Medical billing basics

The physician does not get paid for his services immediately after they are rendered. Majority of the patients have insurance coverage and details of such coverage are provided to the physician before treatment. It is the responsibility of the physician to submit claims to the insurance company and get paid for his services. Submitting Claims and getting paid is a lengthy process and involves a lot of rules and regulatory systems and is very complicated. The physician needs to adhere to all these rules before submitting claims. This is the concept of Medical Billing. Sometimes the physician cannot provide his entire attention to this activity. He entrusts this activity to Billing Companies. This is a process of the physician providing rights to Billing Companies to bill Medical Insurance claims in order to save his time and energy.

Parties in Medical Billing


There are three parties in the Medical Billing Process. The PHYSICIAN, The INSURANCE COMPANY and The PATIENT. The Physician in order to attain his

objective should comply with the rules and regulations spell out by various insurance companies in submitting claims and at the same time should not penalize the patient.

Role of a Medical Billing Company

Physicians appoint Medical Billing Companies to take care of their billing. The Medical Billing Companies should clearly spell out their duties and responsibilities in their agreement with the Physician. The agreement should also clearly state the process to be adopted by the Billing Office in carrying out the objectives. If there are any assumptions to be made it should be clearly stated and in case of problematic issues the course of action should be well defined and the responsibilities should be mentioned. The main objective of the Billing Company is to maximize collections.

3 comments:

Anonymous said...

Very informative blog.

Anonymous said...

Thanks..It's very informative and helpful..

sajan said...

Thanks 4 providing such a useful Information...............


Regards,
Sajan

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