Medical billing process - The Creation of a Claim

Charge-entry is one of the key departments in Medical Billing. Key department?? Yeah, that’s true. It is the keying-in department in Medical Billing. After receiving the super bills from the Doctor’s office, it gets passed through the coding & pre-coding department, and then comes to the charge-entry department. It is only here in this department, the claim/bill is actually created. The charge-entry person creates an individual account for every patient demographics that comes for the first time, and also assigns individual account #for the same.

A patient account # is a unique number (For example) 9 digit # created for our own internal reference, and for our record purpose. These 9 digits are segmented as per their relevance. The first two digits represents the company #, next three digits are for the Julian date (it is the number of days counted from January 1st till the current day), next one digit for the year, last three digits for patient serial #. It is one of the important aspects of charge-entry, which helps us to access any patient’s account easily in the software. Then, as a non-stop person, he looks into the patient demographics, and enters the patient’s information, Insurance information and Doctor’s information (tax id #, Upin #, Facility address etc) in the software, and thus makes a particular patient’s account accessible with complete information as and when needed.

A Charge-entry person also has one other vital role to perform. That is, to look-up the codes entered in the claim, and to assign the relevant charges for those codes. This is also one of the key functions in Medical Billing as there should not be any up billing done by assigning an incorrect charge for the codes. Likewise, he does a commendable job by entering all the relevant information needed, and creates a claim ready for auditing, and then for transmission to the insurance company


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