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Medical billing encompasses numerous processes through which doctors and hospitals receive money from health insurance companies. However, medical billing stands for providing services which settle disputes and deal with delayed or rejected insurance claims as well. Since all this work demands to be handled by trained and qualified professionals, many physicians and health institutions have separate departments which handle all the medical billing work, keeping records about your medical insurance the moment you hand the necessary information on the matter to your physician.

The Process of Medical Billing

Once you hand in the information about your medical insurance, before a bill gets submitted, it needs to be coded. This involves giving an alphanumeric code to each service and procedure done by the medical billing handlers. Depending on the medical billing software, these codes can be given automatically or manually, obeying officially accepted systems of coding. When the process is done, the bill is sent electronically or by fax or regular mail.

After the insurance company receives and checks the bill, accepting it as valid, it allows to cover the predefined expenses, depending on the type of the policy the patient has and the doctor or medical institution he/she is in. Most insurance companies have their own lists of medical service providers and, by opting for people and institutions from these lists, clients get discounts or special offers.

Having sent the result of the claim, the insurance company has either accepted it or denied it due to failure of meeting the necessary requirements. If a claim is denied, the billing service checks it again, seeking errors or inconsistencies, correcting it and resubmitting it again. Naturally, if the claim has been accepted, the medical billing service handles the payment procedures and the coverage of medical expenses.

Find a qualified Medical Billing Provider

A good medical billing provider needs to possess all the necessary “tools” for handling the above mentioned processes.

First of all, he/she should be capable of carrying out medical transcription processes, transferring medical information such as diagnosis or interviews to an audio format, saving it for future reference in an electronic format.

Secondly, he/she needs to be familiar with the coding processes and certifications, following proper medical coding standards.

Finally, a good medical billing provider has to possess a good medical billing software, capable of handling all the data you have successfully, including the process of keeping medical records electronically, sorting them, storing them and backing them up.

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