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A Guide to Help You With the Medical Claims Billing Process

A Guide to Help You With the Medical Claims Billing Process
Today, we’ll be reviewing through some of the steps needed to help you through the medical claims billing process.

Once a healthcare provider is finished providing treatment for their patients, they start the medical claims billing process. This process can appear intimidating at first, especially whenever your medical practice does not place emphasis on paperwork or doesn’t know much about the process. Today, we’ll be reviewing through some of the steps needed to help you through the medical claims billing process.

Get your Patients Registered

If a new patient contacts you to get an appointment scheduled, you cannot meet with them immediately. You first must get them to provide you with their insurance information. A medical practice will need to be able to check if a patient is eligible to get care. By getting patient insurance information, your medical claims billing process will be much faster.

Establish Patient Responsibilities

Medical insurance is going to be different with each plan or provider. Therefore, you need to make it clear from the get-go who has what responsibilities. Your practice will save a great deal of time this way by avoiding confusion later on. Your practice will have to review every patient’s cover so they can determine who handles which parts of a medical bill. There are some instances in which patients cover for a portion of a medical bill while the provider will handle the remainder.

When Patients Arrive

If your medical practice has new patients, the administrative staff must get those patients to fill a few forms out. For returning patients, just make sure that no details have changed since their last visit. Patients must show you valid insurance cards.

Your staff also must get patients to provide you with a form of photo identification, whether that be a driver’s license or a passport. All practices have different means of getting co-payments from their patients. Some may collect those payments upon a patient’s arrival, while others might make collections after an appointment.

When Patients Leave

A claim is created based on the procedure and diagnosis for the visit. It is of paramount importance that this information is entered the right way.

There are ways to mess up the coding process, such as either under-coding or over-coding, both of which can be avoided.

The claims are then sent electronically or on paper to the appropriate payer(s).

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This entry was posted on Thursday, May 27th, 2021 at 1:44 pm. Both comments and pings are currently closed.