The sole purpose of outsourcing medical billings is to provide ease to doctors and all medical professionals. Billing Methods and You, Is Medical Billing as easy as One-Click Pay? It takes all your hassles away and gives your burden to a team of experts. Although the method is simple and detailed at the same time, it does take time. It can take some days to weeks and months depending on the authenticity of claims and submissions.
Let’s take a look at the procedure in detail to get a glimpse of it.
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Registration of patient:
The first step is to gather all the information about the patient containing its name, date of birth, medical history and everything related to and needed for an insurance claim. The data of insurance providers and policies is also acquired. All of this is documented in a file to get the process started.
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Checking finances:
The financial stability and condition of the patient are checked for the second step. This step covers the insurance policy and eligibility criteria for the patient. The patient is made aware of all the costs and insurance coverage clearly.
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Report production:
The schedule and information of patients are double-checked in the file. All the insurance information and payment verifications are collected. A report often called a superbill is produced after the visit of the patient and all the Information gathered is added to it. It contains all the information about the practitioner as well as the patient.
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Claims Generation:
The super bill is used to generate the proper medical billing claim for the insurance company. The bill is then made sure to be compatible with HIPPA compliance, appropriately coded and all the standard guidelines are truly met.
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Claims Submission:
Mostly claims are electronically submitted after all the verifications. The outsourced organization works as a bridge between health care providers and the insurance company.
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Claim verification by the insurance company:
The insurance company verifies all the information provided by the outsourced medical billing company by themselves for the sixth step.
The exact amount of insurance payment and facilities and insurance coverage is determined and documented. The claims are accepted, rejected or denied in this step.
The selected or accepted claims are paid by agreeing to the given data and insurance policy. The rejected claims are sent back to the medical billing company or health care provider to remove errors and submit them again. A denied claim cannot be submitted again because the client was not in compliance with the eligibility criteria.
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Client’s knowledge:
After the respected progression of the insurance claim, the client has billed for all the changes that are beyond the coverage of insurance. The patient or client is told each and everything. They have given a list of every service & cost, the insurance coverage and the remaining amount.
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Process continuation:
And for the last step, the medical billing companies always keep a check on the ongoing process and make sure all the processes are going smooth and the bills are paid.
These points must be enough to clear your doubts about outsourcing your medical bills. Book an appointment now to get these facilities for yourself too!
