Medical billing includes submitting and then requesting the claim with health insurance company to receive payment for services provided by health care provider. This technique is implied for insurance companies, private/government companies.
The medical billing process involves interaction between health care provider and insurance company. This interaction is called as billing cycle which may take from several days to several months. This interaction begins when a physician or office staff will create or update the physical record.
Once the doctor examines the patient, after diagnosis the codes are allocated which further helps the insurance company to determine coverage and medical assistance of the services. The medical biller will then send the claim to insurance company for reimbursement.
Medical billing service includes appointment scheduling, benefits, medical coding, electronic and manual submission, payment posting, denial and receivable management and resolution of the issue if it exists.
Medical billing services procedure starts with data capture and then determining the outcomes. If there is an incorrect entry then it would further result in rejection and denials which further delays the reimbursement procedure. The medical coding services main objective is to reduce denials and maximize claims. The procedure should be followed professionally and accurately. The customer co-operation is very much essential for this process.
Once the procedure and diagnosis codes are known, the medical biller shall transmit the claim to the insurance company. There is ANSI 837 file and Electronic Data Interchange to submit the claim to the payer directly or through a clearing house. The claims are submitted in the form of paper which can be entered manually or automated recognition or OCR software.
There should be consistent financial cash flow managed by team of procession. Offshore Outsourcing medical billing should be able to provide services to large and small organizations. The reports shall be generated as per client’s requirement. There should be continuous monitor and track on each and every procedure to further analyze, process data accurately at all times.
An excellent Medical Billing Outsourcing possesses the capability to control the process and perform with high quality. The main focus is on receivable management. An efficient medical billing software is required to handle the complicated tasks. Continuous balance follow-up and claim resolution is very necessary.
The outsourcing services helps the providers to exclude many expenses such as staffing, hardware, paper and administrative costs. It is very necessary to recruit efficient people, train them as well as apply the strategy to retain them. There should be continuous maintenance and up gradation in the process and it should ideally save the time.
Medical billing services gives immense relief to providers and the providers do not worry about financial and collections. The main focus is to maximize cash flow and also using techniques for cost saving. The generated reports helps the health care providers to understand different trend and monitor financial performances.
A good medical billing services reduces provider’s risk and adhere to all guidelines.