Billing Procedures

Billing Procedures
Paula Rose
December 18, 2011
Fonzette Mixon

Billing Procedures
Most health care facilities have implanted the billing procedures as well as providers of insurance, so both can follow through with the process to obtain a fee for the treatment given to a patient.
The first procedure is “pre-registering patient,” these five tasks includes scheduling, updating appointment, collecting demographic on the patient, collecting coverage information, and reason for the appointment. The next procedure is “determining the patient financial responsibility,” this involves checking coverage, determining a first payer, if patient has two insurances, and accommodated payer terms, such as correct procedures followed and obtain approval for a specific medication. The next procedure is “checking patient in,” if a new person, a complete coverage and medical data is accumulated, for a repeat person, he or she needs to check the data and change if data is incorrect or different. Make sure to get a copy of the person “photo Id” and copy of insurance coverage; then patient’s needs to fill out medical forms and co-pays are rendered then or later. The next procedure is “check-out procedure,” this means every appointment, condition, and medical care is noted and has an “ICD code.”   These “ICD code” is need to process data, revise a person chart, and provide a request for payment from the provider.
The next procedure is “reviewing the coding compliance,” these are an instruction which needs to be accepted to communicate to payer the necessity of services rendered. The next procedure is “checking billing compliance,” this says that for every charge there must be a fee associated and must relate to a specific “ICD code.” The next procedure is “prepare and transmit claims,” this vital step is important because a “claim” must communicate data about a diagnosis, procedure, and charges to payer. The next procedure is “payer monitor adjudication,” this means a...