The medical billing process and the cash inflows are directly correlated in a healthcare business. To run a healthcare business, you require more cash inflows than your expenses. The expenses of the healthcare facility may include overhead charges, staff salaries, system installation and updating, hiring, training staff, etc. The resources of the cash inflows are claims reimbursements, the Patient fee paid in cash, a fee for the medical test etc. To maintain the equilibrium between expenses and cash inflows, you must streamline the medical billing process. Outsourcing medical billing company can be a good option to streamline the revenue cycle management and accounts receivable. It can also help you minimize minor losses incurred due to negligence or human error.
Using a calculator by a healthcare professional
Medical billing is a set of procedures performed by billing specialists to ensure that medical practitioners are compensated for their services. The medical billing process may take a few days to finish. The time of completion of the medical billing process may be prolonged to several weeks or months, depending on the conditions. While the billing process in each medical office may vary substantially, here is a broad outline of a medical billing system.
The following are the steps of the medical billing process.
Registration of Patients
The very first stage in any medical billing process flow is patient registration. Registration of patients includes the collection of basic demographic information a patient, such as a name, birth date, and reason for the visit. A patient file is built using this information that will be referred to during the billing process. Gather Insurance information, including the insurance company’s name, the services they cover. Medical billers verify the patient’s policy number and the patient name. Create a patient file that includes the complete data. A medical biller uses the recorded data for invoice reference. A medical billing company can streamline every step of your billing process. The best medical billing services providers are equipped with professional medical billers and coders, AI-enabled tools and software, and customer relationship professionals. Hence, they provide you with a complete set of services right from the starting point of your billing cycle.
Taking Care of Business
The second step in the procedure is to determine who is responsible for the visitor’s financial costs. This entails reviewing the patient’s insurance information to see whether the insurance covers procedures and services during the visit. Notify the patient that they will be responsible for the charges if any procedures or services are not covered. Your front desk staff will be responsible for customer dealing. Aid them with a cloud-based EHR. A cloud-based EHR will support them in recording the necessary information, sending reminders to patients and providers, avoiding duplication etc.
Ask the patient to fill out paper work for their file during check-in. If this is a follow-up visit, to confirm or amend information that is already on file. Carry out Identification of the patient. Medical billing is a set of procedures. Billing specialists process claims to ensure the compensation for the services of medical practitioners.
You can get the Identification, as well as a valid insurance card, and collect co-payments. A medical coder converts the health information from the session into diagnostic and procedure codes once the patient has checked out.
Then, utilize the collected information to create a “super bill” report. The Super Bill report will contain information on the provider and clinician, the patient’s demographics and medical history, the procedures and services delivered, and the applicable diagnostic and procedure codes.
After that, the medical biller will use the super bill to create a medical claim sent to the patient’s insurance carrier. After producing a claim , the biller must review it thoroughly to ensure it complies with payer and HIPPA requirements. Outsource a medical billing company to create, submit and get your claim clearance. A medical billing company has human resources specialized in coding and billing.
Submission of Claims
Check the claim for correction and compliance. The next step is to submit the claim. Usually, Send the claims electronically to a clearinghouse, a third-party company that functions as a mediator between healthcare providers and health insurance. This restriction clearing house does not apply to high-volume payers like Medicaid, which will receive claims directly from healthcare providers. You can outsource one of the best medical services providers to help claim submission easily and accurately. Outsourcing a medical billing company will reduce the burden on your staff. At the same time, their professional billers and coders create accurate bills increasing the chances of claim clearance.
Keep a close eye on how the “claim process”.
Judgment is the process by which payers evaluate medical claims to see if they are authentic and compliant and, if they are, how much they reimburse the provider. The claim could be validated, denied, or declined during this stage. Insurance company compensate the claim after the requirement are complete.
You must fix the error due to a rejected claim before resubmission. Insurance companies will not pay for the denied claims.
Preparing a Patient Statement
After the claim process, the patient must pay for any nonpayment. Patient insurance covers A full account of the operations and services done, their prices. The statement includes that is payable on the account of patient.
Follow-up on the Statement
Ensuring payments is the final step in the medical billing process. Follow-up with late payers is the obligation of medical billers. If necessary medical billers refer accounts to collection agencies.
Outsource the complete process.
Outsourcing a part of billing services like free EHR features will help you to understand the level of AI-tools that a medical billing service provider is using. Based on the experience of free services you can adopt the option of outsourcing more sections of your revenue management cycle
Outsourcing the complete process to a medical billing company helps you to streamline the medical billing process. You can partner with a company like BellMedEx to access trained and up-to-date coders and billers, who can help you submit, follow up and take care of your revenue management cycle and accounts receivables.