Steps in Medical Billing

In: Other Topics

Submitted By TheresaR75
Words 606
Pages 3
Steps in Medical Billing
HCR/220

6/8/2012

Theresa Rosado

The processes of medical billing used in healthcare, providers and insurance companies have to submit and follow ups in order to receive payments from the medical services. Ten steps are used to complete the medial billing process. There are three categories which is visit, claim, and post claim.
Visit makes up the first categories that consist of the first four steps. Pre-registering the patient is the first step in the visiting area. The two main tasks of pre-registering are schedule and update appointments and collect pre-registration demographic and insurance information. When patients call for an appointment they provide their personal and insurance information for the scheduler. Also the scheduler will ask if you are a new or returning patient.
The first step is to pre-register the patients and get all of their contact information and insurance information.
The second step is try to establish financial responsibilities for all visits and verify insurance eligibility and figure out how much that needs to be collected up front from the patients. A patient that is insured, questions must be answered. For an example: what is the patient responsible for paying? And what are the billing rules of the plan? When the question is answered it would help the medical insurance specialist. In order for the financial responsibility, the procedures need to be followed: check the health plan’s coverage, verify patients’ eligibility for their health plan and more The third step is to check in patients and have them sign in then collect whatever necessary money from them, copy or scan their current insurance card. Check in patients is step three. At the arrival of the patient, the clerk need detailed and complete demographic and medical information. Returning patients would look over their files to make sure…...

Similar Documents

Medical Billing

...Running Head: MEDICAL BILLING AND CODING Medical Billing and Coding as a Career Abstract: Since I became a mother, I have always wanted a job that would allow me to work at home. I have an associate in accounting and tried doing bookkeeping from home but that did not really work out. I did some research and found that being an insurance medical biller and coder is one of the best jobs to have for working at home. Top Medical Billers can earn over $40,000 a year either at home or in the office. “Employment of billing and posting clerks and machine operators is expected to grow by about 4 percent from 2006 to 2016. In 2006, billing and posting clerks and machine operators held about 542,000 jobs; 566,000 jobs are projected by 2016.” (medicalcareersguide, 2007) In choosing a new career path I did a lot of research on my options. The path to success always starts with the right attitude, education, training, networking, and experience. We want to inspire you by not only speaking about the medical billing and coding career but also by giving examples of real people who succeeded. Learn all there is to know about entering into this rewarding field, finding medical billing jobs, and succeeding in your chosen career. This website also answers many questions about starting your own medical billing business, either in a small office space, or from home. I decided upon medical billing and coding because it is a rapidly growing healthcare field and it sounds exciting....

Words: 1344 - Pages: 6

Steps in the Medical Billing Process

...Steps in the Medical Billing Process Stacy Dickson HCR/220 March 20, 2011 Alexander Mejia Steps in the Medical Billing Process The medical billing process is one that requires attention to detail to ensure that all the proper paperwork is completed properly and accurately. This process will begin form the time the patient enters to register for their appointment until after they have finished their appointment. This paper will provide the step by step process. Visit Step 1 Preregister Patients As part of the medical billing process, preregistering patients is required. This could be scheduling a patient for an appointment or it could be to update a patients appointments. This also allows insurance information to be updated in the patient’s files and to retrieve any demographic information. The medical scheduler will also inquire for the reason of the visit so that the appropriate amount of time is allotted for the visit. Step 2 Evaluate Financial Responsibility Evaluating the financial responsibility of the visit is extremely important, to ensure that the patients insurance covers and what the patients is responsible for. It is also establish if any prior authorizations are required before services are performed. Step 3 Check In Patients When a patient new patient arrives it is necessary to take a copy of their insurance card, drivers’ license, and have them complete a new patient form with their medical history, home......

Words: 602 - Pages: 3

History of Medical Coding and Billing

...History and Future Of Medical Coding and Billing John F. McMahon BU480, Central Methodist University Abstract Medical coding and billing affects everyone during their lifetime and yet the regulations of medical coding and billing are extremely complex. Examining the history, evaluation, and effect of new regulations and their cost shed light on an already complex industry. We will review government regulations, technological advancements, and requirements that providers will face in the near future. We will examine our current systems and how they evolved through time and what they may be in the future. We have reviewed articles from the Medical Billing and Coding Association, the Department of Human and Health Services as well as the Office of the Inspector General. We will review the different types of insurance, how they each affect the process of medical coding and billing and then see what the future will be. Finally we will review what steps we have taken that has allowed a government to be so involved in our healthcare decisions. Thesis Statement Medical Coding and Billing has evolved to a point that it affects everyone at one time or another during their lifetime and has only led to complex rules and regulations that you almost need a degree to understand. From times that Physicians bartered for their services to the government telling them what to charge and insurance......

