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Medical invoicing4/8/2023 ![]() ![]() Once the claim has been checked for accuracy and compliance, submission is the next step. Once the claim is created, the biller must go over it carefully to confirm that it meets payer and HIPPA compliance standards, including standards for medical coding and format. ![]() The medical biller will then use the superbill to prepare a medical claim to be submitted to the patient's insurance company. It will include provider and clinician information, the patient's demographic information and medical history, information on the procedures and services performed, and the applicable diagnosis and procedure codes. Then, a report called a “superbill” may be compiled from all the information gathered thus far. Once the patient checks out, medical reports from the visit are translated into diagnosis and procedure codes by a medical coder. Identification will be requested, as well as a valid insurance card, and co-payments will be collected. Superbill Creationĭuring check-in, the patient will be asked to complete forms for their file, or if it is a return visit, confirm or update information already on file. If there are procedures or services that will not be covered, the patient is made aware that they will be financially responsible for those costs. This means looking over the patient's insurance details to find out which procedures and services to be rendered during the visit are covered. ![]() The second step in the process is to determine financial responsibility for the visit. This information is used to set up a patient file that will be referred to during the medical billing process. Insurance information is collected, including the name of the insurance provider and the patient's policy number, and verified by medical billers. This is the collection of basic demographic information on a patient, including name, birth date, and the reason for a visit. Patient registration is the first step on any medical billing flow chart. While the process may differ slightly between medical offices, here is a general outline of a medical billing workflow. Depending upon the circumstances, it can take a matter of days to complete, or may stretch over several weeks or months. The medical billing process is a series of steps completed by billing specialists to ensure that medical professionals are reimbursed for their services. ![]()
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