As we know that Healthcare is a very important part of our lives and as a result the Healthcare Industry is growing with every passing day and to make it better and more effective, Medical Billing comes into the picture.
Medical Billing plays an important role in the healthcare industry, ensuring that healthcare providers get paid for the services they are providing to the patients and it is also of great help for the patients as it helps them understand their insurance coverage and bills.
How medical billing and revenue cycle management works?
- So, the process of Medical Billing starts when a patient visits the doctor or a hospital. So, the front desk collects all the essential information like name, date of birth, etc., as this is important for billing and processing claims.
- Then, before the doctor sees the patient and provides treatment, the medical office checks the insurance coverage of the patient to ensure that the required treatment is covered under the insurance and if not then how much amount the patient will have to pay from his/her pocket.
- After the doctor treats the patient, the medical records are translated into specific medical codes, depending upon the kind of treatment patient took. Accurate coding is very essential to avoid claim denials.
- Once the process of coding is completed, the charges for the services provided by the doctor are recorded. The charges include the cost of consultation, treatment, medicines and everything.
- Then, the medical biller prepares a claim based on all the information mentioned above and then this claim is sent to the patient’s insurance company.
- Once the insurance company receives the claim, they then review the claim to check that whether the treatment is properly covered under the insurance or not. Insurance Company may pay the full amount to the doctor for the treatment or may pay partial amount or may even deny to pay any amount, maybe due to errors made by the medical billing company or due to lack of coverage.
- If the insurance company approves the full amount, then they send payment to the healthcare provider and if there is any remaining balance then the remaining balance bill is sent to the patient and the patient is liable to pay the pending amount from his pocket. But, if the insurance company denies the claim and does not pay any amount due to missing or wrong information, then the medical biller reviews the claim, corrects the mistakes, adds the missing information and send it again to the insurance company.
This is how, the process of medical billing works. Basically, a medical billing company is a connection between healthcare provider and insurance company. And to make sure that all these steps are taking place efficiently and effectively, it is very important to make the right choice while choosing a medical billing company. So now let’s focus on the Top Medical Billing Companies of USA.