Medical billing is a process for things at your medical practice to actually run smoothly and go as planned. But when this happens, a claim is created and it has to go through the process instead of going though one or more steps.

This will speed up the time it takes for a claim to get paid. That is why it is important to work with the best medical billing services in this field. Unfortunately, many people simply think that they are experts even when they are not. Just in case you are not sure whether your practice has everything under control, here are the process for a successful medical billing process.

Patient Check-In

The very first stage of a patient’s appointment should include the notation of the patient’s demographic information as well as information about his/her insurance, like the insurance payer and policy number. Any information that will be useful and necessary in a claim situation should be detailed at patient check-in.

Eligibility and Verification of Insurance

Many regular patients need to verify their information and eligibility before every appointment. Insurance information can change at any time, this is why you need to ask patients before every visit if their insurance information has changed.

While a change in insurance information can impact benefit and authorization information, so it is always worth the trouble of double-checking.

Diagnosis, Procedures, and Modifiers for Medical Coding

The correct coding of claims is important for informing the insurance payer of what exactly the patient is being treated for as well as the method of treatment the patient is undergoing.

Also, be sure to use the correct diagnosis codes to describe the patient’s symptoms or illness and the correct procedure codes to describe the patient’s method of treatment.

While using accurate CPT and HCPCS code modifiers to provide additional information about the service or procedure performed. However, only the insurance payer can make an accurate assessment if they know the correct codes.

Charge Entry

Charge entry refers to entering the charges for services that the patient received. This includes the appropriate linking of medical codes to services and procedures rendered during the patient’s visit.

Submission of Claims

After the claim has been properly completed, it must be submitted to the insurance payer for payment. On the other hand, medical billers need to have access to the information that they need about the insurance payer, as there are so many variables for each insurance payer in determining how and when to submit a claim.

While most of the companies follow a standard set of guidelines for billing. However, there are some payers who have other ways of doing things. Certain aspects of medical billing are payer specific, so it is important to check each payer to make sure that you are accurately following their rules and regulations for claim submission. Further, there are certain medical billing services in USA such as AMBSI that follow all the rules and regulations during a claim submission.