Going by the name, medical billing sounds like a simple enough task that any billing professional can manage easily. However, when you actually look into it, you will learn that there is not one, not two, but as many as ten stages for securing medical reimbursement. This can also mean that not one professional on your payroll can manage all the functions alone. Moreover, you cannot expect them to not upgrade their skills or know everything ongoing within the industry. Compared to that, hiring professional medical billing services in Orlando seems like a more reasonable option.
How the Process Goes
Register a Patient
In the first stage, the patient has to give a record of his information, including his reason for the visit, his full name, date of birth, and location. Insurance information including the insurer’s name and policy number is also collected and verified before moving on. This information further comes in handy whenever the revisits for the same ailment.
Check for Available Coverage
There are a few conditions that medical insurers generally do not cover. They don’t always specify this verbally even though it’s all there in the document. If there is a condition that the patient doesn’t know of, they are told again that this won’t be covered by insurance and that they will have to pay for it from their pocket.
Create a Full Report
This stage authenticates the patient information and validates the insurance card. It also makes a note of the procedures and services that have been already rendered, and how the medical specialist attending them should proceed.
Generate a Medical Claim
After everything is verified, the medical billers generate a medical claim to be sent to the insurance for disbursement. The biller also has to ensure that the claim is generated according to applicable HIPAA compliance guidelines.
Submit the Claim
After cross-checking for accuracy, the claim is submitted for a final screening. This screening authenticates all the entries made to it. This stage is crucial to determine that there is minimal chance of the insurance company ever denying your claim.
Final Review of the Claim
In this stage, the claim is shared with the insurance company for submission. It is the stage when all the bills should get cleared if everything is in order and if no further services not covered by the insurance were required.
Raise the Absolute Invoice
Once the claims are reimbursed, the medical service providers check for remaining outstanding bills. If the patient of availed any service not covered by insurance, they will be asked to pay for them. They will also receive a complete invoice mentioning details of services delivered, payment by insurance, and how much the patient needs to pay now.
Follow-up for Reimbursement
At times, insurance may take a while before clearing the claims. If that happens, medical billers will have to follow-up with them and take the necessary steps to obtain the reimbursement according to the policy.
Good Things to Know
Medical reimbursement can reach you within a couple of days or could take over a month, depending upon different circumstances. These circumstances include the availability of staff as well as their skill-set, accuracy with ICD codes, expertise with raising invoices, and know-how of follow up procedures. The complexity of the procedure can also determine the time you will have to wait for compensation. If you ask for it, your billing services company should be able to give an estimated timeline for the same.
Wouldn’t you want to know more about how professional medical billing services in Orlando can raise your productivity from day one? Then call your area’s leading billing services company and obtain more information about their benefits for your practice today.
Gables Medical Billing has adapted to the ever-changing medical billing environment, modifying and adding to its services to proactively meet the needs of its clients.