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Medical billing is not at all an easy task and it is not a process handled by a single individual. The process involves the role of front office staffs like receptionist and back office staffs like medical biller and coder. It is a step by step process that starts with the collecting the personal details of the patient to that of receiving payment from the insurance companies. The process of medical billing includes understanding the payment responsibility of each of the individual since it differs from one patient to another, evaluation and analysis of medical charges and insurance coverage to prepare accurate billing forms and collecting of exact payments from the insurance service provider or individual patients.

Billing made easy for physicians by medical companies

Most of the physicians hate to hang around the tiring and time-consuming process of medical billing. This is the reason why they depend on reputed medical billing service companies to get quality and timely service at affordable rates. The companies with a good team of medical experts make use of the advanced software, tools, and techniques to make the process of recording and filing of bills so easy than ever before.

Personal details and claim checking

Once the appointment is fixed with the physician, the first task is to collect the personal details of the patient to open the patient record or file. The billing expert will then collect the details of the insurance plan including policy number to check for the services covered under the insurance policy to confirm the payment responsibility of the insurance company and the individual patient. This is the primary step in the medical process. Once the patient file or record is open, details of all of the treatments and tests are recorded in the file to start with the next process.

Coding and billing

Medical billing for insurance company should be made in accordance with the requirement set by HIPAA (the Health Insurance Portability and Accountability Act). The medical biller should make the bill in the prescribed format using the medical codes. Once the coding and billing are done perfectly, then the bill is submitted to the insurance company which is called transmitting the claim. This is one of the important processes in medical billing.

Adjudication

This is the important process followed by the insurance companies when the insurance claim is received from the healthcare provider of clearing house. The company checks the claim through different steps and consider different factors to evaluate the bill. The company will check for whether the bill amount is made in accordance with the medical standards and as per the insurance contract with the medical practices. The insurance company will take the final decision of settling the total amount, part of it or to deny the bill. In the case of denial, the medical billing company will make the necessary changes and resubmit the bill. Once the bill is settled to the individual patient and amount in reimbursed to the healthcare provider the file will be effectively closed.

At present most of the physicians enjoy timely billing with better payment cycle with the service of top medical billing companies.

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