Medical billing is a complex series of procedures that require a great deal of time. You must be a well-trained professional to follow the procedures. It is the process by which health care facilities get payment from health insurance companies. The medical billing process is a vital part of the health care industry. No medical facility can operate without payment.
Patients are billed for any tests, procedures, or exams they have performed for them by the health care provider. As a trained medical billing specialist, you will know how to extract all information needed from a patient’s medical record to properly bill their insurance company. Once you extract the information from the medical record, the billing process begins.
After the medical record is coded the billing specialist submits the claim to the insurance company for payment. Once it is submitted the insurance company either sends payment to the health care facility for the provider or they send a denial notice meaning they denied the claim. If the insurance denies the claim. The provider and the billing specialist must go over the claim to ensure there are no errors or missing information. If so, corrections must be made and the claim must be resubmitted. It may take several times before the claim is paid.
Once the claim has been paid to the provider it is up to you as the billing specialist to send a bill to the patient for any out of pocket cost the patient may have.
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