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EMR EHR Billing Solutions: Understanding the Benefits of Medical Billing

Medical billing is a method of healthcare system payment practice in the United States, involving submission and follow up of claims by a healthcare provider to the insurance companies to receive the right payment for the rendered health care services such as diagnostic procedures, treatments, laboratory examinations, investigations, and medications. The professionals who are in charge of processing patient information are called medical billing and coding workers.

 

The primary objective of medical coding is to help healthcare facilities to be reimbursed or billed efficiently and correctly, and they are also used in diagnosis and treatment, tracking the spread of a disease or testing the effectiveness of a particular medical procedure. The three parties involved in the medical billing process include the patient, the healthcare provider, and the insurance company. It is the job of the medical biller to process negotiation and arrangement for payment between these parties. The medical biller makes sure that there is proper compensation for the healthcare provider's services by billing the payers and patients. For the correct billing to be executed, the medical biller gathers all of the patent's information relating to his condition, medical code procedures done and compiles everything into a bill presented to the insurance company. The insurance company treats it as a claim, with the demographic information of the patient, his medical history, and his insurance coverage, along with the report of medical procedures done and the reason they were performed.

 

Medical billing at this site directly overlaps medical coding in the creation of a claim, wherein medical billers use the codes for diagnosis and procedures that medical coders used in order to create a claim. The medical biller ensures that the claim complies with the insurance company's rules and policies and that the claim us correct and factual. This process is complicated requiring an in-depth knowledge of allowable and valid claim so that the payer can do a full evaluation of the procedure and make a decision about the amount that needs to be reimbursed to the healthcare provider.

 

Once the claim is approved, it is then returned to the medical biller with the amount the payer pays, and the biller takes the balance and sends it to the patient. For more information about medical coding, medical billing, and patient billing, feel free to visit our website or contact us directly so we can help you get these services.

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