Words: 2509 - Pages: 11

Medical Billing

...research that I have done, there appears to be ten steps in medical billing. The steps are as follows: * Preregister patients * Establish financial responsibilities for visits * Check in patients * Check out Patients * Review coding compliance * Check billing compliance * Prepare and transmit claims * Monitor payer adjudication * Generate patient statements * Follow up patient payments and handle collections For step one, preregistering patients gives you all the information that you will need as in contact information and insurance information. This way when billing comes up you know who you need to contact whether it be insurance or patient. Step two is knowing WHO is going to pay for any medical procedures that need to be preformed. Verifying insurance eligibility and figuring out how much to collect up front from the patient is a must. Step three is having the patient sign in, collect whatever necessary money from them, copy or scan their current insurance information. Step four is checking out the patient, and verify one last time that you have all of the correct information from the. Step five is to obtain CPT and ICD-9 codes from the doctor(s) and verify that all information is correct before entering it into the computer system. Codes can be tricky and you need to make sure that you have all of you bases covered when entering them in. Step six is making you know how to submit billing for different insurance claims. I know that......

Words: 458 - Pages: 2

Steps in Medical Billing Process

...Steps in the medical billing process The following ten steps will show you the order in which to do the medical billing process: I. Pre-Register patients: patient’s appointments are needed to be scheduled and kept updated. Basic insurance information should be added to the patient’s record, as well as their personal information: age, gender, weight, and height. To make sure no appointments get missed a reminder call should be made. When the patient makes their appointment, ask for an insurance card, copy it front and back then add to the patient’s medical record. II. Establish financial responsibilities for visits: As the patient shows they have insurance: their health plan coverage needs to be reviewed and its eligibility needs to be verified. It is recommended to be sure to ask the patient whether or not if there is more than one insurance company. If this is true, then the first payer should be decided. Once verified and checked that all provisions have been met, steps need to be followed to acknowledge payment for services. III. Check in patients: A new patient who is new to the practice; complete personal and medical information is collected. If the patient is returning their information needs to be reviewed, updated and verified if needed. Insurance cards and identification cards should be copied front and back, and placed in their medical chart. Any office visits that are co-payment dues should be collected at time of service. IV. Check out patients: ...

Words: 722 - Pages: 3

Medical Billing Process

...Medical Billing Process HCA 220 11-03-13 Axia University of Phoenix Medical Billing Process When you go to the health care provider’s office for care, the admitting or office registration department gathers information about you the person responsible for paying for the services and the insurance that will be billed. Step 1: Pre register Patients. By scheduling and updating appointments get the patients demographic and insurance information. Step 2: Establish Financial Responsibility for their visits – verify insurance eligibility and figure out how much to collect from the patient. You get this info by figuring what services are covered by the plan and what services are not covered, and if there are any billing rules to the plan. Step 3: Check in Patients have them sign in then collect whatever necessary money from them, and copy or scan their current insurance card. When this is a new patient they collect detailed and complete demographic and medical information. A regular patient would need to verify their demographic and medical information is correct. Step 4: Review Coding Compliance. Compliance means actions that satisfy official requirements, with coding compliance means following official guidelines when codes are assigned. Obtain CPT and ICD-9 from the doctor(s) next verifies all information is correct before entering it into the computer system. Step 5: Review Billing Compliance. This is where you need to figure out which fee is......

Words: 512 - Pages: 3

Medical Billing

...Medical Billing and Coding The program that I am currently in, is medical billing and coding. Some professionals that are medical coders with a minimum of an associates degree, are a part of an organization that is called AAPC. AAPC stands for American Academy of Professional Coders. In 1988, AAPC was founded to provide education and professional certification to physician-based medical coders (AAPC, 2014). In order to be a part of this organization, a member has to follow by a specific protocol. Another organization that is most known and recognized, is The American Medical Billing Association (AMBA).There's a list of different certifications that one could gain, as a medical billing and coder. Just to name a few more, CMRS (certified medical reimbursement specialist) specializes in insurance reimbursement. CHBME (certified healthcare billing and management executive) is geared toward managers, executives, and supervisors (A-T-M-B, 2014). Professional standards in the healthcare field, means having a certification or a license. Having a certification, means you indeed, have met the specific requirements. Depending on the specific job one chooses when entering into the healthcare field, in order to practice in the state that one lives in, it is mandatory that one has a license to practice within that state. The importance of professional standards in healthcare, is for one, to distinguish yourself from others who are not certified or licensed. It shows how dedicated you......

