Medical Billing and Coding – What Is the Process Involved
Medical billing and coding are important processes in any medical office. It involves assigning the correct diagnostic and procedural codes to various diagnoses and procedures recorded in the patient’s medical records and submitting the medical claims to insurance companies. These need to be done with absolute accuracy to avoid coding errors. Medical coding and billing services cover accurate recording and processing of patient data, including treatment records, insurance information, bills, and other relevant data. These services are a great support to individual physicians, physician groups, free standing diagnostic facilities, clinics, multi specialty groups, long term care facilities, acute care facilities and hospitals.
Medical billing services and medical coding services are available for almost every medical specialty such as emergency room, allergy and sleep medicine, infectious diseases, cardiology, behavioral medicine, neurosurgery, nuclear medicine, nursing, obstetrics & gynecology, occupational medicine, oral & maxillofacial surgery, osteopath, otolaryngology, pain management, and more.
Processes Involved in Medical Coding and Billing
Billing services include charge entry, recording and registering patient information (demographic entry), payment posting services, charge entry, appointment scheduling and rescheduling, insurance verifications and insurance authorizations; billing and reconciling of accounts, code checking and analysis, appeals, denial management, claims/patient billing transmission, AR follow-up, collections management, DRG/ICD-9-CM, HCPCS coding validations, CPT coding, medical coding audits, emergency room e-code evaluation and more.
Medical billing and coding tasks include:
- Demographic entry: Recording and registering patient information. In this process, the patient’s personal information is recorded as required in filing claims.
- Charge entry: This is all about booking the amount equivalent to services rendered.
- Insurance verification: In this process, the authenticity of insurance credentials provided by patients is verified. The insurance coverage will also be determined here.
- Payment posting services: Here settlements or payments from insurance companies are monitored and booked.
- CPT and ICD-9-CM coding: This involves applying the standard medical codes to services rendered to patients.
- Claims submission: It is the actual process of preparing the claim form and submission of the claim to the insurance company.
- Follow-up: Checking up on the status of the claim.
- Appointment scheduling and rescheduling: Here, patient appointments are scheduled. Those patients that have canceled their appointments or failed to appear as per schedule can be identified easily.
- Denial management: this has to do with claims that have been denied by insurance companies. Any corrections needed are made and the claims are resubmitted so that reimbursement can be secured.
Medical billing and coding services can help run your medical practice smoothly. Hire a medical billing and coding company that can provide customized services and enable you to access the services whenever you require them. You should also be able to maintain smooth communication with your chosen company. This will ensure that your practice functions uninterruptedly while you enjoy the peace of mind knowing that your services will be duly reimbursed.
About The Author
Outsource Strategies International, one of the chief healthcare business process outsourcing companies in the Oklahoma area is offering complete medical billing management services.
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