparation and transmittal of claims; the monitoring of payer adjudication; generation of patient statements; and the follow-up of payments by the patients and the handling of collections. HCPCS, HIPAA, CPT, and ICD have an influence on every step of the process. The 9th Revision-Clinical Modification (ICD-9-CM) is a global categorization of disease and contains sets of codes. These codes give information for evenly measures and diagnoses. The ICD-9 code has three digits, and these three may be followed by a decimal point and then two more digits. The Healthcare Common procedure coding system (HCPCS) does not give diagnosis information, only information about the procedure area. The purpose of HCPCS codes is to process hospital treatments for outpatient services. Physicians also use these codes. ICD-9 procedure codes are required by HIPAA for their porting procedures of hospital inpatients. The numerical codes for CPT and the diagnoses areas signed by the coding team. They make these assignments based on information given by the provider. A charge is then created, following the billing rules that pertain to certain locations and carriers. People who work on the process of medical billing have to maintain patient information confidentiality based on HIPPA rules. Employees must also be truthful and conduct themselves with integrity. Every procedure and diagnosis has to be correctly documented and then coded accurately to avoid any delays in…

    • 288 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    There are ten basic steps in the medical billing process. Each step has certain things which must be done to correctly complete the entire process. In order to complete your duties as a medical biller efficiently, you must follow the medical billing process. Following this process leads to maximum and appropriate payments in a timely fashion. These steps range from the pre registration of the patient to the collection of the payment. In this paper each step will be describe with a brief outline of what each step entails.…

    • 748 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    Medical billing and coding is a lot more detailed and difficult that many people outside of the medical field know. Because there are so many different codes and the numbers of different insurance companies, Medicare and Medicaid all have different codes among themselves it can become overwhelming for the billing staff in offices to make sure that everything is right. Unfortunately all the codes have to be correct in order for doctors and hospitals to get paid in a timely manner. All medical billing is started the same way though.…

    • 927 Words
    • 4 Pages
    Good Essays
  • Better Essays

    Outsourcing has become an integral part of many organizations today. Outsourcing has its advantages and disadvantages that organizations will have to weigh to decide whether or not outsourcing is the best possible solution to their current problems and business operations. Outsourcing refers to the process of hiring external provider to operate on a business or organization function (Venture Outsource, 2012). In this case, two organizations or businesses enter a contract where there will be an exchange of services and payments. This paper will discuss the possible risks an organization may encounter in outsourcing in relation to the use of an external service provider for data storage, use of an enterprise service provider for processing information systems applications such as a payroll, human resources, or sales order taking, use of a vendor to support desktop computers, and use of a vendor to provide network support. This document will also discuss the risk mitigation strategies for each individual situation.…

    • 1256 Words
    • 6 Pages
    Better Essays
  • Better Essays

    The receptionist or other clerical worker will either call, or receive a call from a “patient” or other authorized individual. During this communication, the associate must be careful to observe HIPAA rules related to “protected health information.” when “schedule, canceling, or rescheduling” encounters. When gathering benefit “information,” the representative must be diligent to accurately enter data into the “patient’s” file. Discerning insurance cards, policies, and all applicable guidelines of each plan are applicable to the “front and back” office. Abiding by the payer’s regulations, and the coordination of benefits,” associates will input this data into the patient management program (PMP). During these procedures, insurance specialists will be cautious to correlate the correct information with the correct patient. The “front or back office” will then confirm coverage with designated plans, along with all essentials, such as if a “referral or preauthorization” is a requisite. Prior to consulting with the physician, patients will need to be alerted about their rights, in coordination with HIPAA privacy standards, as well as those of the provider. During that time, if the patient owes any monies for coinsurance, or copayments, this will be submitted to the “front office.” While checking out patients, insurance specialists will transfer the descriptions of “diagnoses and procedures” from the “physician’s report” into appropriate “codes” for ‘claim” generation. This facet is most crucial, because of the HIPAA specifications regarding the transfer of PHI “by covered entities” (Valerius et al., p.…

    • 1235 Words
    • 5 Pages
    Better Essays
  • Satisfactory Essays

    The medical billing process and all of the functions that pertain to it are the responsibilities of the medical insurance specialist. It addresses all tasks that will be performed by the administrative staff members during the medical billing process. These functions are typically handled by front office staff members such as the receptionist (registration) and scheduling.…

    • 672 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    It is a very long process for billing to prepare the bill that is required to submit for payment. There also have been a lot of mistakes when billing because some did not know the guidelines of medical coding when sending the bill to the insurance company. This assignment will show how to making medical billing and compliance strategies so mistakes will not be made. Even through that not any means is any one perfect…

    • 804 Words
    • 4 Pages
    Good Essays
  • Better Essays

    The need to correctly document medical records, apply appropriate billing codes, and accurately charge payers for medical procedures and services is essential for today’s medical facilities. Physicians rely on medical insurance specialists to process claims so that they can be reimbursed for their services. This essay will emphasize the importance of correctly submitting claims for reimbursement, as well as, how compliance plans are put in place to benefit everyone involved in the billing and coding process.…

    • 921 Words
    • 4 Pages
    Better Essays
  • Satisfactory Essays

    A medical billing and coding specialist’s main goal is to provide medical billing and coding services so the health provider is paid for medical services rendered. Every medical service is assigned a numeric code to define diagnostics, treatments and procedures. It is the medical biller and coder’s job to enter this information into a database using medical billing and coding protocol to produce a statement or claim. If the claim is denied by the third-party payer, the medical billing and coding specialist must investigate the claim, verify its information, and update new details into the database. Medical billing and coding specialists are also responsible for dealing with collections and insurance fraud.…

    • 612 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    Coding and reimbursement go hand in hand. Proper medical coding is important on many levels, from ensuring accurate payment for physicians to creating a valid record of…

    • 489 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    Or you may want a full service package from the private practice management company where they manage all your reporting, invoicing and filing systems so that your full medical team is doing work they are qualified for. The main benefits of outsourcing private practice management are you can focus on your main objective of treating and caring for patients, your cash flow is maximised, processes are streamlined therefore faster and more accurate, electronic invoices are validated before they are sent out and patients will be able to pay for their medical bills by credit or debit card. The less time spent on administrative duties that can be handed over to external private practice management the more resources can be spent on more patients and their welfare. Private practice management services can chase paper trails and invoice discrepancies from creating invoices on your current financial system through to recovering outstanding invoices or raising credit…

    • 376 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Medicaid Essay

    • 1223 Words
    • 4 Pages

    As I understood Medicaid are those personal cares services which are fundamental, non-acute services provided to facilitate recipients who require assistance with the activities of daily living to remain in their home or community, maintain their current health status and prevent, delay, or minimize deterioration of their condition. Personal care services are intended to supplement care provided by a recipient 's family or primary caregiver, not replace it. Services may be provided in the home or in setting outside the home, when necessary.…

    • 1223 Words
    • 4 Pages
    Good Essays