Just Like That !: Medical Billing. MEDICAL BILLING TRAINING MANUALMEDICAL BILLINGAn Introduction. There are more than 5. United States who need to billfor their services. Most healthcare providers employ billing staff in their own office or arepart of a larger organization like a group practice or a hospital that processes their claimsand helps manage their finances.
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Some healthcare providers choose to outsource theirclaim processing and accounts receivable management, and qualified billing services havethe opportunity to provide these services. What is a billing center/ house? Billing center is a centralized office that handles the provider/ hospital’s billing activities.
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- MEDICAL BILLING TRAINING MANUAL MEDICAL BILLING An Introduction There are more than 500,000 healthcare professionals in the United States who need to bill for their services. Most healthcare providers employ billing.
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Itcould be a part of the hospital network or can be an outsourced organization. Billing housesrelieve the burden of maintaining hospital bills and accounts and assist in claims submissionprocess. Billing houses can handle more than one hospital/ provider at a time as they areindependent organization.
How Billing Companies Charge For Services? Two common methods used to charge for billing services are: • Flat fee per claim basis• Percentage of accounts receivables per month. The flat fee method was popular when this service business first came into being.
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Companies would charge from $2. All other charges would be billed separately. Ex: patient bills, EMC fees, andpostage costs.
This method is not widely used today. The number one method used today is the percentage of accounts receivables in a givenmonth. This percentage can range from 5% to as high as 1. It is our opinion that 1.
If you are contemplating going with a company charging this rate besure that there are no additional charges and try to lock that rate in for a few years. Manycompanies will include patient bills, clearing house fees, and postage costs as part of yourpercentage. This is an area where you may be able to negotiate. The one time set up feesrange from $5.
Priorto the first claim being generated your practice needs to be set up on computer. Thisinvolves setting up your providers, places of service, provider ID's, insurance carriers,ICD9/CPT codes, fee schedules, patient base and productivity reporting.
The billing serviceneeds to contact carriers advising them of the billing intermediary status on your behalf aswell as testing and getting you set up with the EMC carriers. Those companies charging thehigher rates may be setting up software for you and or training your staff along with someconsulting services. What is the overall billing process? After the provider renders services to the patient, the billing company will submit bills to theinsurance company/ payer, using the insurance information that was last provided, as wellas information about the reason for the examination, and the exact type of procedureperformed. Medical Billing and Collection Lifecycle.
What does a billing center do with respect to claims process? A billing center's full service approach includes: claim entry, primary and secondary electronic and computer generated hard copy claims, patient primary, co- insurance and deductible billing, the handling of all telephone and written inquires regarding claims and billing issues, payment application and deposits, and insurance and patient follow- up on unpaid claims. It should be able to provide electronic billing for all insurance carriers, including. Medicare, Medicaid, Blue Cross/Blue Shield and NEIC companies and also a vast arrayof medical practice analysis reports, to facilitate better management of your medicalpractice operation. The needs of all medical practices are not the same.
The billing center should customize itsservices to meet the unique needs of each client. Whenever possible, however, proceduresand forms already in place should be utilized. The billing center should be able to adapt itsprotocols. Various Departments in the Billing House: Charge Entry Team. Quality Assurance.
Transmission. Scan. Cash Posting Team. ARCHARGE ENTRY TEAM: They are responsible for registering patient details & the charges in the billing system.
Registration Process: This is a process wherein patient information is collected from the patient at the time ofentry at the hospital. The hospital front office staff has to do the following functions in thisregard: When a patient first requests an appointment, before the formal registration process begins,the practice requests the patient for the name of his or her insurance company. For e. g. if apatient has an insurance plan that requires him or her to seek services only from acontracted physician and the practice does not include a contracted physician from thatplan, but still the patient insists on an appointment, the hospital informs the patient of his orher obligation to pay the physician in full on the day of the appointment. If a patient belongsto a plan, which requires a referral (an authorization from a patient’s PCP), the correctreferral information - the proper paper form or an authorization number is collected.
