Steps in Medical Billing

Steps in the Medical Billing Process

HCR/220

January 26, 2014

Steps in the Medical Billing Process

The medical billing cycle is steps that lead to maximum, appropriate, and timely payments for patients’ medical services. In order for a medical insurance specialist to complete their duties and contribute to financial success, they must follow a medical billing cycle.

The first step is to pre-register a patient which involves scheduling or updating appointments. If new a patient is calling, a scheduler must obtain preregistration demographic and insurance information in order to determine payment as well as medical reason so they may schedule the appropriate visit.

The second step in the medical billing cycle is one of the most important steps which are to establish financial responsibility. It is to determine financial responsibility by collecting information from the patients about whether they have a specific health care plan or if they will be paying for services and their responsibilities for paying the charges that the health plan does not cover.

The third step is to check in the patient and to collect detailed demographic and insurance information. This includes photocopies of the front and back of the insurance card along with driver’s license for new patients, and to review or update current information on already established patients. This is also the point when payments are due, copayment, a previous balance, or fees for non-covered services.

During the office visit, the doctor will examine, diagnosis, and treat the patient while documenting their condition. After the visit is when step four should be completed which is reviewing coding compliance. After the doctor performs their duty, the diagnoses and procedures must be assigned medical codes in order to submit this information to the patient’s insurance provider so they may receive proper payment for specified procedures and evaluation.

Step five is to review billing compliance. At...