Eight Steps of Medical Billing Process

Like medical coding, medical billing California might seem vast and complicated, but it’s a process that’s composed of eight simple steps.

The Steps Involved in the Medical Billing Process

Patient Registration

• The medical billing process begins from the front desk. As soon as the patient calls, the front desk officer will seek the patient demographics if the patient has previously been registered. If no previous information about the patient is seen then the patient’s demographic information needs to be registered carefully which covers name, address, SSN, insurance information and the reason for the visit.

Insurance Eligibility Review and Authorization

• As soon the patient gives insurance information and the reason for the visit, it is now one of the most crucial stages of the medical billing process that is to review for the eligibility of the patient for medical services. There are many types of insurance plans and all of them vary in numerous ways. 

Patient arrives

• When the patient arrives for the registered appointment, the front desk officer proceeds by confirming the information which can be insurance card and verifying with a personal ID.

Coding

• There are two types of medical codes used to provide medical bills: ICD-10 (International Classification of Diseases) and CPT (Current Procedural Terminology) codes. ICD codes are used to represent the patient’s diagnosis and CPT codes detail the clinical procedure conducted by the physician. 

Charge Entry

• Charge entry is the step in the medical billing process when medical billing specialists assign the dollar value as per the service fee.

Claims Submission

• Once the medical billing expert verifies the accuracy of the claims, they become ready to submit. Mostly, medical claims are submitted electronically and insurance companies have a different schedule for claim submission. 

Medical Billing and Collection Method

• Medical claims adjusters review the claims and release the payments after a certain period or if they find some problem with the claims, they send it back with the reason for the denial.

Payment Posting

• Making sure that the provider has been correctly paid is the last step in the medical billing process. If the payment meets the claim, they are posted or the remaining balance is invoiced to the patient.