Billing_Procedures

Billing Procedures Paula Rose HCR/220 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 payer must put the “claim” through a series of steps to determine to pay for all or part of the charges and this determines how much a person would owe the facility. The next procedure is “generate patient statement,” they take the amount the payer pays, then takes it off patient bill, and then the remaining amount is mailed out to the patient. The next procedure is “follow-up patient payments and handle collections,” this means the facility tries to collect an overdue bill owed by a patient and sometimes the facility has to get a collection agency involved in recovering the overdue bill. Billing procedures is a necessary process because this lowers the cost of a facility and to request payment from a provider in a timely manner. Every health care facility must follow these procedures with precision and exceptional quality. Reference The first step in medical billing process. (2008). Retrieved from http://www.ezinearticles.com/'the-first-step-in-the-medical-billing-proces&id=1392031