What is Medical Billing?
Medical billing is the practice of submitting claims to Insurance companies or various government entities in order to receive payment for services provided to a patient by a medical doctor or other licensed health care provider. Medical billers usually work away from the public eye in the claims processing office, or in the billing department of a medical office, clinic or hospital. Many well trained and experienced billers set up their own home-based businesses. What is a Medical Biller? Medical billers are important members of the medical office team. Their vast knowledge, flexibility, and skill comes into play each time a patient is seen by a provider, a claim is coded, billed, and processed. Somebody has to do all that and keep track of what was done and abide by all the rules involved in the process. The medical billing career offers challenges, rewarding experiences, and good pay. People who pay attention to detail and have good organizational skills do very well in this busines
Typically, billing involves collecting needed data for completion of insurance claims forms (patient information, copies of insurance cards, and a copy of the superbill or encounter form, the form on which the doctor documents what kind of care was provided and the code to use for procedures performed and the diagnosis) and entering it into a practice management/patient accounting software program. Lytec, Santiago, Medisoft, and Altapoint are the names of a few reputable less expensive software vendors. By less expensive I mean less than $3000. See the “How to Choose Software” section for more information. Sometimes the Biller may also be required to verify patient benefits prior to the doctor providing care. The Biller must know the claim submission guidelines before submitting to an insurance carrier. Most claims will be submitted electronically but there are still claims that must be sent on paper. Therefore a Biller must know how to fill out an HCFA-1450 (UB-92) or HCFA-1500, the t
Medical billing is the process by which doctors and hospitals receive payment from health insurance companies. It also involves resolving any disputes and following up on claims that have been delayed or rejected. Medical billing is a complex series of procedures that require a great deal of time by skilled professionals. In fact, large hospitals often have an entire department dedicated to billing. The medical billing process is vital to any health care organization; hospitals and medical practices cannot operate without payments from insurance companies. When you visit a doctor’s office or a hospital, a detailed record is kept of any tests, procedures, or examinations that are performed in the treatment of your condition. Any diagnoses made by the medical staff are also noted. This is your medical record, and it provides information necessary to the billing process. After you provide your insurance information to the doctor’s office or hospital, the medical billing cycle begins. Befo
