Medical Billing Process

Steps in the Medical Billing Process
Amanda Splan
February 12, 2012
Deborah Ryan

Steps in the Medical Billing Process
Medical billing specialist must follow steps in the medical billing process to complete their duties. These steps are important to follow to ensure accurate, appropriate, timely payment for the patient’s medical services.
The first step in the medical billing process is to pre register patients. In this step of the process the medical billing specialist schedule’s and updates appointments for new and old patients. They ask new patients for basic personnel and insurance information, and both new and old patients are asked for the medical reason for the visit so that they can schedule the appropriate visit for them. This step is to basically get all the personnel and insurance information on the patient and to find their medical reasons for scheduling the visit and making sure that all information is accurate and correct for each patient.
The second step is to establish financial responsibility for the visit. This is an important step and there is a set of questions that need to be answered for all patients. The medical billing specialist must determine what services are covered under the patient’s plan, and what medical condition establishes medical necessity for the services. They also must determine what services are not covered, what the billing rules are of the plan, and what the patient is responsible for paying (Valerius, Bayes, Newby, & Seggern, 2008). By knowing the answers to these questions it will help to correctly bill insurance companies for the services for the patient and to know if the patient will have to pay a fee out-of-pocket for some services. This process helps the billing specialist verify the patient’s health plan and coverage of the health plan. This helps the billing specialist to correctly bill insurance companies and patients for services.
Checking in patients is the third step of the process. In...