Words: 447 - Pages: 2

Hcr 220 Week 1 Assignment Steps in the Medical Billing Process

...Assignment Steps in the Medical Billing Process Get Tutorial by Clicking on the link below or Copy Paste Link in Your Browser http://hwguiders.com/downloads/hcr-220-week-1-assignment-steps-medical-billing-process/ For More Courses and Exams use this form ( http://hwguiders.com/contact-us/ ) Feel Free to Search your Class through Our Product Categories or From Our Search Bar (http://hwguiders.com/ ) Medical insurance specialist addresses all the tasks that are completed by administrative staff members during the medical billing process. To ensure that their duties are complete medical insurance specialists follow a medical billing process which involves ten steps. The first step in the medical billing process is to preregister patients. With preregistering patients schedule and update appointments and collect preregistration demographic and insurance information. When patients call for an appointment they provide basic information and information about their insurance. Patients are also asked about the reason for their visit. HCR 220 Week 1 Assignment Steps in the Medical Billing Process Get Tutorial by Clicking on the link below or Copy Paste Link in Your Browser http://hwguiders.com/downloads/hcr-220-week-1-assignment-steps-medical-billing-process/ For More Courses and Exams use this form ( http://hwguiders.com/contact-us/ ) Feel Free to Search your Class through Our Product Categories or From Our Search Bar (http://hwguiders.com/......

Words: 3181 - Pages: 13

Medical Billing and Reimbursement

...Medical Billing and Reimbursement Grand Canyon University: HCA-530-0101 July 14, 2015 Healthcare organizations’ services provided are civic and moral in nature. These services are directly impacting a society and community’s ability to function and be productive. One might say, healthcare organizations must always prioritize the moral objective or vision at all times, however, in order for healthcare organizations to continue providing access to healthcare, these organizations must be financially sound. Revenue stream is one area that initiates an organizations ability or inability to thrive. Billing accurately and timely for these services will ensure revenues are collected avoiding delay in providing healthcare to the community. According to Cleverley, Song, & Cleverley, 2011, p. 14), “Healthcare firms are for the most part business-oriented organizations. Their ultimate financial survival depends on a consistent and recurring flow of funds from the services they provide to patients. Without an adequate stream of revenue these firms would be forced to cease operations”. A critical role in ensuring that there is an adequate stream of revenue in a healthcare organization is the medical coder/biller. This role is tasked to start, process and file a claim to a patient’s insurance (private or government) for reimbursement. These claims are the lifeline of an organization’s revenues and must be process correctly to ensure all services provided will be paid. There are......

Words: 1059 - Pages: 5

10 Steps in the Medical Documents and Billing Cycle

...Steps in the Medical Documentation and Billing Cycle Step 1: Preregister Patients The first step in the cycle is to gather information so patients can be preregistered before their office visit. This information includes the patient's name, contact information, the chief complaint, and whether the patient is new to the practice. The information is obtained over the telephone or via the Internet, if the practice has a website. Step 2: Establish Financial Responsibility for Visit Most patients are covered by some type of health plan. While scheduling the appointment, it is important to determine whether the patient has insurance and, if so, to obtain the identification number, plan name, and name of the person who is the policyholder. Once the insurance information is obtained, the patient's current eligibility and benefits are verified with the payer. Verification may be done by telephone, but most often it is done via the Internet and takes a matter of seconds. It is also important to make sure that the health plan's conditions for payment, such as advance approval requirements for particular treatments or procedures, are met before treatment is provided. In addition, physicians usually participate in some health plans and not in others. If the physician does not participate in the plan, the patient may be liable for all charges. All of this must be determined and communicated to the patient before the appointment. Step 3: Check In Patients When patients arrive...

Words: 659 - Pages: 3

Ten Billing Steps

...2015 Ten Step Billing Process The ten steps of the medical billing process have been divided into three categories: The visit, the claim and the post claim. Following the billing steps to complete correct claims ensures that providers are paid accurately and timely for services and procedures. The Billing process begins with the preregistration of patients. Collecting personal, basic demographic information, and insurance information and entering that information into the database. All of this personal information can be referred to at any time during the medical billing process. Keeping up to date patient and insurance information makes patient check in more efficient and eliminated potential billing errors. Confirming financial responsibility is the next step in the billing process. Once a patient’s information has been updated in the computer system it is then the medical staffs’ responsibility to determine who will be paying for the services rendered for the appointment. Insurance providers are contacted and benefits are verified as different plans have different levels of coverage. Once the medical staff is aware of what the allowable insurance benefits are, contact with the patient should be made so the patient is aware of their responsibility for out of pocket, non-covered expenses, co-payments, and deductibles. During the appointment, the physician makes notes of the examination and services provided. These notes become part of the patients’ medical......

