Medical Billing

Hospitalization and treatment go beyond a happy patient and a satisfied doctor. The expenses involved are also not confined to the drain in the patient’s purse, but stretches towards the listing and recording to every minute expense detail involved in the treatment of each patient, every day and through the years! Truly a gigantic task! Medical billing is a very important part of any treatment, anywhere in the world. From the time that the patient becomes an in-patient with an entry with the OPD or out-patient department, till the dispatch papers are ready, the procedure involves the perfect co-ordination of various departments and a management team.

Now, many hospitals either outsource this work or exploit the time saving applications of dedicated software to take care of the nitty-gritty involved. These resources help the management to assimilate the necessary account set-up input and keep a record of the panel of physicians involved, the Tax ID’s and passwords. All this is secured onto a network with the help of the state of the art advanced encryption technology. Medical billing involves the arrangement for the conversion of the existing medical data. The data conversion to the billing software is essential for the maintenance of records. The process also involves the access to the data on the physician’s office computer and file-transfer.

The medical billing services enable the physician to access detailed billing information. This is taken care of by the Account Executive, who configures the data on the office computer. The billing information is processed via a file-transfer system, to electronically transfer the super-bills and EOBs. The procedure also involves the preliminary training of office staff to use the system. The process is taken care of by the Account Executive via additional assistance that is further enhanced with technical support available 24/7. The medical billing involves the recording of a variety of financial reports generated by the various departments involved in the treatment.

It is essential that the management co-ordinates roles and functions between the various departments while applying the medical billing process. This results in the access and processing of the accounts and a free-to-concentrate-on-receivables staff. The configured and installed accounts are then processed by the medical billing specialists. The procedure is important to any clinical set up for it to function professionally and cover the basic expenses occurred, per patient. The patient demographics are entered into the billing system and transmitted via electronic medical billing claim or by regular mail claim, to the insurance company. This culminates in the timely coverage of insurance claims and dues in cash from the patients before being officially discharged.

The process also involves the receipt of audit reports and acknowledging the notification of errors or omissions in the claims made. This enables the authorities to track unpaid medical billing claims and resubmit any EOB not received within 30 days of the last billing date. The medical billing also includes a dedicated follow-up with the insurance companies after the base period and claims for denials, follow-up calls with the medical insurance resources and inter-departmental contact in the event of missing information. On the completion of the base period of 180 days, the department prepares the patient aging report to decide on the next course of action.

The medical billing procedure also involves record keeping of all the payments received. The billing service enables the management to access a complete and comprehensive review of the fee schedule and an understanding of the charges versus payments by the different insurance companies. This enables them to come up with a workable strategy. The procedure, if well maintained and applied helps to reduce the accounts hassles for the healthcare providers. The process allows the healthcare professionals to convert today’s excesses and denials into cash. However, appealing for denials is just a small fraction of medical billing. It involves dedicated help to physicians, hospitals and clinics to solve late insurance payments and bills that can go haywire, if not addressed on time.