Medical Billing Records - what it is

Medical Billing Records


There is a lot of paper associated with billing and it has to be organized and filed. Frequently when working on secondary or tertiary insurance claims, we have to retrieve the primary EOB. We also find it necessary to occasionally dig out an old superbill. It is very important to have and organized filing system. Otherwise you waste a lot of time looking for documents. Write Appeals A medical billing specialist may occasionally need to write a letter to the insurance carrier requesting payment for a denied claim. This is usually a letter with information such as claim number, date of service, provider identification number, patient group or policy number, why the claim is being appealed, and what action is requested. Responding to Patient Billing Questions

We get some interesting phone calls from patients sometimes after statement are sent out. When a patient has a question you have to look up their account in the medical billing software and explain their charges. Sometimes they are not too happy about it. We've learned to be patient and diplomatic when explaining a patient bill. Angry patients are actually very few - especially when the patient statement is formatted to be easy to read with good descriptions of the charges. For my largest practice we typically send out greater than 300 statements a month - and we might get one agitated patient every few months. Run Reports Doctors frequently want to know how their practice is performing financially. Most software programs have many useful pre-formatted reports that show a lot of useful information. Having a software with the ability to customize and filter these reports is very helpful to the medical billing specialist. It seems like every provider has a different preference for practice information. Working on insurance aging requires running an aging report. If the billing has been neglected this can be rather long.

Other Medical Billing Specialist Knowledge and Skills Most smaller practices do not have a dedicated coder so it's important to have some coding knowledge to be able to look up ICD and CPT codes and know how they are organized. Understanding managed care authorization and coverage limits is necessary when investigating unpaid claims. Some specialties, for example mental health and physical therapy, have limits on the number of approved visits. A medical billing specialist may be required to call and verify the number of authorized visits for a patient. We use our billing software to add reminder notes that pop up when the patient records are accessed to remind us and the front office receptionist.

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