An insight to medical billing services

1. A medical billing service is the process of submission of medical insurance claims to the insurance companies in a specified format. Claims are prepared according to the services rendered to the patient by a recognized or credentialed medical provider. This whole process of claim submission up to reimbursement is also termed as RCM or revenue cycle management. The RCM cycle may be briefly defined as the process of generating profit out of a business operation. Here the business operation is a medical billing service. It is a step by step process also referred to as an AR (Accounts Receivables) follow up process.

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3. A medical billing process involves several steps: • Medical Transcription- the entire recorded conversation between provider and the format is converted into a readable format. • Coding- A team of CPCs (Certified Professional Coders) assign codes to the services rendered on basis of the decoded format. • Insurance verification services in healthcare- involves the process of verifying the eligibility of a patient’s coverage with the insurance provider company. • Claim Submission- involves preparing invoices/ sales orders and then submitting the claims via mail, electronically or through fax medium. • AR follow up services- This step involves the follow up process on the partial payments or denied claims or may be over the claims whose status is still unknown.

4. Insurance Verification Services in Healthcare These services are meant to verify the status of the patient’s insurance coverage. These services allows medical practices to forecast the total patient responsibility amount for the services rendered. Insurance verification services provide advanced protection in cases where the patient is unsure about the coverage and helps in avoiding related denials. It is more of a way to deliver excellent customer service and educating patients on their insurance coverage.

5. This phase involves the identification and analysis of the claims listed on the claims aging report. The claims that are processed and paid out, have some balances outstanding in terms of patient responsibilities that need to be adjusted off. After the required adjustments, the claim invoices are closed. For the claims, that are still unpaid or whose status is still unknown are followed up with the insurance companies. There are some denials due to the unforeseen or unexpected reasons that need to corrected and re-submitted on time so as to obtain the payments. This step also involves updating the payment details over the electronic billing software so that it may be used for any future references.

6. Medical billing services for small practices can become complex and time-consuming. It becomes difficult for them to concentrate on their main task- patient care, and simultaneously take care of all the billing chores. Outsourcing is said to assist medical providers in handling the business related tasks efficiently and helping them grow their business. It has several advantages as it helps in reducing the expenditure associated with billing services plus it saves time and valuable resources as well. It is also said to improve patient satisfaction levels to an appreciable extent and at the same time grants full control of the business processes. Proved to eliminate information security related risks and provide scalable services at an affordable cost.

7. US Office 99 Wall Street #158, New York NY 10005 Medical Billing for Healtcare: +1 800-935-0865 General Queries: info@bikham.com Health Care: healthcare@bikham.com