What Is Medical Billing? Process and Management Explained

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What Is Medical Billing? Process and Management
Explained
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• Medical billing is an important process within
  the healthcare industry and represents the method
  in which healthcare providers get reimbursed for
  their professional services rendered. The process
  involves the translation, by way of standardized
  codes, of a patients medical records submitted
  as claims to insurance companies for
  reimbursement of provided services.
• Knowledge of medical billing for small owners of
  medical practices is important for the
  maintenance of financial health and operational
  fluency.

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Understanding the Basics of Medical Billing

• Put simply, medical billing involves the
  conversion of medical services provided by
  healthcare providers into a bill claim. It goes
  as follows
• 1. Patient phones up to make an appointment
• 2. Patient registration, where they give personal
  data and insurance details
• 3. The medical services are provided to the
  patient.

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• 4. Detailed records of the visit of the patient,
  along with the diagnosis and treatment, are noted
  within the patients medical record.
• 5. Finally, medical coders assign standardized
  procedure codes to every service performed. The
  process by which this is done is called medical
  coding.
• This step is crucial because these codes will
  convey certain information about the patients
  visit to the insurance companies. Precise coding
  is what guarantees that the healthcare provider
  gets adequately reimbursed for their work.

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The Importance of a Medical Biller

• Medical billers are important in the circle of
  healthcare services. They take care of filing the
  coded claims with the insurance providers, follow
  up on outstanding claims, and are responsible for
  the receipt of payment by the healthcare
  provider.
• To go about their work, the medical billers have
  to be aware of the nuances of different insurance
  coverage plans and all those minute details about
  health insurance policies.
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