The Steps in the Medical Billing Process

Steps in the Medical Billing Process
Katherine Patton
April 20, 2014
Lydia Cavieux

Steps in the Medical Billing Process
Medical billing is an important task that requires accuracy to ensure the payment for medical services. In order to maintain these accuracies, a medical insurance specialist follows a billing cycle. This cycle is made up of ten steps, that when followed lead to timely payments.
The first step in this process is to pre-register the patient. Pre-registration mainly consists of scheduling appointments, or updating them, and collecting the patient information. This information is collected when the patient calls for an appointment. During this phone call the scheduler will obtain the reason for the visit and basic personal information, i.e. name, phone number, and insurance. The second step is determining the financial responsibility. If a patient has insurance then the billing agent will need to determine how much coverage there is. They will need to find out what services are covered and which are not, how much the patient will be responsible for paying and the rules for billing that plan. Some patients will have multiple health care plans, so they will need to find out who is responsible for paying first. If a patient is uninsured, they will be advised of the charges for each service preformed and if the services are extensive, they may be offered a payment plan.
Step three is checking in the patient. When the patient arrives to the appointment more detailed demographics and medical information is collected. If a patient has been to the office before, they are asked to verify that their information is correct. During this step the front and back of the insurance cards are to be photocopied as well as the patient’s identification card, such as a driver’s license. If an insured patient has a co-payment, this is when it will be collected. The fourth step is to review the coding compliance. This step includes verifying that all...