When you’re helping take care of lives and even potentially save them, some of the more necessary and administrative details may fall through the cracks, such as medical billing, a necessary step that needs to be taken by all patients, and usually is the responsibility of the hospital to initiate. In a hospital that sees hundreds of visits every day, keeping accounts and making sure the medical billing and patient billing all gets taken care of can be a major headache, particularly if their administrative staff is overworked. In these cases, it might be in the hospital’s best interest to look into medical billing resources, that can help them take care of these matters.
What Is Medical Billing?
Medical billing is a procedure that revolves around sending in and checking in on health insurance claims submitted to insurance companies, so that the healthcare provider can receive payment. This also usually involves medical coding, as an extra step in checking that everyone gets paid properly. Medical coders review each record submitted, assign it a particular code in the system, and them make sure that the healthcare providers are appropriately compensated for the work they completed. The whole process can take a significant of time and involves a good number of people.
With the graying of America comes more hospital visits. Indeed, the Centers for Medicare and Medicaid Services predict that by 2020, almost $50 billion will be allotted for national healthcare. This means an uptick in jobs as well; the U.S. Bureau of Labor Statistics predicts job growth for medical transcriptionists will be over 10% and health information technician positions will be up 20% through 2018. This also means more claims will be coming and hospitals will want to make sure they have the right medical billing resources at their disposal to handle the influx.
What Are Some Of The Steps In The Process?
Amazingly, in an average healthcare system, one medical billing process can pass through as many as 250 different hands — from the office with the nurse to the medical coder. It always starts with the physician, their personnel, and the patient. The patient’s record gets updated, marked with a diagnosis and procedure code, which helps the insurance company figure out how much they owe. It then gets sent to the insurance company electronically. It’s then the insurance company’s job to process the paperwork, using medical claim examiners or medical directors. They assess the claims based on a number of factors and if the claims are marked as okay, the healthcare provider is reimbursed for a percentage of the bill that have already been negotiated between the two parties. If the claim is denied, the healthcare provider is informed immediately and must be corrected, and then resubmitted. The claim will either get completely accepted, or the provider will have to take a partial reimbursement.
As you can probably tell, there are a number of steps involved in the process and it can take months to complete one billing cycle. It’s important for health care providers to have good medical billing resources on hand to deal with claims as speedily as they possibly can.