What is Medical Billing?

by Applied Medical Systems

As a healthcare provider, your goal is to provide your patients with the highest quality of care while getting paid for the services you provide. To ensure you receive compensation for your services, you must have a team of in-house or outsourced medical billing specialists. Medical billing specialists handle the entire medical billing process which involves creating and submitting claims to insurance companies so that you can get paid. Let’s take a closer look at what medical billing entails.

The Job Responsibilities of a Medical Billing Specialist

Regardless of whether the medical billing specialist is working in-house at a hospital or healthcare facility or for a medical billing company, they have three main job duties. These duties include:
  • Understanding each patient’s payment responsibility as payment responsibility varies from patient to patient.
  • Analyzing insurance coverage and preparing accurate medical billing forms.
  • Collecting accurate payments from insurance companies and/or patients themselves.

4 Steps Involved in the Medical Billing Process

A successful medical billing process involves four main steps. When these steps are followed, you will get paid accurately and on time while your healthcare practice runs smoothly.

Step 1: Patient Check In

When a patient checks in for their appointment, their insurance information including their payer and policy number should be collected. This information will be used when filing a claim.

Step 2: Patient’s Insurance Eligibility is Verified

Since insurance information can change at any time, it’s imperative that each patient’s insurance eligibility is verified. All patients, including regular patients must be asked whether their insurance has changed at every appointment.

Step 3: Patient Diagnosis and Treatment is Charged

In order for the insurance company to pay you properly, the coding of what each patient is being treated for in addition to the particular treatment they are undergoing is essential. The coding specialist typically takes care of this step.

Step 4: Claim is Submitted

Lastly, the claim must be submitted to the insurance company for payment. To complete this step, medical billing specialists need to have access to certain information about the insurance company because the way claims must be submitted varies from each insurance payer.

Interested in Medical Billing Services? Contact Applied Medical Systems Today

If you’re interested in maximizing your profits while minimizing the amount of time and money you have to spend to collect them, you should consider outsourcing medical billing services. Contact Applied Medical Systems today for more information on outsourcing medical billing from us. You can call us at 919-477-5152 or fill out our online contact form.