Medical Billing Services
Outsourced and online medical billing services
In the medical industry, billing is a complex practice. It requires specific knowledge and training that many health care providers and staff don't have. Secure, accurate medical billing is an important part of the healthcare and insurance industry, so working with a medical billing company is generally an accepted part of a healthcare professional's day-to-day activity.
While most medical billing companies will take all the work out of your hands, it's important to be familiar with the process. Knowing how medical billing works and the services that a medical billing company can provide will help you monitor your claims and better understand patient care.
What is Medical Billing?
Medical billing is the method health care providers use for submitting medical claims to health insurance companies and following up to receive payment. When a patient is evaluated by a physician, information on the nature of the illness, the examinations conducted, the medications given and other pieces of important information are recorded. This information is then evaluated to determine the appropriate level of service and is passed on to the medical biller (either in person or electronically for online medical billing services. The medical biller will translate the information into a numerical code known as a "procedure code." The diagnosis is also translated into a code and will be used in the billing process.
Once the codes are determined, the claim is passed to the insurance company electronically. The insurance company will process the claim and reimburse the designated percentage of coverage for the services that were billed.
Medical Billing Consulting Services
While it is possible to do medical billing on your own, most health care facilities will work with medical billing services (also known as medical claim billing services). These services are staffed with professionals who are certified after taking the Certified Medical Reimbursement Specialist Exam.
Providing billing services for medical practices is challenging, because many patients either can't or don't want to pay for their procedures once they are done. If you're hiring a medical billing service, you'll want to make sure they have a good success rate for collecting claims. You'll also want to look at factors like turnaround time and technology used to ensure claims are secure, error-free and delivered in a timely fashion. Finally, you may want to see if the company offers any other services, such as medical transcription services, which might benefit your office.