The Medical Billing Process

The Medical Billing Process

Wendy May

HCR220

Sunday February 14, 2010

The medical billing process is a process that is followed by a medical insurance specialist. This is a ten step process that must be followed in order to get patient information and get payments processed through the patients insurance. The steps in this process are preregister patients, 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, follow up patient payments and handle collections.

The first step in the process is to preregister the patient. This is when the patient provides basic information such as name, number, and insurance information. This is also when appointments are scheduled. The reason for the patients visit is also recorded at this time.

The next step in the process is to establish financial responsibility for visits. This is basically when the patients’ insurance is verified. The insurance specialist checks to make sure what is and is not covered under the patients’ insurance plan. They also inform the patient of their obligations to pay their bill and their different payment options.

The third step in the process is to check the patient in. This is when new patients are to fill out detailed information sheets with all of their demographic information. Return patients are asked to verify their information. A copy of the insurance card is also made and if necessary the patients’ co-payment is collected.

The next step in the process is to check the patient out. The most important part of this is to check the medical codes for the patients visit. This is done to properly bill insurance and the patient for the visit. The charges for the visit and all the basic transactions are input into the patients’ ledger.

Step five in the process is to review coding compliance. This is when the...