Healthcare system in the United States is a trillion-dollar industry, which consists of pharmacies, pharmaceutical companies, medical equipment manufacturers, and medical care services. Millions of Americans, running on a day-to-day basis relies on specialized professionals tasked with controlling these processes. One such system is the medical claims procedure. The processing of a medical billing claim can look like a long and difficult project; however, we are here to break it down into a simple and easy to understand some steps.
First Step:
The first step of the procedure begins with the patient. When the patient arrives at the provider’s office they will require to hand their insurance card over and then complete the doctor’s demographic form. It is essential that all their details are filled in correctly as the demographic form contains pertinent info regarding Social Security or driver’s license details; the name of the actual policy holder as well as any extra and essential information about the policyholder if they differ from the patient; and other basic info such as patient name, age, address and contact details.
Second Step:
When the demographic form is complete – as well as any other essential paperwork – the patient then sees the specialist and the services required are administered. It is during this procedure that the doctor must record all the various billable services that they rendered to the patient.
Third Step:
Once the provider has detailed all the billable services they administered the details are passed on to the coder who must then extract the applicable billable codes that will properly reflect the services rendered.
Four Step:
Another step in the process is sending the billable codes to the medical biller. It is at this point that the codes are inserted into the appropriate medical claim form provided by the medical billing software. Once the codes are put into software, the claim is then mailed for payer reimbursement to what is well-known as a clearinghouse or even directly to the payer.
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Nice blog. Thanks for sharing it. Approaching a Outsourcing Medical Billing company to perform medical coding process for healthcare organization can reduce the operating costs. Outsourcing medical coding process helps physician to be less stress and will not be burdened with extra work and allow to focus more on patients care.
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