After fixing up the appointment of when the patient comes into the hospital, the staff givesa registration packet to the patient. This contains the hospital brochure, the financial policyand the registration form. With the hospital brochure, the hospital welcomes the patient,describes in brief about the hospital history and structure, about its doctors, staff, facilitiesetc.
It also gives the scheduled appointment timings of various doctors. The financial policydetails about the payments by patients for treatments not covered by insurance, noncontractedpayers etc. The registration form contains the patient information and theinsurance information.
The patient or an authorized person should sign the registration format two places - one for authorizing the physician to release medical information in order tosubmit a claim and one for assigning benefits to the physician. Ideally this packet would bemailed to the patient immediately after his appointment is fixed so that when the patientarrives on the appointment day, he or she would have completed filling in the registrationform. The hospital must also request the patient to give a copy of his insurance cards. This is verymuch necessary since the card copy contains the insurance plan details and the correctidentification number of the plan and the claims mailing address. A copy in the patient’s fileis also necessary for the fact that at the time the patient leaves the hospital, the card copycan be verified to see if any co- pay needs to be collected from the patient. A copy of the patient’s driver’s license is also necessary. This is required because, patientcan be traced of his whereabouts when he has moved or left no forwarding address.
Pre- authorization: This is a requirement to be adhered to before the patient gets registered for treatment. Alsoknown as pre- certification, this requires notification to the plan of certain planned servicesand all elective inpatient hospitalizations before they are rendered. Depending on the plan,either the patient or the provider must seek pre- authorization for these services. Certainmanaged care plans require the patients to go through a contracted physician participatingin their network. If the patient gets treated through a physician not part of the network thenthe managed care plan require the physician to call the plan and notify them of thetreatment before hand. Only after their approval can the treatment proceed.
If thetreatment is done without the approval, then the managed care plan will not reimburse thephysician for their services nor can the physician bill the patient. This approval is called preauthorizationand a copy of this should be made available in the patient’s file before thetreatment is rendered. Another requirement is to obtain a second opinion from an impartialphysician regarding medical necessity of the procedure to be performed.
A service is deemed medically necessary when- It is appropriate for the diagnosis being reported. It is provided in the appropriate location. It is not provided for the patient’s or his/ her family’s convenience. It is not custodial care. Custodial care is care that can be provided by people whoare not trained medical professionals.)Once the authorization has been granted, an authorization number would be given. Thisnumber should be reported on the claim for the service. Demographic Entry requires the following information: 1.
Patient Details – Last name, First name, Middle Initial. Patient’s Sex & DOB – DOB should be in the format MM/DD/YYYY. Patient’s SSN# - Social Security Number is always 9 digit numeric. The Social. Security Administration of the United States of America allots this number to all. American Citizens. Patient’s Address. Guarantor’s Details.
Employer Details. Insurance Details – Name, ID#, Group#, Address, Subscriber Details. Charge Entry Process: When the initial procedure of registration of patients is completed, the treatment is carriedout. During this activity, the physician has to fill in the charge sheet or the super- billshowing details of the treatment rendered. This form shows the patient name, date ofservice, time of service, doctor performing the service, procedure description and diagnosisdescription.
The attending doctor should sign this form. A sample charge sheet/ super- bill isattached. Based on the procedure & diagnosis descriptions, the CPT/ HCPCS codes and the. ICD- 9 codes would be filled in.
This is an internal form and would be used in filling up theclaim to be sent to the carrier. This should not be used as a medical record to be attachedalong with the claim. Frequently there may be situations where there is more than one diagnosis to be fixed for aparticular procedure.
In such cases it should be made clear on the charge sheet or superbill. Coding of procedures & diagnosis: This is a process whereby the procedures and diagnosis given in the charge sheet arecoded. As discussed earlier the most common coding systems used for procedures anddiagnosis is CPT- 4 and ICD- 9 respectively.