The medical billing and coding professionals have the responsibilities of monitoring all the financial charts for the physician’s office, generating the maximum revenue and maintaining the financial stability of the doctor’s practice. Therefore, the medical and billing and coding personnel are essentially the main key for success for a medical practitioner. The medical billing and coding professional have important jobs that they must complete for every individual patient. We have included a brief overview of some of the important tasks that the medical billing and coding professional must complete for every file.
Before the Appointment
The medical billing and coding process begins before the patient see the doctor for the first appointment and then it continues through the final reimbursement of payment from the insurance company or from the patient. Any problems or miscommunications in this process can delay payment for the doctor and can cause problems. Therefore the patient’s insurance benefits will need to be verified as early as possible and well before starting any procedures. Often the patient must be called before so he or she can provide all the necessary insurance information, documents or medical reports. If the patient fails to respond to these requests, the physician should be notified and the office should have a standard operating procedure on how to handle these types of situations.
Appointment Day
The patient should be required to fill out a detailed patient information sheet, which includes all insurance information. The patient should provide their insurance cards so they can be copied and proof of identification such as a driver’s license or other photo ID. The patient must then sign the Assignment of Benefits from and the HIPAA form so that all of the necessary documentation is available to file the claim with the insurance company. The medical biller also has the responsibility of collecting any co-payments from the patient and negotiating any further payment plans with the patient.
After the Appointment
After the appointment the medical billing professional must write down each and every detail of the patient, their reports and so forth. The medical billing and coding expert will then convert the entire medical record into an alphanumeric code according to coding standards.
Documenting this information is an important part of the job. The medical billing and coding staff must enter all of the data correctly so the the proper charges and diagnoses are recorded. It is also necessary sometimes to attach detailed reports along with the insurance claim in order to accommodate easy and quick claim processing.
Patient Billing
Generally, insurance companies are billed first with the residual amount sent to the patient after the insurance has paid and provided an EOB, or explanation of benefits. However, the deductible must be paid first and upfront and only after the deductible limit is satisfied will the insurance company be liable to pay.
