What is Medical Billing?
Medical billing is the practice of submitting medical claims to health insurance companies or the U.S. government in order to receive payment for health, medical, or preventative care services as well as supplies that were given by a doctor or a licensed health care professional.
Medical billers can work in physician’s offices, hospitals, insurance companies, outpatient care centers, and nursing homes.
An individual working in medical billing, or a medical biller works to bill for health or medical care services, equipment, consultations, medications, and supplies. This is done by sending claims to an insurance company, posting payments, following up on claims, responding to requests about a claim, or discussing a denied, pending, or reviewed claim with a patient. The work is done systematically to bill and collect fees for care given to a patient.
Medical billing is a part of the business aspect of the health care industry. The work between medical billers and physicians, lawyers, managers, or medical coders does not have much overlap. Instead, they are responsible for much of the administrative and billing work from a health care provider.
Some of the work involved in medical billing includes:
• Handling co-payments
• Collecting and managing accounts receivable
• Managing claims denial appeals
• Organizing medical bills and statements
• Negotiating with various collection agencies
• Speaking to insurance companies on behalf of a client
• Understanding an office’s billing routine and a patients insurance company policies
Most standard medical billing services provide
• Claim Submissions: Submitting claims that include patient information, encounter information, and insurance information that then get stored in a database.
• Following up on claims: Medical billers follow up on claims until they are completely paid, this allows more claims to get approved in a shorter time.
• Patient billing and answering inquiries: Medical billers are responsible for handing the logistics of billing while handling any patient questions
• Extended billing services: While these services may not be involved to invoicing, they can include
o Medical transcription
o Practice management services
o Credentialing insurance companies
o Diagnosis and procedural coding
o HR management services
In order to start working in the medical billing field, the medical biller must have adequate training in Medicaid billing and coding, medical bookkeeping, basic insurance, medical law, and procedural terms. Along with this, a medical biller needs to be familiar to the various plans provided insurance companies.
Furthermore, anyone working in medical billing must also have basic office knowledge, know how to use a computer, understand medical practice management software, and be able to provide good customer service.