Overview of Medical Billing Process

Medical billing codes are not mere bland numbers – each of them has a story to tell. Together they give a clear picture of the patient’s treatment. It requires an insightful medical coder to approach the various diagnoses and treatments documented in patient records with a clear head and assign the right diagnostic and procedural codes. Medical billing codes decide the reimbursement of the medical providers. They are also determining factors when it comes to who will pay for the treatment – whether the insurance company, Medicare/Medicaid will cover the treatment expense, or whether the patient will have to pay. Many billing issues, frustrating to the patient, the physician as well as the payer originate from wrong medical codes.

The right medical codes reported in a claim submitted to the insurance company make the entire diagnosis and treatment process easily comprehensible. Accurate coding makes it easy for the payer to decide whether a claim is reimbursable or not.

Medical Billing and Coding -- The Problem and the Solution

Medical billing and coding becomes an issue when these vital processes are either done in a hurry, or when they are done by incompetent staff not very knowledgeable regarding medical codes. To assign the correct medical codes – both diagnostic and procedural, the coder should be thorough with the ICD-9 and CPT codes pertaining to each medical specialty. He should be familiar with individual payer requirements and regulations state wise, and keep himself updated on all latest developments in the medical billing scenario. This is too much to ask from your medical office staff. To avoid frustrating your office staff, and to enjoy peace of mind, your best option is to outsource medical billing to a company you can trust. Medical billing and coding services will help the smooth and efficient functioning of your medical practice. Besides streamlining the billing process, it facilitates the integration of the entire patient management system.

The professionals at a reliable firm will manage your entire medical billing process, track your accounts, submit and follow up on claims to secure payments due to you. Single practitioners, dental groups, small and large hospitals, acute care facilities, doctor’s offices, multi-specialty groups, long term care facilities and physical or mental rehabilitation facilities can all benefit from these services.

The Medical Billing Cycle – Comprehensive and Challenging

Here's a quick overview of the entire medical billing process.

Patient statement creation and mailing
Patient information collection and analysis
Processing medical insurance claims
Solving the billing queries personally
Insurance verification and insurance authorization
Continuous monitoring and follow up of rejected claims and resubmitting them after resolving any problems
Effective collection of compensation
Providing on time payment for all of the services provided
Payment plan setup
Credit bureau reporting
Generating reports with details of payments and claims, which helps you adjust your billing practices and improve cash flow.
Continuous evaluation of accounts
Regular quality checks
Charge entry
Cash posting and reconciliation
Analysis and recommendations
Scheduling and rescheduling
AR collections
Customized reporting to track business activity and productivity
24/7 customer support and technical assistance

Medical Billing Services – Simplifies the Billing Cycle

Medical billing and coding services are provided with the support of advanced technology and a knowledgeable workforce. Medical billing companies upload the files to the payers via secure file transfer protocol (FTP). `To carry out the process efficiently, electronic medical claims billing services utilize various advanced software packages such as Medical Manager, IDX, Eclipse, Medisoft, e-clinical, Misys, Lytec, Inception and Next Gen.

For comprehensive billing services, partner with an experienced and reliable medical billing company. With such a firm, errors such as billing for the wrong treatment, double billing for the same treatment, billing for services that are not covered, unbundling and upcoding are all avoided. As a healthcare provider you benefit from accurate reimbursement, and more importantly, the happy smiles of your patients.

About The Author

OSI offers medical billing and coding services for clients to ensure timely reimbursement, ultimately affecting their bottom line and cash flow. OSI also offers quality physician billing services to prevent backlog and heavy financial losses in medical practices