Important Steps in the Medical Billing Process

Important Steps in the Medical Billing Process

what are the steps in the medical billing processProper medical billing is extremely important for healthcare revenue cycle management and to avoid facing challenges when billing patients, healthcare companies and insurers for services rendered by a healthcare professional or hospital. Therefore, effective medical billing is essential for making sure that the providers are reimbursed appropriately for their services and that it is completely in a timeous manner. There are four important steps in the medical billing process that need to be adhered to in order to provide an efficient billing service.

Capturing patient information correctly

The first step in making sure that medical billings do not get rejected is making sure that all the patient’s details are captured correctly and according to how the patient’s medical insurer has done so. This process begins when patients make their appointment or present to the staff of the service provider. Correct patient details need to be collected by the staff as well as copies made of the medical insurer card which needs to be added to the patient file for ease of reference. There’s nothing more frustrating that medical billings being sent back because the patient details are not captured correctly. This adds to the time before the provider is paid for their services and it also results in additional fees that need to be paid by the provider.

Informing the patient of their financial responsibility

The next step in effective medical billing includes informing patients about their respective financial contributions that need to be made, if applicable. There are insurers who don’t cover all the medical expenses of a particular service so it remains the responsibility of the patient to settle such outstanding fees. A clear notice needs to be made in the service provider’s office or on the invoice statements supplied to the patient. Failing to do so will result in loss of income for the provider because the patient will not accept liability for any outstanding fees that they were not made aware of.

The use of automated medical billing systems

Manually submitting a rejected claim should be a thing of the past especially with the availability of automated medical billing systems. Not only do these systems cut down on the time spent resubmitting claims, but before a claim is initially submitted these systems will notify the person entering the data that there may be a potential issue that may result in a rejected claim. This also helps to curb losses attributed to unnecessary submission fees that get charged to the provider.

Avoid entering inaccurate billing codes

The last step in the medical billing cycle is to avoid entering incorrect billing codes. The ICD-10 codes that have recently been implemented to replace ICD-9 codes have proven to be a more effective and easier billing code system to follow. This has helped to prevent submitting the wrong billing codes for procedures as well as incorrect hospital billing codes, but there are still some inaccuracies that can be addressed. Certain areas that need improving include entering the correct 7th character for trauma and fracture codes, the mistaken use of guidance tools, inadequate documentation of devices and components used by providers, and misidentifying conditions such as respiratory failure. Frequent training in ICD-10 code updates and submitting such codes should be mandatory for individuals and companies that provide medical billing services.

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