Words: 1284 - Pages: 6

Medical Billing Worksheet

...University of Phoenix Material Steps in the Medical Billing Process Part A Reference: Ch. 1 of Medical Insurance Complete the following table by identifying the 10 steps in the Medical Billing Process. Write 2 to 3 sentences describing each step. Be as specific as possible. For example, Step 1 may be, “Preregister Patients.” |Step |Description | |Step 1: Preregister patients |The patient schedules and appointment to see the doctor. The doctor’s office collects | | |preregistration demographics and insurance information. Appointments are updated if | | |needed. | |Step 2: Establish financial responsibility |Once the appointment is made now you have to see what is covered under the patient’s | | |insurance plan. What is not covered? You also need to find out the billing rules of the | | |patients insurance. | |Step 3: Check in patients |When the patient arrives for their appointment they are to sign in. Once they do that new| | ...

Words: 720 - Pages: 3

Steps in the Medical Billing Process

...Steps in the Medical Billing Process Annette Callen 02/11/2012 I am writing this paper to discuss the ten steps of medical billing. The ten step process consist of patient preregister, establish financial responsibility for visits, check in patients, check out patients, review coding compliance, check billing compliance, prepare and transmit claims, monitor payer adjudication, generate patient statements and follow up patient payments and handle collections. These steps are under three categories these categories are visit, claim and post-claim; throughout this paper I will explain each of these ten steps. The first category is visit; step one of visit is preregister patients. This step usually involves the clerks at the front desk or nurses depending on the size and location of the health center. The clerks are responsible for checking in patients, scheduling appointments and making appointment reminder calls. The clerks are also responsible for collecting the patient personal and payer information. Step two is establishing financial responsibility for the health visit. This step is where the clerks will collect the payer insurance information, set up a payment plan, and let the nurses and doctors know what is covered by the insurance company such as treatments, testing and medications. If the patient does not have medical insurance then the clerks need to determine if the patient needs to be on a payment plan or if they can pay for the service in one...

Words: 974 - Pages: 4

Medical Billing

...Medical Billing Process Nathia Herod HCR/220 2/26/2012 Melinda Sousa Medical Billing Process There comes the time in everyone’s life that just about almost everyone who is adults has gone through some part of the medical billing process. It is a process in what keeps most workers in the field their job and some patients their health. In the end, in order for everyone to be satisfied, everyone must play their role and work together. In order for the patient to understand what they are paying for; the biller must know who to bill and what they are paying for as well. There are ten steps of the medical billing process and the first step of this process would be to always pre-register the patients. When you break this step down a little further all it means is that you are setting appointments for the patient but first thing’s first, you must get their insurance in order to know what the patient is going to pay and what they are not going to pay. When the patient is done being preregistered; you are now available to state their financial responsibility for the visit. Most of the time when patients are preregistered, they kind of already have a prejudgment as to what they are going to pay because of their insurance which also establishes a financial responsibility. You must clarify clearly in the beginning as to why they are paying for this and not paying for something else. You must always try your best to get the patient to understand or else there will be a lot...

Words: 817 - Pages: 4

Medical Billing Process

...Medical billing is a process that doctors and insurance companies use. Doctors use the process to submit claims to insurance companies so they can be paid for their serves rendered. The billing process consists of 10 steps. These steps have been broken down into three different categories. The visit, the claim, and the post claim. The first category consists of the first four steps. The first step in this category is “The Visit”. During this step the patient is pre-registered. A returning patient or a new patient is pre-registered by making appointments for a future visit or an appointment to start serves. Each patient upon their visit is as asked for their insurance information and demographic information. Returning patients and new patients are to provide the facility with the medical purpose of the visit. Step two is to determine what the patient’s financial responsibility will be. The patients insurance usually has a set payment, which is usually 80/20. The insurance will pay 80% of the bill and the patient is responsible for 20% of the bill. For patients that are uninsured, the patient is responsible for all of the medical charges. Step three, the patient actually gets check-in. Returning patients are asked if all information is still the same as the last visit. Which includes insurance, address, phone number, ect. New patients are asked for all medical and insurance information. All patients are asked for proof of insurance cards and identification, which are......

Words: 722 - Pages: 3

トキの歌 | Decoder Satellitare Dvb-S2 Tivusat Humax 6800S-Hd Tivumax Pro 2 - Con Tessera | Malaysian Pop